BPH, TURPS, and Alternatives |  

Finally had the TURP procedure in late July, spinal anesthetic, couple of days in the hospital. This after 4-5 yrs. of Active Surveillance; glad to be off the pills and no major issues.

Can u do a detailed video on Prostatitis?

I mention another new treatment below. I'm a posterchild for this video, around the 8:40 mark describes some of my current situation so this is for those to whom it may apply although as we all know or come to find out the hard way the sample size for prostate cancer and BPH is 1. Every case should be looked at individually. I have 3+4 intermediate stage cancer (Decipher) and spent awhile deciding on treatment after biopsy initial diagnosis in March of 21. I also was told I had enlargement in the transitional area of the prostate (mine was considered slightly enlarged 40cc) which is the area of the prostate right around the urethra well away from the cancer in one part of the apex. This was discovered at my first multi parametric MRI in October of 21. BPH symptoms (urgency, some additional nighttime trips to urinate) were mild (and stayed that way a while) while I researched cancer treatment. I also got diagnosed with moderate sleep apnea at this time. ( Age 68 now 70) so I already had sleep issues for at least the preceding 20 years. I decided on MRI-linac (Meridian) hypo-fractionated radiation treatment, 5 treatments. The length of time that elapsed from the MRI that found BPH diagnosis to making my decision about cancer treatment allowed the urgency and frequency to get progressively worse and eliminated any time for treatment since the second MRI showed some cancer progression but still focal and and no ECE but still time to proceed with cancer treatment and not BPH treatment. The normal protocol for MRI-linac was disregarded against my vehement protests. The Doctor in FL (where I travelled for this specific treatment) said it was still safe (very long story). I totally disagreed but already had one treatment so I finished the 5 treatments. I developed a pretty bad case of radiation cystitis at 9 months post treatment. (Thanks Doc for not telling the truth and sticking to the known protocol of treatment of every other day). Lots of blood in the urine, I believe they like to call it gross hematuria, and of course now the BPH symptoms intertwined, so also much difficulty in urinating anyway. This played out over 2 and half months this summer including 1 trip to the ER. Flomax helped somewhat until the cystoscopy showed the damaged tissue from radiation in the bladder. I was prescribed Hyperbaric Oxygen Treatment to stop the bleeding and accelerate the healing process as well as staying on Alpha blocker. I did 57 consecutive weekdays (ending 11/21/23) of 90 minute treatments at 45 feet below sea level at the best facility where I live in Atlanta (They have been in business over 20 years and said they could not recall anyone doing that many treatments without missing a day. I was prescribed 60 at the facility but chose to stop at 57). Bleeding long gone at the moment but radiation poisoning is the gift that can give at any time so will just have to see what happens.(Exactly what I told FL doc I was most worried about and wanted to take all proper precautions to avoid and now at only 9 months it begins instead of the average of 25 months....thanks doc) I'm still on Alpha blocker, I prefer Uroxatral for sustained release and antegrade ejaculation versus retrograde with Flo max. BPH symptoms still present but manageable. I want to get back to Kegels instead of medication but seems counterintuitive to exercise same muscles that the medication is forcibly relaxing, so will wait another 2-3 months before deciding on a next step. I have below low normal free testosterone but very normal total testosterone. No symptoms there though radiation can cause this. I exercise 6-7 days a week with plenty of energy, not overweight, no caffeine almost no alcohol (2 drinks or beers once a week along with large amounts of water, which together (and I guess the medication) have a great relaxing effect and allow the best urination of the week. No incontinence but the brain knows at home it doesn't have to wait so more frequency then when I'm out and about for several hours with no issues. Getting up once a night which is as much (treated and treating) sleep apnea as anything. I hope the radiation will eventually shrink the prostate enough to lessen and maybe even eliminate the urgency and the need for the very few treatments available post radiation as discussed in the video. It's been 13 months, PSA slowly down from 7.6 to 1.4. Never any ED (in fact still the opposite situation which some might call ED ha ha :)) and still not dry orgasms but getting closer to that. Optilume is probably the newest procedure for BPH and the doctor is looking into whether I can do that one. He says I could do Urolift which I am not impressed by so far. Not sure about Itind yet but I like the concept though likely not as effective post radiation. All the others especially TURP are out as mentioned in the video. My doctor in Atlanta where I live is a surgeon doing prostate removal as well as treating BPH. I'm hoping in the months to come to find out more about Optilume.

Aquablation...thoughts ?

I have a question, what about aquablation procedure, is it effective?

When I had Tulsa it reduced the size of my prostate from 160 to 30 and it solved my bph problem.

Thanks, great video ! If you have a TURP procedure, how long must you wait for it to heal, before undergoing radiation ??? Is there a standard timeframe for the incisions to heal ? Thank You !!

I was having typical urinary symptoms that started my prostate work up. According to MRI nearly my entire gland is a tumor. I am 4+3+7. Just started 6 mos Lupron and will have radiation mid way. If my pre existing urinary issue persist after treatment can/should I consider one of these procedures on my radiated prostate?

I had a TURP procedure a few years ago. It was straightforward and I was discharged the day after the surgery. It helped somewhat with the urgency, but not a great deal with the frequency. The downside is that I am now impotent and have to rely on Viagra. I also don't like that I can't ejaculate anymore.

My radiologist demands I have TURP before he does HDR brachy. Something about "otherwise you're gonna wear a catheter for the rest of your life." Nothing else was ever offered. No word on side effects. I am considering to change health systems and try different doctors, or is that a common process when you cannot fully empty your bladder and HDR brachy is on the menu?

Why no mention of HOLEP?

What about holep procedure.