Surgery advice for enlarged prostate (BPH)

I realize this string is a year+ old, but maybe someone has a perspective: my large prostate (114 cc) is limiting my treatment choices. Could I have Holep or Aquablation or another treatment to REDUCE my prostate size in order to expand my PCa treatment options? Right now, what I'm being told is RP or hormones/ADT for several months and then, possibly, radiation. Neither of those is attractive. I'm 80, in good health otherwise, TC1, 4+3, localized PCa, no metastases showed on recent PSMA-PET. Anybody have similar issues and dealt with the PCa in 2 steps?

@tdgillett Yes, you can. Ask your doctor about this and PLEASE get a second opinion!
Phil

@tdgillett
Check out PAE. I just had one to shrink mine and it’s a piece of cake and equally as effective or better than other procedures.

@dribbles
I had mine at Mayo, a lot of centers don’t have interventional radiologist to do it so they don’t recommend it. Look for someone that can do it. My options for radiation improved, and also took care of some urinary issues I was having which they recommend to do before you have radiation.

I had BPH surgery three weeks ago and I still have minor bleeding. Is this normal? I am an active guy and this is torture that I can't do anything but sit around and a few small chores. When will the bleeding end. Even then will I be able to get back to my normal activity level?

@stephenwalter
Ray Detor here. I recently had aquablation for BPH and cancer.
You did not say, unless I missed it what type procedure you had.
Your urologist should have informed you of expectations?
For me, Dribbles. Trace of pink slough, 2 weeks post treatment.
I am told you can expect light bleeding on and off for several months.

@stephenwalter
You need to speak to your urologist. He may have an answer, May want to do a cystoscopy to see what’s going on. I had one and it was really painless and simple to do.

You can wear a pad in your underwear So you can Have a normal life. Those of us that have had incontinence live with that. At least you aren’t incontinent.

The Tena pads Sold on Amazon work real well, Very absorbent.

@tdgillett my hubby had RASP, robot assisted simple prostatectomy, done in March. He had a gigantic prostate. The doctor basically cored out the prostate, no nerves, or huge amount of ureter cut. He has had no problems, at all. Almost no leakage after surgery, no ED or incontinence. He does have PCa, so he will have radiation in a few months. We feel so lucky to have found a surgeon who could perform the RASP. Because his prostate was so huge, a regular prostatectomy would have not spared the nerves. The amount of ureter that would have been cut, would have left him with lifelong incontinence.
Read up on RASP, and see if it would be an option for yourself. Good luck.

@lizziew Thanks for your note. At my age (80) I'm trying to avoid surgery, but RASP sounds like it may be a possibility that could work. Sending good luck wishes back at you both.

@tdgillett surgery, being laparoscopic, was an outpatient procedure. Hubby went home same night.
BTW, hubby is 73 when he had his surgery this past March.
This is info on RASP.
Robot-Assisted Simple Prostatectomy (RASP) is a minimally invasive surgical procedure used to treat severe urinary blockage caused by a very large prostate. It involves removing only the inner, blocking tissue of the prostate while leaving the outer capsule intact, and is distinct from a radical prostatectomy performed for cancer. Users on the Mayo Clinic Connect Discussion generally agree that RASP provides a durable, highly effective solution when non-invasive treatments or smaller procedures are insufficient for large prostates.

I will offer prayers for a good outcome no matter your choice.
Take care,
Lizzie