Of all possible outcomes arising from a Prostate procedure, incontinence scares me the most. I do not care if I ever have an erection again (66 year old). Despite lifelong intermittent flareups, my condition seems less serious than those here on the forum. Other than continual, but mild epididymitis, hesitancy is my main problem...now being managed well by double-dose Tamsulosin. Someday though I may need one form or another of procedure.
Question is, from you who have experienced a prostate procedure, are there opinions on the procedure least likely to cause permanent incontinence? Thanks.
When i finished my research I picked PAE.. I was taking 2 flomax a day ... I had PAE over two years ago and I am still off flomax which is great.
I am 69 years old. I did a greenlight laser treatment around 15 years ago. It worked for around 2 years, but I still had to take medication to get the flow at a decent level. My next treatment was a turp. It was better, but not that much, as I recall. The prostate, grew back as it did with the greenlight therapy and so I did a second turp. By then, my bladder, must have stretched out so much that after the second turp, I coudn't urinate on my own. So presently, I am doing cic. It's the best thing I've done for my condition. If I could go back to 15 years ago, I would first try the cic. My bladder, feels really empty after doing cic. It's the best feeling over the laser greenlight and turp! If I were you, try cic first. Less damage to your prostate. Good luck!
I had a UROLIFT 3 years. Never had a problem. All the others have a degree of incontinence and other side effects. If you can get off that pill and get something else. Don't let the problem get to you and cause you other problems Ken
Following 8 years of hesitancy, retention, infections, nocturia and bladder stone formation, all due to BPH, I opted for the HoLEP procedure.
In and out of hospital on the same day without a catheter and within a week the incontinence (the occasional dribble if that) had cleared up. I did make sure that I carried out frequent pelvic floor exercises in the month prior to the procedure which must have greatly helped in ensuring no post op incontinence.
Two and a half years later, I'm still peeing like a teenager. Erections are still available should I want them but retrograde ejaculations which doesn't worry me in the slightest.
Good luck with whatever route you choose to go down.
My flow diminished in my mid 40’ and over the years it became all more complicated. Relieving was taking more and more time, although you get used to it to work around the problem. An acute urinary retention brought me to the urologist. Recommendations went from Turp, Urolift, Rezum, Láser treatment. During my research I consulted with several professionals and one in particularly convinced me and I had the treatment done the end of October 2017. On the way to recovery I have experienced several stages. All in all, I am very happy with the outcome. Relieving works very well, I can sleep 3 to 4 hours without getting up, I have control and sex life is good too. I am glad I did it and really pleased that I am much better off from any angle I look at. Every person is different and responds differently. Have an open conversation with the urologist you trust and feel comfortable with. In my opinion if the patient and the doctor can connect with each other, the outcome of the procedure is more promising. I also would want to be assured that the doctor always goes with the least invasive option to start with.
Hi all, it really depends on whats causing your specific problem, but generally speaking my research says definitely FLA as it does not cut away anything important and saves all the important bits and without those nasty side affects.
I have herd horror stories on every type of operation accept FLA, I know of one guy who had incontinence before FLA and now its gone and life is great again, I spoke to a leading urologist who said incontinence from TURP usually happens on the second operation so my reasoning is avoid the first operation by having FLA and without the side affects, I used Dr Karamanian in Houston who is very good.
FLA and Dr Karamanian is an excellent option. I consulted with him too and was very close to have myself treated with him. For some reason I went with another professional who recommended a GL / PVP treatment done. I was warned of potential side effects. None of them happened to me. I have been lucky! As Dr. K said, any surgery has it's risks.
I'm reading good reports of the "Cooled ThermoTherapy" ...apparently a cooled microwave tip with few side effects. There is a doctor 65 miles away who offers the procedure.
Ed Just read up on this procedure. There are a lot of side effects that can happy. Make sure you get all the information you can. Good Luck Ken
Its important to note than incontinence is rare with any of these procedures and this forum (or others like it) are not representative of the outcomes of any procedure as the success stories, that far outnumber the problems are almost never posted here. Most come to look for answers after problems, or for info prior to a procedure.
That said, TURP, Holep and Greenlight all can cause incontinence. Rezum, Urolift, PAE and Focal Laser ablation have almost no reported cases of it, even when the procedure failed to bring relief.
It sounds as though you don't need anything right now and may never. If you even start experiencing retention, make sure that you deal with it - either by self cathing or via some kind of procedure. Straining to pee and bladder stretching can cause incontinence or render you unable to void without a catheter (self or indwelling) so if that problem develops, don't delay in doing something about it.
Are you happy about taking a double dose of Tamsulosin with all of its side effects?
I had fla and had no side effects but only helped the meds work better. As before fla i was taking flomax and finasteride and where starting not work. I will be having another fla this Wednesday in hopes of a better out come. At this time the only meds i take are 8mg flomax.
jim
Hi everyone
Had Urolift 8 months ago. So far so good No incontinence. A little tiny leakage and urgency early on but that went away. Good intense ejac- no retrograde. No meds. Never was on them. Had bleeding from bladder stones. Stone removal and Urolift for better flow and emptying hopefully will prevent reformation of them. Will find out soon at recall checkup. All the best. Tom
That is good to hear Tom I had mine done 3 years ago. No problem at all. And no med after the procedure. On a pill now because my external Sphincter muscle is to tight. Trying to losing it up. Have a good day Ken. PS If I have to have more clip put on the prostate I would do it in a minute.
So far no effects whatsoever. The single, .4mg dose began losing effectiveness. The double dose gave me back a good stream.
I am in Australia where it seems we are a decade behind other countries using this site. Others seem to have a magnitude of options while we seem to be stuck on mostly medical responses with a few TURPS thrown in. This site indicates a general move away from these treatments. I was prescribed Alpha1s Flomaxtra(Tamsulosin)/Prazosin 4mg a day from 2006 to 2015 for moderate BPH. Though Urologists had known since 1995 these drugs would need increased dosage beyond 2 years no research had been done by 2013. There was no Pharmaceutical Company billion dollar benfit. So when Alpha1s became less effective I was prescribed Duodart(Dutasteride+Tamsulosin) + Prazosin March 2013 to March 2014. This took my Alpha1 intake to 8mg a day contrary to Duodart’s warnings.
Dutasteride trials indicated a possible increased risk of life threatening PCa. The supplier put this down to a fault in the study design but instead of redoing with proper input the drug was released. They are not required to report PCa as a “side effect2 and Urologists do not mention this risk to BPH sufferers they prescribe the drug to. Since release the Australian supplier of Duodart has reported 6 suspect PCas to our TGA’s Database of Adverse Events. For some reason they are not required to include Gleasons but as database advice is only required or “serious” events we must assume these would be high. Our Health Department says if we want to learn the “side effect” risk we should read the 26 page complicated scientific “Product Information” on the internet. Our Commonwealth Ombudsman says adverse effects detected post-release do not have to be considered a “side effect”,
I was diagnosed with Gleason 3+4 PCa and the gland was removed November 2015. Though pre-surgery advice included the possibility of some incontinence for a couple of months serious incontinence is now over 26 months on with no prospects. They don’t know the full functions of the prostate or the parts you loose with it. The 5ARIs play around with testosterone to unnaturally manipulate prostate cells. I now have other new conditions on top of the incontinence. Kidney stones, Polymyalgia rheumatic, joint and muscle problems ,highly increased inflammation markers and low testosterone. There is also the loss of masculinity and whatever else hormone changes will produce.
5ARIs seem to becoming a much lesser treatment for BPH in other countries but is used here to reduce government costs irrespective of the personal cost to patients. I was 72 when diagnosed and like you most of the possible side effects were of lesser concern than or others on this site. I now know I failed to take proper precautions and took advice I should not have. Do a lot of personal research especially if prescribed 5ARIs.
Have you tried one a day Cialis?
I was on one a day 4mg of flomax for years.. after 8 or so years had to go to two a day. The side effects after long term use were loss of feeling in the penis, no ejaculations and other minor issues. I had the PAE procedure done Oct. 2015. I reduced the flomax to one pill a day right after and then eliminated flomax all together after about 5 weeks. It took about a year to start getting feeling in my penis and started to have some ejaculations. After two years I now have good feeling in my penis and pretty good ejaculations. I will probably have the PAE done again in two years or so. They are more aggressive now than they were then. The self pay now at the University of North Carolina now is 10,500 dollars. When I had mine it was 6500. Medicare will cover this procedure now, but most private insurance will not.
Had an MRI in Nov. which indicated an area of concern and had a fusion biopsy Dec. 26. All sixteen cores were negative.