Prostate and Bladder Issues: What to do?
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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EDIT: "Jump-cut to April of last year: " this year, not last year. So I have been on a waiting list since this April 2023.
I just read your Rezum post. I'm very sorry. Regrowth was my reason for not having TURP, apart from possibly needing a transfusion. I have no mRNA in my blood and I won't get into the controversy about this, but it is a concern and I'm already looking into medical requests for "auto-donation" pre-op for surgery- I'll receive my own blood. I just don't need any more health issues. Your choice for HoLEP is likely your best one & done with adequate hemostasis because the laser cauterizes as it passes so the need for transfusion is almost nil.
I've been in and out of operating rooms as a laser operator and I confess that I am literally having nightmares about general anesthetics and post-op recovery. Scared to death. I live alone, I'll have to depend on strangers to help me. Maybe I'm braver than I think?
@delmar418 Delmar, I am sorry about the delay you've been handed. Socialized medicine is great but doesn't always hit the mark. Here's hoping that you get to the front of the line soon. Be sure to keep all of us in Connect up to date.
I have an appointment with my PCP and hope to get a referral to an experienced HoLEP Urologist.
Thank you so much for your expression of wellness to me. The best and sometimes only virtue of Soc. Medicine is that it's available. I think HoLEP is probably the best bet until the PAE becomes more widely available. I strongly suggest asking in a diplomatic fashion- framing the context of the doctor in your shoes- that he would want to know how many procedures his doctor has done and the percentage of favorable outcomes out of those cases.
Some doctors gaslight and have egos, so framing your specialist as the patient is a smooth path. Write a list of questions, a lot of them. This isn't your first rodeo, so you already know this. There's a brilliant doctor, I think she works out of Texas? She has some videos of full procedures on youtube. I don't know if she's with MAYO, or not.
When there is news, I'll be sure to keep you informed.
It's rare I'll comment on many posts if I don't have enough to offer. I read them every day.
May your appointment be productive and give you assurance and confidence with a sound professional.
I had Foley catheter in/out for 1 1/2 years..mostly in. Had the Holep in Indianapolis at IU medical. This hospital preforms more Holep than any hospital in the USA....500+ per year. Go with experience...very important.
How did yours go? Any complications? Incontinence issues? Down time? Pain?
Experience counts on this one. I will demand to have a face to face to ask questions. Of course they can lie. Once I'm out on the table they can stick a kid in there to use me as a practice doll and play Ninetendo with my penis with a crowd of grads behind him / her. I really shouldn't be having these thoughts. I see how they use AI to practice these days and the model they use probably doesn't look anything like my prostate, once you get in there and lose orientation things can get accidentally lased- through the capsule, bladder sphincter, so it's important to know if they are familiar with the "en bloc" technique.
" 'En Bloc' HoLEP with early apical release is a safe technique that allows for easier recognition of the surgical plane and preserves the external sphincter's mucosa to provide low rates of post-operative stress incontinence and significant functional results."
https://pubmed.ncbi.nlm.nih.gov/30035424/
I had Hotep late October. First two weeks, pretty sore on urination....pass blood,etc. But able to urinate with good velocity stream. The second week, I noticed, the blood tapering off, each day brought a little less blood, until after 10 days...no blood in stool at all. Urination still painful, but also each week a little less sore. The burn is noticeable, but seems to be less and less. So far only complaint is frequent urination....when nature calls, you better be quick to the restroom. Have had a couple of instances where I could not hold it, very embarrassing . I'm learning to urinate about every 2 hours to keep safe, so far pretty good. Doc says learning to urinate is a no quick cure, just be patient and take time. I am at about 3 weeks now in recovery....had my foley catheter on for 1 1/2 years, feel tremendously better.....I would advise having this procedure.....it works !!
Hello to all! I had HoLEP in May of 2022…..absolutely the best decision I could make. I still cannot believe how lucky I am to have found and pursued this procedure. I went to the Mayo Clinic in Jacksonville, FL and Dr. Dora is the best…I’m not kidding….so very glad to have gone this route. Recovery was great, bleeding stopped in about 2 weeks. I urinate easily, I have no issues. Best of luck to you and I hope everything goes well for you!
5 weeks after HOTEP proceduce....Able to pass urine easily and with good flow. When I have to urinate it is immediate, now...no hesitation. IS there a way to control a little better when to release urine. Can be embarrasing in situations. Any help?
Sorry to hear of your sometimes “immediate” urge to empty. I did not experience this when I had my HoLEP procedure. I’m wondering if your symptoms are a result of having the Foley in for the extended period prior to your HoLEP procedure last month. I went back to see Dr. Dora at 90 days…..are you planning a follow up? Would be something to ask him for sure! You can probably ask that question now from your patient portal as well. Hope your symptoms improve soon.