Prostate check before or during BPH surgery?

Posted by fiddlinchuck @fiddlinchuck, Apr 27 2:34pm

I have been treated with meds for BPH since 2020. I have had multiple meds over the years and am currently on Doxazosin (10 mg), Finasteride (5 Mg), and am now on a trial of Gemtesa (75mg). Last winter, my urologist declared that meds were not doing any thing for me and that I should consider surgery. He performs bipolarTURP surgery. He used to offer green light surgery but has transitioned to bipolarTURP. He asked that I make an appointment for March of this year, when we would discuss surgery, which I did. In preparation for the March appointment, I researched bipolarTURP, learning that it is a surgery to reduce the mass of the prostate and therefore alleviate BPH symptoms. It is an improved version of TURP. It then clicked in my brain that the last time my prostate size was checked was digitally in 2020 by the urologist that preceded my current urologist in the practice and who has since retired. The size was depicted as something like “normal” or “medium”. I began to wonder if I was being treated for a condition I did not have and if there is something else going on, e.g., overactive bladder or excessive urine production during the night. At the appointment, I indicated to my urologist that it was over 5 years ago that my prostate was last checked and another data point seemed warranted before agreeing to surgery. I suggested possibly an ultrasound scan for an accurate quantitive size measurement. He assured me that such a procedure would not be needed because, as he said, the first thing he does during surgery is to use his camera to obtain an accurate measurement. He did not offer to do a digital check. Call me crazy, but a size measurement seems like something that should be done pre-surgery to help assess whether surgery is warranted. I was left with the sense that he does not like to do digital size checks, being that he has never suggested it in the years I have been seeing him and that he now prefers to wait until surgery has begun so he can use his camera to do the job. While the digital check is not something I look forward to, I’d rather have it now and know my current prostate size than after surgery is over. Additionally, there are many surgery prostate options available, each with their own pros and cons, but I would be locked into bipolarTURP with him because that is what he does. I am considering going to a different urologist for a second opinion, but there is a scarcity of urologists in my area. I have an appointment coming up on May 12 to resume surgery discussions and am not sure what to say to him, other than that am not comfortable with going ahead with surgery at this time. Anybody have a similar experience or have any suggestions? Thanks in advance.

Interested in more discussions like this? Go to the Men's Health Support Group.

Profile picture for divemaster @divemaster

I've had turp surgery 3 years ago and almost no side effects and I'm urinating like I'm 18 again.
Get a second opinion
I switched to MD Anderson Jacksonville and I see Dr. Stieglitz
Best decision I ever made

Jump to this post

@divemaster

Thank you!

REPLY

I have had BPH for decades. At first, it was managed by medications, but my urologist eventually recommended a TURP. That was back in 2005, and I don't know if it was monopolar or bipolar.
My TURP worked well for almost 10 years, but in 2025 I needed another procedure.
My urologist gave me a choice between green light laser ablation, and a Uro-Lift. After some lengthy discussion, I opted for the Uro-Lift. That was about a year ago, and so far I am very happy with the results.
No pain, and very little blood. Recuperation was quick and with no discomfort.
I recommend the Uro-Lift.

REPLY
Profile picture for neilb @neilb

I have had BPH for decades. At first, it was managed by medications, but my urologist eventually recommended a TURP. That was back in 2005, and I don't know if it was monopolar or bipolar.
My TURP worked well for almost 10 years, but in 2025 I needed another procedure.
My urologist gave me a choice between green light laser ablation, and a Uro-Lift. After some lengthy discussion, I opted for the Uro-Lift. That was about a year ago, and so far I am very happy with the results.
No pain, and very little blood. Recuperation was quick and with no discomfort.
I recommend the Uro-Lift.

Jump to this post

Just like me, quick recovery and NO sexual side effects!

REPLY
Profile picture for olderandwiser @olderandwiser

I would suggest a second opinion.
Before I had my UroLift procedure done three years ago, they first needed to see if I did in fact have BPH. They did a Cystoscopy first and then a rectal ultrasound to determine the exact size of my prostate.
A few weeks later I had the UroLift done and it has worked wonders.

Jump to this post

@olderandwiser

Good to know. I had a cystoscopy 3 weeks ago (fun, huh🙄) and my prostrate is .50. Having Urolift done in 3 weeks.
I'm 69 so I'm hoping the benefits will last for 5 years or so.
You still doing good with it?

REPLY
Profile picture for leaddogy2k @leaddogy2k

@olderandwiser

Good to know. I had a cystoscopy 3 weeks ago (fun, huh🙄) and my prostrate is .50. Having Urolift done in 3 weeks.
I'm 69 so I'm hoping the benefits will last for 5 years or so.
You still doing good with it?

Jump to this post

So far, GREAT!
I'm still peeing like a teenager!

REPLY
Please sign in or register to post a reply.