Prostate and Bladder Issues: What to do?

Hi @ch665296f, thank you for reaching out. You should ask your doctor about your surgery options directly, but have you voiced your concerns about the medications you've been prescribed to your urologist? Also, here is some information I found on TURP surgery and the occasional need for follow-up treatment: http://www.mayoclinic.org/tests-procedures/turp/basics/definition/prc-20020214

I'm also tagging @krunch, who has written previously about getting an alternative surgery to TURP.

In 2011, I had a prostate procedure known as HOLEP performed by Dr. Humphreys at Mayo in Phoenix and it has completely solved my prostate issues. I would recommend this procedure to anyone that is having enlarged prostate issues. Good luck!<br />

Hi, @ch665296f. I ran across your April 19 posting while looking for men who have had experiences similar to mine and wanted to see how you're doing.

In my case, after 5 years of medicating to control urinary incontinence, my bloating prostate got the best of me. The always-unreliable meds and supplements failed me completely. My new urologist recommended TURP, which was performed 7 years ago. He's retiring in August, so I'm looking for a successor, and knowing the current state of medical treatment is vital to making that choice. As usual, I turned to Mayo for advice and found the web page provided you by @aliskahan in this thread. It's highly encouraging to me, and to you as well, I hope.

I'm facing a decision on whether to have additional tissue removed from my prostate. My first impulse is to undergo another TURP. After my first TURP, I have had regular cystoscopic examinations of my bladder and prostate after discovery six years ago of a small tumor on the surface lining of my bladder. Those repetitive exams showed me I need not fear another TURP.

However, today I'm looking for a urologist who administers HoLEPs -- laser surgery removal of excess prostate tissue. I got this from the National Institutes of Health earlier today -- specifically from the following web pages at the National Library of Medicine: At http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446381/ (an article entitled "HoLEP: the gold standard for the surgical management of BPH in the 21st Century") and a related article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763780/.

I hope you can call up these three web pages and give them a read. If you have trouble with that, let me know and I'll figure out another way to get them in your hands.

It's been more than two months since your initial posting, and I hope you have made progress against your prostate problems. It would be very helpful to me and many others on Mayo Connect if you could give us a brief update on your situation. I will be appreciative, and I suspect others will as well -- and together we may find more answers to our common problems.

Since I started this thread, I have had a robotic prostatectomy, gleason 7, combined with a diverticulotomy which was very large. The surgery was on April 11. I had issues with previous incontinence before the surgery, and continue to do so. I have tried most meds, kegel exercises, self cathing...not a lot of success. I continue to manage by wearing diapers of some kind. I am 70 yrs. old, and really do not want any other kind of surgery...artificial sphincter, and a lift were suggested. Is it acceptable to manage as I am? I'm at the point where it doesn't bother too much. Some days are better than others. I just don't want to take a chance and go without protection.

Greetings, Testosterone-fueled Brother, @ch665296f - I am guessing, you were not under the care of a Mayo Clinic Urologist specialist when all this litany of medical treatment you describe was delivered to you. Unfortunately, that urological treatment "Horse Is Out Of The Barn" already for you.

Background on me – Miniscule PSA #s, no cancer, but a distended bladder due to years of living with BPH. In 2011, at age 70, I had "Gold Standard" TURP surgery performed on me for BPH by one of Mayo's "Top Uro-Docs." My Mayo Uro-Chair Doc carved out the inside of my prostate gland to dropping jaws & oo's & ah's of the observing urology residents and nurses.

I came out post-TURP-op "Clean & Green"... Removed the operation catheter shortly after the operation with no bleeding-burning. No temporary or long term difficulty urinating, no incontinence (as in "No Diapers Required"), no urinary tract infection, no TURP syndrome post-op low sodium in the blood, no sexual dysfunction/erectile dysfunction (had no sexual/ED dysfunction pre-op)... It was ONE & DONE w/ no need for a TURP retreatment.

I agree, the various “Prostate Shrinking” medication the primary care and non-Mayo urologist doctors prescribed for me were valueless, and did nothing, nada, zero, zed for me while I was taking them in the years prior to my Mayo connection, and Mayo TURP surgery.

I do not know where you reside, relative to the geo-location of Mayo’s three clinics. My first recommendation would be to “Get Thee To A Mayo Clinic For A Medical Evaluation… ASAP.” You have had too much whacking, hacking, “Green Lighting,” robotic prostatectomy, Gleason 7 Diverticulotomy Combo work. How much more “Let’s Try This Next Experimentation On @ch665296f” can your male “Plumbing” take?

Short of receiving a solid, "Take It To The Bank" Mayo Evaluation of your gear, try places like Cleveland Clinic, Texas Medical Center – Houston, Shands, & et all. Good Luck, “Prostate Pardner.”

In response to your question as to where I reside, I live in Iowa. My treatments have/are taking place at the University of Iowa...another very reputable hospital. I have read and heard that there are some of us that have incontinence issues from a prostatectomy see complete continence in time, some a little, and some not so much. As I mentioned, I'm done with anything being done "down there". As you stated, how much more can my "plumbing" take. I don't want to live the rest of my life recovering from surgeries. I am embarrassed by the stigma attached to adults wearing diapers, but it is what it is. I see my surgeon/urologist next Oct. I'm sure he will have some suggestions. I hope I'm brave enough to stand my ground.

Hello @ch6652961f, it's been 13 months since I exchanged messages with you, and I'm glad to have a new chance to commune with a fellow BPH veteran. In some respects, you and I have been through similar challenges -- BPH, prostate resection (TURP in my case), bladder surgery (TURB in my case) after 12 small malignant tumors appeared on the internal lining of my bladder. My incontinence turned out to be short-term -- same as my recovery from surgery. My bladder sphincter is still on the job after 9 years. During that time, I have had regular cystoscope examinations of my bladder and am pleased that no more tumors have appeared -- yet -- although what was left behind of my prostate is growing slightly. My urologist recommended Finasteride to discourage more growth, and I'm fortunate to have no side effect from the medication.

Before my surgery, I used diapers regularly for a few weeks, and I still carry a few in my briefcase or suitcase, although I haven't had to use them for years. I have an understanding with my urologist that surgery of any kind to treat prostate cancer will be a last resort, but I haven't ruled it out altogether. Instead, my preference is "watch and wait." I haven't had a PSA test for years, and my prostate remains unremarkable in transanal examinations.

One mammoth advantage has developed since my surgery 9 years ago. Immunotherapy based on genomic tests has changed my outlook 180 degrees. I no longer see prostate cancer as a threat, because immunotherapy can cure it without knife or heat or frost or laser -- the trusted old fashioned ways of removing prostate tumors. Even gioblastomas, such as those that took Senator Ted Kennedy and are threatening Senator John McCain, are now being cured in clinical trials that are leading to public treatment in the near future. So I hope you can join me in optimism that cancer is not the threat we feared in the past and that accepting the most modern therapies will give us better life experiences for the rest of our lives. Martin

@ch665296f - Thanks for the courtesy of a timely reply. Welcome fellow (I assume) native Midwesterner. I am a favorite nephew of my Uncle Popeye, and “City Of Big Shoulders Born.”

It is/was not my intent to sully your unnamed urologist healthcare provider/team, or, necessarily, to try to dissuade you from going where you feel comfortable with the doctoring. You must forgive me as I am “Bullish On 150+ Year Old Mayo.” My response to you was written for you, as well as for the greater good, interest & information of any testosterone-fueled eyeballs afflicted with Benign Prostatic Hyperplasia (BPH), who may be reading our e-chitchatting exchanges.

I, clearly, am “Bullish” on Mayo. I went into MCF with a heavily testosterone-marinated prostate, and a necked down urinary tract opening at my “Septuagenarian-Vintage Testosterone-Bloated Prostate,” which was suffering from BPH… I came out of the MCF operating room post-TURP scalpel prostate innards carving, “Clean & Green,” fully functional with no nerve damage, no nuttin’ & no problemo… I view that result as a personal “Veritable Miracle.”…which at Mayo is “Patient-Care Business As Usual.”

I call your attention to my related e-babblings over in Men’s Health: “Adventures In Male Agri-Care: ‘Mushrooms’ Fertilized With Testosterone.” I write there about on how we “Blue Tee-Shirters” need to stick together, get “Kilted” and organized, because greater public society tends to put us “Blue-Shirted Baby Boys In The Corner” when it come to Charitable Spending & NIH/Federal Research Bucks and Public Service Announcement Awareness, etcetera. Paraphrasing Johnny Castle in “Dirty Dancing,”…”Nobody Puts Us Baby Boys In The Corner.”

Keep up your pursuit of “What’s Best For @ch665296f’s Plumbing,” not what is best for your doctors and University of Iowa Med at following protocols because you have good health insurance. Remember, it is your body that you are living in, not theirs. You know best what is happening in there/down there. Keep The “Blue Tee-Shirt” Faith, Brother.

You're a hoot, @catgic!

@predictable - Thank you, I will take "Hoot" anytime 🙂