Prostate and Bladder Issues: What to do?

Thanks for reporting your experience, kayak. Sounds like you are another satisfied customer of the Mayo Clinic! 🙂 My doctor recommended having a new PSA test done 3 months after surgery to "reset my baseline number" because you can still develop prostate cancer after this type of surgery. My last PSA before surgery was 6.7 My new number three months after surgery is 0.32! That is the lowest PSA I have ever had going all the way back to my first one probably 30 years ago. Quite a dramatic change. I am glad to hear it all went well for you. Please check back again in a couple of weeks and let us know how you are doing.

Have you had a TRUS (trans rectal ultrasound ) or an MRI to get a more accurate estimate of the size of your prostate? I ask because they don't seem to recommend Rezum or Urolift for larger prostates over 90 grams. Mine was 120 grams with an obstructing medium lobe which required either HoLEP or BiPolEP. I had BiPolEP and I am completely satisfied with the results.

Yes, I had a TRUS and have an MRI scheduled in seven weeks. He wanted to have a better picture of the prostate. He said my prostate was 67 ml and it should be under 80 for urolift. Urolift may not last as long as Rezum which takes 3 months to fully recover from.

All I could add to this is that a friend had Rezum procedure and is now very happy about 2 years out. He did say it took months before he saw improvement.

My first urologist wanted to do Urolift with prostate size over the limit but he thought he could add extra clips. That’s why I have a new urologist.

It’s tough to make the decision on which procedure to go with. If you haven’t already done so, I would recommend getting a second and a third opinion on how you should proceed. In my case I visited three Urologists once I was told by the VA that I must have my prostate removed, and due to my prior laparoscopic surgeries they could not perform the surgery. First thing I did was investigate, reading, YouTube, whatever research tools I could find to read up on the topic of prostate removal. I reached out to the Mayo Clinic Urology Department and booked an appointment 2 1/2 months out. In the mean time, I visited a Urologist who did the Rezum and Urolyft surgeries. He was quick to recommend Rezum. It bothered me that the “steamed” prostate tissue was left to die and decay in my body. He identified the possibility of Sepsis and the need to be on antibiotics before and after the procedure to compensate. Next I went to a well rated Urologist who also performed Rezum, Urolyft, TURP, Robotic, and several other procedures……he came straight out and said that there was only one procedure for me….HOLEP….and only a few Doctors in Florida can perform it. He’s the Doctor that told me Rezum would not work for me given the medium lobe growing up into the bladder. He recommended a Urologist at the Mayo…..which happened to be the same Doctor I had an appointment with weeks later. I can’t tell you which to choose, I can tell you I am happy with the procedure I chose. All of the enucleated prostate tissue removed was sent to pathology. I was given a 5 day prescription for an antibiotic following surgery. I do not have a catheter, I do have blood in the unlined (expected) but it will stop soon, I’m having very little leakage now 4 days after surgery and I am certain that will end soon. I believe in second and third opinions. Good luck friend, let us know what plan you settle on. I’m rooting for you!

Re: Rezum, that is similar to what my Urologist said. Plus I would have to be catheterized for three days. It sounds like Rezum is significantly more involved than Urolift. He said Urolift is a same day procedure and you walk out of the office. I would like to hear from someone if Urolift is effective (only one or two trips to the biffy each night) and lasts until I don't need it any more.

I had a very similar history. I am 69 but surgery was in 2016. My incontinence brought me to the artificial sphincter surgery but it is not controlling my incontinence. I have bad bladder spasms and they do not respond to two different medications. My next step is botox injections and I have a scope and Urodynamics test to qualify me for the injections. I too am wearing guards and diapers and it is frustrating. I don't believe the AUS device has helped me that much and the real problem is the bladder spasms which nothing has worked. Avoid the surgery.

There is a new procedure called P.A.E. Prostate Artery Embolization.
They don't go through the urethra, they go through the ephemeral artery in the groin or the wrist with a catheter that injects tiny beads into the prostate to cut off part of the blood supply to reduce the size of the prostate. This is performed by an Interventional Radiologist, using x-ray guided imaging to position the beads. I've been reading a lot on this, I'd love to hear from someone who has had this done. I've only seen a couple of non-promotional videos. No sexual problems, retro-ejaculation, incontinence. I have a 99cc prostate and they have has success with prostates larger than mine with the PAE. It's an in-office under light sedation procedure. This is the second time I've posted this and I've had to reset my password here three times.

Thanks for posting. I have had the Rezum procedure done recently and am waiting for good news. In the meantime I continue looking around in case I need a backup. How has PAE treated you? How long from the procedure until you were back to normal? What was/is "normal?" Will the prostate be completely gone in time? As an aside, can PAE be a treatment for prostate cancer?

Hey there, I am exploring the PAE option after doing research on the internet. After watching the outcomes of others and reading in various other forums to make comparisons, I'd rather opt for this than the others- providing it's available to me here in Europe. I have not had any procedure other than an indwelling urethral catheterization going on three months. I see this urologist this coming Monday. Maybe I'll get some answers. A PAE for P. Cancer? This is a good question. I can only guess at this point that they would need to have the exact location of the cancer. If they can do this with the radioactive seed implants, maybe. But this treatment is for shrinking the prostate without taking finasteride and tamsulosin and other bladder-specific drugs. I would ask this question definitely.
On your end, I'm happy you're already planning a back-up, they say everybody is different- doesn't this make us the same? I hope EVERYTHING turns out in your favor with a LASTING outcome. Please keep us posted, often. I'm hoping that you'll hear good news!