Prostate and Bladder Issues: What to do?

Day 3 Urolift procedure. Pain is less but I see no improvement in BPH symptoms or urine flow. After talking with Doctors office they say it is because of inflammation. I am again taking 1 Tamsulosin a day, Motrin for inflammation. They tell me they do not know if the muscles, and nerves that regulate bladder function like in a man before having BPH for years will ever return to normal functions even after having this procedure. They tell me take it may take 6-8 weeks to see any results I hope so, because so far this not what the Uroflift brochure advertised. I'll post again in a week or so for an update.

Hey @amgracing1, It's been a couple of weeks since your Urolift surgery. How are you doing? Improvements?

It's been 3 weeks since I had my Urolift prostate surgery. I seemed to get a bit better after I started taking a lot of noninflammatorys like Motrin, Advil. But all in all I have to say that this procedure did not significantly improve my symptoms. On a scale of i-10 this is about a 3. I am still taking one Tamsulosin a day instead of 2. I guess that could be called an improvement. But the goal was to be completely off medication and have a big improvement. I am going to give it some more time I see the Doctor again in 3 weeks, I'll wait and see. So far this is a disappointment.

Where did everyone go? I hope Steve from Ohio is doing well. My name is Bill and will soon be 69 y/o, a former athlete still very active cyclist (split seat), elliptical and moderate weight conditioning. Good overall health except..... I've had BPH for at least 3 years with some problems I'll talk about, I'm doing fairly well on Tamsulosin. I have been seriously researching other options as I know the future of this condition doesn't get any better on it's own.

My problem started with a retention incident of my own making, waited too long. I knew I had a problem so I took myself to the emergency room. Voided over 1000cc. Found a good Urologist that I vetted best I could at a urology group nearby. Did the usual exam and put me on Tamsulosin that immediately helped. I do void a decent amount with about 60cc or less remaining in bladder as ultrasound has shown. I usually sleep about 6 hours but don't drink anything about 2-3 hours before bedtime. I easily void about 12-14 oz in the morning, a little slow but usually within 1-1 1/2 minutes. I do have moderate pain upon starting the stream which could take about 10 seconds to start.

Here's my concern and problem. My prostate is 150 grams according to Uro's estimate. About 6 months ago I saw a little bright red blood before the stream started. Saw the Uro and urine analysis showed elevated white blood cell count. I did have very mild pelvic pain, prostatitis was diagnosis (my thinking was non bacterial). After 10 days of antibiotic symptom came back within a month so I went for the dreaded cystoscopy of bladder. There is a history of bladder cancer in my family but I understand it generally is not hereditary unless you have same personal habits that may cause it (I don't) although I was a NYC firefighter in a busy area and that happens to be a risk factor. Thankfully my bladder was clear. The hardest part of that examination was the young female nurse holding on to me. During the exam Uro said I had a very vascular prostate and the blood was probably from a blood vessel rupturing. The blood happened one other time but in my research I may have found the remedy. Each time it happened I had a difficult bowel movement. A light went off in my head so I went to Dr. Google and my Grey's Anatomy copy and see the rectum is right next to the prostate. I added prunes to my morning routine and everything is fine now, no blood and pelvic pain gone.

So my next problem is knowing I will eventually need a procedure. I'm leaning toward a Prostate Artery Embolization as my first least invasive procedure. Will be having a consultation sometime this year with a good Intervention Radiologist in Boston who has done many of these procedures. Decisions decisions, nobody said this will be easy. I am thankful for the Mayo Clinic and everyone on this board. The knowledge and experiences here are invaluable for people like us. Together we'll deal with this male curse. Glad to be a part of the community.

Hi, @bill5letsfixthis. Looks like lots of similarities between us. Maybe my experience will be helpful to you. BPH was my main problem 12 years ago. After 5 years on Tamsulosin (Flomax), my urologist urged me to avoid the potential problems from long-term reliance on the drug. One reason: It was no longer effective. My urinary problem became more difficult, so we decided on a TURP (transurethral resection of prostate tissue). After removal of tissue, the cystoscope lit up a small papilloma in the bladder lining that had been hidden from view of imaging technology. It was removed immediately, and a follow-up cystoscope exam found a dozen more of those tumors, all superficial and not invading bladder muscle. We performed a TURB (bladder) and removed them, followed by a 5-week treatment with BCG solution to eliminate seeds of any other tumors. Since then, I have had periodic exams by cystoscope and found no more tumors. Once or twice a year, my urine turns pink from blood leaking into my bladder for a couple of days, but it's never been "frank" (undiluted) blood, and my urologist urged me to consider it non-critical. Three urologists, actually, all said leaky blood vessels in the prostate were not uncommon after a TURP. Unfortunately, BPH doesn't give up and continues to grow as the years pass by, so we're always checking for its intrusion into the bladder. Martin

Thank you Martin for your reply and concern for me and everyone else you have helped on this forum. In reading some of your previous posts I was going to bring up your thoughts on my next visit to my doctor. My goal of course is to get off the Tamsulosin with a smaller prostate and I am resigning myself to the fact it will be a lifelong ordeal. I do believe I have a little time as I am as close to normal as I can expect to be and manage my prostate well enough to have a regular life (I know where all the good bathrooms are if I need to travel). I drink 2 liters of water a day and mostly work at home so voiding every 2-3 hours or so is fairly easy. Without all the pressure (no pun intended) that I need to go straight to the gold standards of TURP and HoLEP right away I am hoping I am on the right track by researching everything first. I have a number of friends on finasteride with side effects that are not acceptable to me. My doc offered it to me but I declined as I felt Tamsulosin was working for now. My Dad had a TURP in I think 1989 which basically ruined his life but my doc assures me the advances have come a long way. My doc thought a Urolift would be suitable as extra clips could be used for the large prostate but the Urolift people say no, so that's out. The PAE interests me, I just need more info.

I've never seen any pink urine, just those 3 times of a little blood at very beginning of stream, but I will bring up the papilloma question, thank you for stressing that. I have a question for you. You mention blood leaking into your bladder, but am I correct to say leaking blood from the prostate will go directly into urethra? Or, can it go into the bladder as well? The prostate intruding into the bladder from what you say would be a major concern for me with a large prostate. Thanks, Bill

I have been told by two Urologists that I must have my prostate removed. Im considering HOLEP. Im looking to Connect with someone who has undergone this procedure in the past year so that I might ask a few questions about the patient experience. Thank you!

I had the HoLEP procedure in 9/21. I have been very happy with the outcome, and would be happy to answer your questions.

I would be happy to hear this experience including the Q&As. Others probably would as well.

I’ve just joined the Mayo Clinic Connect forum and I am not sure how to build on this discussion so that others can follow. I’m not that technical. I’d love to copy you, or keep you and others informed, but I don’t know how to do it.