Prostate and Bladder Issues: What to do?

Posted by ch665296f @ch665296f, Apr 19, 2016

I am a 68, nearly 69, year old man that has had bladder issues for years. I had green light prostate surgery 8 yrs. ago which helped for a while. Now, my prostate has had some regrowth and I have developed several bladder diverticulum. I have had just about every bladder test possible. I also have some incontinence issues, and manage by wearing diapers when necessary. I'm ok with that. My urologist had me on a combination of tamsulosin and finastride, but have not realized much of a difference. I'm a bit afraid of some of those drugs because I have read that they could mask the development of a more serious prostate cancer.

My urologist suggests that I may be a candidate for surgery, but what kind? Turp or total removal of the prostate? I have also read that turp sometimes needs to be repeated. Don't want that to happen either. What to do?

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@kayak461

Hello ch665296f….I am in a similar situation, I’ll be 70 in two months, I have been told by 3 Urologists that I must have my prostate removed. I am going to see the Mayo Clinic Urology Department on Friday…and will let you know what the results are. I will no doubt choose a direction in 48 hours. I’ll come back to this group to let everyone know what it looks like for me! This is a great group of guys in the loop….glad to see you her too!

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Have you had biopsy? Did you get a Gleason score or group number?

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@rfherald

Have you had biopsy? Did you get a Gleason score or group number?

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No sir….I have not had a biopsy and do not have a Gleason score. A lobe of my enlarged prostate is growing up into my bladder. For that reason alone, Urologists I have been to in the past three months are saying I must have the prostate removed. Perhaps after my appointment tomorrow at the Mayo Clinic I will have additional information and possibly a different plan…..we’ll see!

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One thing about catheterization. I chose to self-Catherine for about six weeks between my crisis and my Holep procedure, rather than be on a bag. The equipment was very easy to use and self lubricate. I found it not a bad thing at all. I actually considered perhaps just doing that for the rest of my life rather than having the procedure. But I was advised that while I find it easy to do now at 70, it might become a big problem when I get older. And someone would have to do it for me. So I had the HoLEP and I’m very happy that I did as it went fine. But for me at least, self catheterization was not a problem at all.

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@kayak461

No sir….I have not had a biopsy and do not have a Gleason score. A lobe of my enlarged prostate is growing up into my bladder. For that reason alone, Urologists I have been to in the past three months are saying I must have the prostate removed. Perhaps after my appointment tomorrow at the Mayo Clinic I will have additional information and possibly a different plan…..we’ll see!

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What did you learn at your appointment @kayak461 (if you don’t mind sharing)?

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I wanted to get back to the group with an update on my progress to date, I think I’ll begin with just a short refresher on how I got to this point. I’ve had BPH for many years and have been under the care a VA Urologist, and have been taking Finasteride and Tamsulosin to help control the BPH. 5 months ago I decided on a second opinion, and during my 1st appointment with that Urologist a Retention Test was performed and the Urologist quickly recommended a Cystoscopy. I went for the Cystoscopy and it was determined that my prostate was very large and the median lobe was growing up and into the bottom of my Bladder. The Urologist immediately told me that the prostate must be removed. I had 2 previous Colon surgeries and bilateral hernia surgery, all laparoscopically achieved. In light of the laparoscopic surgeries, the Urologist told me that I wasn’t a candidate for the Robotic process, and told me I would have to go outside the VA for surgery and to do my own homework on what’s available. An MRI on the prostate was performed to learn it’s size and look for abnormalities. That was a bit of a shocker, but we began to research the various procedures that are out there. We opted for a second opinion. We went to see a different Urologist, his recommendation was to do the Rezume Procedure and I left his office with a survey date. As we continued additional research We decided to see a 3rd Urologist. This Urologist looked at my records and images and said….there is only one operation for you and that’s HOLEP. He said he could do all the other procedures, except for HOLEP! He said there are only 2 doctors in Florida that that he would recommend for the HOLEP procedure and he recommended a doctor at the Mayo Clinic in Jacksonville. Coincidentally….this was the same Doctor I had the appointment with this past Friday. Having a Urologist tell me to go where I already had an appointment scheduled was satisfying.
This brings me to my visit to the Mayo Clinic this past Friday. I thought the campus was great, everyone I came into contact with was very helpful, professional, and on time. I met the Triage Nurse first for vitals, and then with the Doctor’s assistant as the Doctor had been called to an emergency. So we discussed our visit and reason for being there, my history, and status with the assistant while the Doctor was addressing the emergency. But after awhile, the Doctor arrived in our location and we discussed my condition. He reviewed images and the MRI results, and HOLEP was the procedure he recommended. The risks of long term effects with this procedure seemed to be at a minimum. The only long term side affect that I expect to live with is retrograde ejaculation, everything else should be normal. He took the time to explain everything, what to expect before, during, and following the procedure. He has performed roughly 1100 HOLEP procedures, at this point it is done as an outpatient procedure. There are things to do the day before, the day of, and the day following the procedure to make sure everything is on track, and because I live 150 miles from this Mayo Hospital, I’ll stay in a hotel on campus for 2 or 3 nights. The night in the hotel following the surgery is only like $25 and the hotel has a nurse available 24 hours a day. So we will opt to go up the night before the scheduled surgery, and stay two nights after….this will insure that if anything does go wrong, I am close by for medical help. The hotel will be contacting me soon to schedule. So…the decision We wrestled with for several months has been made, I’m scheduled for HOLEP on May 3rd, and expect to be fully recovered by May 28th! I’ll let this group know how it all goes!

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@kayak461

I wanted to get back to the group with an update on my progress to date, I think I’ll begin with just a short refresher on how I got to this point. I’ve had BPH for many years and have been under the care a VA Urologist, and have been taking Finasteride and Tamsulosin to help control the BPH. 5 months ago I decided on a second opinion, and during my 1st appointment with that Urologist a Retention Test was performed and the Urologist quickly recommended a Cystoscopy. I went for the Cystoscopy and it was determined that my prostate was very large and the median lobe was growing up and into the bottom of my Bladder. The Urologist immediately told me that the prostate must be removed. I had 2 previous Colon surgeries and bilateral hernia surgery, all laparoscopically achieved. In light of the laparoscopic surgeries, the Urologist told me that I wasn’t a candidate for the Robotic process, and told me I would have to go outside the VA for surgery and to do my own homework on what’s available. An MRI on the prostate was performed to learn it’s size and look for abnormalities. That was a bit of a shocker, but we began to research the various procedures that are out there. We opted for a second opinion. We went to see a different Urologist, his recommendation was to do the Rezume Procedure and I left his office with a survey date. As we continued additional research We decided to see a 3rd Urologist. This Urologist looked at my records and images and said….there is only one operation for you and that’s HOLEP. He said he could do all the other procedures, except for HOLEP! He said there are only 2 doctors in Florida that that he would recommend for the HOLEP procedure and he recommended a doctor at the Mayo Clinic in Jacksonville. Coincidentally….this was the same Doctor I had the appointment with this past Friday. Having a Urologist tell me to go where I already had an appointment scheduled was satisfying.
This brings me to my visit to the Mayo Clinic this past Friday. I thought the campus was great, everyone I came into contact with was very helpful, professional, and on time. I met the Triage Nurse first for vitals, and then with the Doctor’s assistant as the Doctor had been called to an emergency. So we discussed our visit and reason for being there, my history, and status with the assistant while the Doctor was addressing the emergency. But after awhile, the Doctor arrived in our location and we discussed my condition. He reviewed images and the MRI results, and HOLEP was the procedure he recommended. The risks of long term effects with this procedure seemed to be at a minimum. The only long term side affect that I expect to live with is retrograde ejaculation, everything else should be normal. He took the time to explain everything, what to expect before, during, and following the procedure. He has performed roughly 1100 HOLEP procedures, at this point it is done as an outpatient procedure. There are things to do the day before, the day of, and the day following the procedure to make sure everything is on track, and because I live 150 miles from this Mayo Hospital, I’ll stay in a hotel on campus for 2 or 3 nights. The night in the hotel following the surgery is only like $25 and the hotel has a nurse available 24 hours a day. So we will opt to go up the night before the scheduled surgery, and stay two nights after….this will insure that if anything does go wrong, I am close by for medical help. The hotel will be contacting me soon to schedule. So…the decision We wrestled with for several months has been made, I’m scheduled for HOLEP on May 3rd, and expect to be fully recovered by May 28th! I’ll let this group know how it all goes!

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I hope so too. This is where the value of Mayo Clinic Connect comes in - Men sharing their experience with each other. It's important. I learn more here than I do from my urologist.

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@kayak461

I wanted to get back to the group with an update on my progress to date, I think I’ll begin with just a short refresher on how I got to this point. I’ve had BPH for many years and have been under the care a VA Urologist, and have been taking Finasteride and Tamsulosin to help control the BPH. 5 months ago I decided on a second opinion, and during my 1st appointment with that Urologist a Retention Test was performed and the Urologist quickly recommended a Cystoscopy. I went for the Cystoscopy and it was determined that my prostate was very large and the median lobe was growing up and into the bottom of my Bladder. The Urologist immediately told me that the prostate must be removed. I had 2 previous Colon surgeries and bilateral hernia surgery, all laparoscopically achieved. In light of the laparoscopic surgeries, the Urologist told me that I wasn’t a candidate for the Robotic process, and told me I would have to go outside the VA for surgery and to do my own homework on what’s available. An MRI on the prostate was performed to learn it’s size and look for abnormalities. That was a bit of a shocker, but we began to research the various procedures that are out there. We opted for a second opinion. We went to see a different Urologist, his recommendation was to do the Rezume Procedure and I left his office with a survey date. As we continued additional research We decided to see a 3rd Urologist. This Urologist looked at my records and images and said….there is only one operation for you and that’s HOLEP. He said he could do all the other procedures, except for HOLEP! He said there are only 2 doctors in Florida that that he would recommend for the HOLEP procedure and he recommended a doctor at the Mayo Clinic in Jacksonville. Coincidentally….this was the same Doctor I had the appointment with this past Friday. Having a Urologist tell me to go where I already had an appointment scheduled was satisfying.
This brings me to my visit to the Mayo Clinic this past Friday. I thought the campus was great, everyone I came into contact with was very helpful, professional, and on time. I met the Triage Nurse first for vitals, and then with the Doctor’s assistant as the Doctor had been called to an emergency. So we discussed our visit and reason for being there, my history, and status with the assistant while the Doctor was addressing the emergency. But after awhile, the Doctor arrived in our location and we discussed my condition. He reviewed images and the MRI results, and HOLEP was the procedure he recommended. The risks of long term effects with this procedure seemed to be at a minimum. The only long term side affect that I expect to live with is retrograde ejaculation, everything else should be normal. He took the time to explain everything, what to expect before, during, and following the procedure. He has performed roughly 1100 HOLEP procedures, at this point it is done as an outpatient procedure. There are things to do the day before, the day of, and the day following the procedure to make sure everything is on track, and because I live 150 miles from this Mayo Hospital, I’ll stay in a hotel on campus for 2 or 3 nights. The night in the hotel following the surgery is only like $25 and the hotel has a nurse available 24 hours a day. So we will opt to go up the night before the scheduled surgery, and stay two nights after….this will insure that if anything does go wrong, I am close by for medical help. The hotel will be contacting me soon to schedule. So…the decision We wrestled with for several months has been made, I’m scheduled for HOLEP on May 3rd, and expect to be fully recovered by May 28th! I’ll let this group know how it all goes!

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Thank you for the update. It sounds like you have a good plan in place. I am confident Mayo Clinic - JAX will take good care of you. I hope all goes well for you. Please keep us informed.

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I am so thankful that the Connect Forum I available. It is a wonderful resource center for so many topics and health issue that we sometimes face. Where else can one gain knowledge from the experiences of complete strangers? I feel that I can ask any health question and get solid information that helps one make better decisions. It’s comforting and I appreciate it….and “thank you” to each of you for sharing.

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I came to Mayo in JAX this morning to complete several appointments in preparation for HOLEP Surgery tomorrow. A big day for me tomorrow! I wanted to brief everyone on the process completed today. My first appointment was at 1:00 PM, to have an EKG conducted. I arrived about 20 minutes early and was taken back for the test about 10 minutes early. It went great, not much to report other than the fact that literally everyone we come in contact with is so nice, professional, and helpful. Only took a few minutes. Next appointment was for Urine collection. The instructions I had and prepared with indicated the need to come with a full bladder. As it turns out, they just needed a small sample, maybe 1/3 cup. This appointment happened ahead of schedule, very quick. Next came bloodwork….two tubes sampled, a very typical blood test. Everything went great. My next scheduled appointment was with Urology, the Physician Assistant reviewed my records, talked about the procedure, answered questions, told me how things would happen for me tomorrow, I signed for it, and that was that! Again, very professional, friendly, and nice. Next was a visit with the anesthesia department, we talked about my history, medicines, condition. Very knowledgeable, and informed me of how things would go for me. Last stop I had to make before the end of the day was a test for Covid. After 6:00 PM, I will be able to call to verify my scheduled time to report for surgery, and providing that my Covid Test shows “ Undetectable “ I’m cleared for surgery. The Covid Test results will not be available until late tonight. If I were to test Positive…..I would need to reschedule. I’d like to emphasize that this hospital seems to be staffed to enable on time appointments. I’ll let the group know how it goes for me tomorrow!

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