Benign prostatic hyperplasia (BPH) Surgery Options

I am 60, I developed BPH in my early 40s. I had the Green light laser treatment in 2012. It worked well, but I now have bleeding issue. I need help. I take Tamsulosin .4 mg and Finasteride 5 mg nightly. The local Urologist wants to do TURP. I'm 60, I plan to live into my 80s (Lord willing) and have had BPH for 15+ years already and need a truly lasting solution.

I’m in my mid 70s and also successfully had Green light laser treatment for BPH in 2018. Two men I know have had robotic surgery and whilst expensive have not regretted it. Wish I could add more as I feel for your situation. Good luck with your search into the help you are after.

Hello @tlosborne and welcome to Mayo Clinic Connect. Thank you for joining this discussion to share your experience with the green light laser treatment. Is your doctor concerned about your bleeding issue? Can you share more?

Yes, my doctor is concerned about the bleeding and scheduled me for an MRI the next day to see if the bleeding might be due to kidney stones. The results were negative, no kidney stones. After 16 years dealing with BPH and the long term side effects, i.e. continuing to take drugs and the wall of my bladder thickening and now bleeding issues, I'm looking for a more permanent solution.

I have an appointment with the urology department at the University of Iowa on June 9th. They do the Rezum treatment which sounds promising but aside from removal of the prostate in part or whole I really don't see much hope (apart from a miracle from the Lord) for a lasting solution.

Thank you for the well wishes.

I am a standard issue 75-year-old man with self-diagnosed BPH. I get up in the night every 1-2 hours to urinate. I have considered take one of the processes that lessen the restriction of the urethra to relieve my symptoms. In addition to the good feeling that a full night’s sleep provides, my main concern is that disruption of sleep can advance Alzheimer’s Disease. There are many articles in the popular press as well as professional journals that provide me with the motivation to act. That insurance will cover of the procedure lessens any hesitancy. Today the Rezum process seems to be the most preferable to others. Have any readers tried it? Have you found success with other procedures? Both pros and cons would be helpful to any decision I would make.
I am taking the doctor’s recommendations on the way to a permanent action. So far, he has diagnosed an Overactive Bladder and prescribed Myrbetriq (mirabegron). I have taken it for about a month and it has reduced my urgency to urinate, which is welcome, but it has had no effect on my sleep interruptions, my main concern. I fully expect his next recommendations will be the non-medical steps of Sleep Hygiene (exercise, no caffeine after 4 pm, avoid alcohol, etc.) before offering a referral to a urologist. Any of your histories and recommendations would be welcome.

Hi, you are describing exactly my symptoms almost to a tee. After much research I decided to go with the Green Light Laser surgery in 2018 at 72 and have not regretted it other than coming down with a serious sepsis infection within 24 hours that got quite serious. I believe the cause may been due to the difficulty of removing the catheter. It just kept filling making removal difficult. Never had an issue like that before and very rare apparently. I now sleep right through the night and when I urinate I am able to empty my bladder fully and easily. No more sitting on a toilet for 10 or so minutes dribbling. This is just my experience of course but certainly happy I went the way I did with absolutely no regrets. Good luck with your decision whatever you decide.

Thanks, Jeff

@rfherald There may be newer options or alternatives that are available where you are too but I wanted as minimally invasive procedure as possible. Intimacy did suffer, but I had been having issues that way for several years previously and don’t think it was due to the surgery. So I just have to put up with hugs and passionate kisses now 😉😁.