So, I have a question that perhaps someone here can answer... Other than a few procedures like Urolift, PAE, HIFU and FLA (there may be others) why do procedures (like TURP, REZUM, Button TURP...) cause RE and can they be performed to reduce BPH symptoms but also avoid RE? I’m referring to procedures like TURP which somehow cause RE. Can’t these procedures be performed so as not to damage the bladder neck and avoid RE or is that not the issue?
I have a note from a post on HOLEP regarding Dr. Nicole Miller. Someone who had the procedure done by her posted that she tries to minimize the chance of incontinence. I'm not sure if this would apply to RE. Here's the text of my note: "post says that she leaves a little bit of prostate tissue around the urethral sphincter which she said would help prevent incontinence issues."
Obviously I can't vouch for the veracity of this post. I wrote the note in case I consider BPH surgery since she would be one of the doctor's I would speak with.
I should add that Dr. Miller is at Vanderbilt University.
Rdemyan
Good evening.
It would also depend on if they stay away from the Ejaculatory Ducts and it also would depend on how much of the tissue she get rid of by the bladder neck because that is were you seminal channel is. If they get rid of that you may as well forget it.
Have a good day..Ken
That is an interesting theory. If she really does that in an effort to preserve continence then she has my respect.
In a conversation with a uro, he told me the bladder neck is unable to close after a turp. He did not explain why.
I do not know anatomy well enough to comment intelligently on the subject but it would seem somewhat logical that if they would stay away (or stop short) from the bladder neck, perhaps there would be less chance of incontinence and RE.
You would think they would have tried this and perhaps it didnt help or perhaps it is just impossible/unavoidable to do some of these procedures without doing damage to the neck.
I had holep about 6 weeks ago.....no RE.
I had a button turp about a year ago and I'm very pleased that I don't have RE. I met with five different urologists until I found one who was willing to perform the procedure, which included staying away from my ejaculatory ducts and being very cautious around the bladder neck.
The average length of time to have a turp procedure done is usually one and a half hours. But because my urologist was so patient and cautious, and wanted to make sure that I was happy with the results, my procedure took three hours. I found that most urologists are unwilling to spend that length of time for a turp procedure. The key is to find a urologist who is patient, meticulous and willing to take whatever time that's needed to prevent RE.
i had turp and dont have RE so it can be done.
Hey Buddy
That is because when they do the Turp they start from the bladder neck and shave it down going all the way around to make the tunnel.
With Holep it all depends on how the doctor does it. Some only take half the tissue and stay away the the ejaculatory duct. Others will core out the prostate and leave shell. With the shell you will have retro. And with a button Turp they have more control of the button and what they take out. And stay away from the duct and the bladder neck.
Remember you need a good doctor that cares enough to take there time and not rush like what Bob's doctor did
Have a good night or morning.Ken
Bob and I7016 did...Sorry
In this discussion, keep in mind that BPH with median lobe growth seems to be a special category, as there may not be a great increase in the overall size of the prostate, but the median lobe will grow to protrude into the bladder. When there is protrusion into the bladder, reducing or elimination the obstruction without damaging the bladder mouth function requires special care.From all that I've read, the FLA procedure done by an experienced doctor gives the best chance of a good outcome.
I had median lobe growth and, unfortunately, was directed to a urologist whose prognosis scared me into having TURP. The result was a complete disaster in all respects. First, he damaged the external sphincter causing high level and permanent incontinence.I was fortunate to find specialist who implanted an AUS, which works well to control the incontinence. I just have to accept the ED and retro that came with the six procedures I had over a two year period, and also accept that the AUS could require revision surgery in the future.
This is Great information for men everyone!
So it appears a TURP (or Button TURP) can be performed and not cause RE if you have a urologist who is skilled and willing to take the needed time during the procedure.
I had read that FLP generally does not cause RE. Unfortunately, that procedure is not covered under insurance so it’s about $21,000 out of pocket. I I also understand that Urolift can be performed without causing RE. I was recently told that Urolift is now being covered under some insurance plans so that is also good news.
Can tell us what you experienced in the days and weeks following your button TURP? If you had a Foley catheter in how long was it in? What about post op pain and bleeding? What about sleep issues, etc? Thanks for any info....
Tom
Hey Glenn
I am sorry for what you were rushed into and the side effect you have to deal with. Right now there are other option over the last few years that have com up.
We have had some doctors on here that are doing a mini Turp with a laser. With this they just address the median lobe and do not touch the rest of the prostate and or the bladder neck. The men that had it done had no side effects and no retro.
We also have the new procedure from the Urolift company called the Midlift. This is where they pin the median lobe to the one side out of the way. This was just approved last May and there are doctors trained in it around the country. I have gotten the addresses for some of the men from the company. More doctor are going to be trained. My doctor has already done a few with good results.
You just have to research the procedure because there is always something else less evasive out there that can work.
Do your research and don't let a doctor scare you into any procedure luck Glenn was.
Take care....Ken
Tom,
After the procedure, when I woke up my urologist had placed a foley catheter in me. He suggested that I keep it in for at least 4 days. To be on the safe side, I chose to keep it in for 7 days.
Here's the weekly breakdown after the catheter was removed: Week one, every 2 to 3 hours I had to go urinate. Week two, every 3 to 4 hours I had to go urinate. Week three, every 4 to 5 hours I had to go urinate. Week four, every 5 to 6 hours I had to go urinate. Week five, I was back to my normal routine, able to sleep 7 to 8 hours before I needed to go urinate.
There was a little bleeding the first 2 weeks. No big deal at all. As far has pain, my doctor prescribed some pain medication, but I never had to use it because I was never in any pain. The most challenging part for me was constantly going to the bathroom the first few weeks which prohibited me from getting a good nights sleep.
Hope that provides you with more insite on my button turp experience. Needless to say, I'm very pleased with the outcome.
Same with me.
Thank you for your detailed reply. "The most challenging part for me was constantly going to the bathroom the first few weeks which prohibited me from getting a good nights sleep.". That's what I am going through now - up every hour to hour and a half all night, so I never get a good night's sleep. I had a PAE about a year and a half ago, but now I am back to where I was before that treatment - a bit worse actually. I have been exploring the various procedures and a big part of my decision is the post op side effects.
Thank you,
Tom
Is there another name for the "mini Turp with laser" procedure? I tried googling that without getting a clear result... Thanks...
Hey Steve
I'm going to have to look for it again and see who was the guy that had it done. That was the way his doctor did the surgery. She called it a mini Turp. She only removed the median lobe and I also read one that only got rid of the prostate on the other side of the seminal vessels
Both did well and no retro. I will let you know...Ken