BPH

[jclovesus]

Was just informed last week I need to have laser surgery. I am 41 and have dealt with enlarged prostate for at least the last 5+ years. Was on Flomax, not working as much and now on Terazosin. Uroxatral worked great for me but not covered by insurance. Anyway would appreciate any advice about laser surgery, risks, how long off work, anything. I am told by my uro that it is a 20 min surgical procedure, outpatient, and I would be out cold the whole time. I read on the Mayo clinic one man had this and was normal the same day, but I also read where others are dealing with symptoms for many weeks. I am not comfortable and would like to be. Thanks for reading.

[Dave]

From my understanding laser surgery has good results with less time out of action; but everyone is different. Although if you can, speak to people who have actually had the procedure. Hope it all goes well for you.

Is there anyone out there who has actually had laser surgery for prostate BPH?

Dave

[jclovesus]

What I am learning is that "laser" surgery for BPH is relatively new, compared to the other "gold standard" procedures I read online. There also appears to be more than one form of laser surgery. So at this point I am a little confused and will discuss this more with my Uro. For some people it works out well but for others, depending on how well the Doc does the procedure, there can be some mild to serious post surgery side effects. That is the part that concerns me. So as you say, I would appreciate hearing from others that have had it or have researched it. Thanks to you all!

[Dave]

Yes, I think the best thing is to ask as many questions about it as possible.

I often find a good way is to try and note down on a slip of paper the questions in my mind before I visit my Doctor. I shall be doing this when I visit the specialist next month.

All the best with it. The only laser I have heard about is the 'green laser' procedure. But like when you are undertaking anything a satisfied (or not) customer's recommendation is always worth considering. Laser is still in its early days, but like anything bear in mind the plusses and minuses. Hope it all works out well for you.

Dave

[FloridaRetired]

Ever since I was diagnosed with BPH I have basically ignored it as my urine flow was pretty good. I'm nearly 67. However, 3 weeks ago I had to go to emergency as I could not urinate at all. Have had a catheter in and out 3 times. On Flomax but does not seem to be helping much. Researched all of the options and have settled on laser therapy. Greenlight (PVP) laser is one and Holmium (Holep) laser is the other. Both do basically the same thing, reduce the size of the prostate through "ablation" which is a form of vaporization. (the prostate is 90% water and 10% matter believe it or not). The Laser vaporizes the prostate tissue surrounding the urethra. In other words it clears out a space, around the urethra, in order for the urine to flow without obstruction. Due to a cauterization technique apparently the vaporized tissue does not grow back even though the prostate may continue to enlarge over time. From what I have been reading the Holep technique is somewhat better than the PVP technique simply because the Holep beam only penatrates to .5mm whereas the PVP beam penatrates to 2.5mm. I guess that more tissue can be damaged at a deeper penatration. However, I never fully believe most of what I read off the internet. So, I am checking with both of my Urologists on this.

[Dave]

OK thats useful. I live in the UK and the laser treatments are starting to be used over here now too. Basically, when I go to see the urologist I will hopefully get confirmation of my condition (its probably BPH) as I have only been to see my general doctor who has done a DRE and got a PSA test done. However, once I do now what I have, I will then discuss all my options with my Doc. I hope the laser surgery goes well for you and keep us informed on the forum as to how it went.

Take care.

Dave

[FloridaRetired]

I have BPH and also first stage prostate cancer (T1c). After reviewing many options I opted for Greenlight Laser to clear the enlarged prostate obstruction around my Urethra which had closed off my urine flow. Had the procedure done on Monday on an outpatient basis. 2 hrs pre-op, 1.5 hrs treatment, 2 hours post-op. Back home the same day with a catheter in. On third day had catheter removed by Urologist. Was able to urinate like a race horse. A little residual blood and very few small clots in urine. Have had no pain and just minor discomfort through the whole thing. The most annoying thing, of course, is having the catheter for 3 days. My Dr. says 3 days, instead of 24 hrs, just to be on the safe side. Today is Saturday and I am at about 90% of normal. Urine is almost clear. Still getting up 2 or 3 times a night. However, I attribute this to the bladder and attachments getting back into the routine and also healing. Have not had any incontinence. But, wear a pad in my underwear just in case. Will dispence with this after a couple more days.

Will allow the complete healing process to take hold and will probably then do either the Cyberknife or the Proton treatment in January to erradicate the small amount of cancer.

I attribute the complete success, with minimal side affects and no complications, of my Greenlight Therapy to my Urologist Dr. Jo. They come for miles around to have this procedure done by him. This man is an excellent surgeon. That is so important. His practice is in Ocala, Florida.

[boris1957]

I am 49 and had trans urethural resection by lasar about 6 months ago. Outpatient surgery, experienced MD, BHP, non cancerous, appx 9 cm in size. Surgery went fine, stayed in hospital for one night due to hypertension issues which have been present since mid 20's. Urine output before surgery that of an 80 to 90 year old man. After surgery burning with urination for about 2 weeks. No other complications with the surgical procedure itself. Now the bad part. Talk to your physician at length about retrograde ejactulation. This is where upon climax, your ejaculate does not come out of your penis, it goes back into your bladder because of the widening of the bladder neck during the surgery. I was told there was a 50/50 chance of this happening. I was on the unlucky side. I have no ejaculate upon climax at all and was told by my physician that it would be that way for the rest of my life. I was also told that there would be no problems with ED which there have not been. MD also said that there would be no changes in sensation upon climax and that normal feelings wsould be as usual just with out the ejaculate. Again, I am on the bad side. I have lost about 3/4 of my sensation during intercourse and or masterbation which has lead to depression and a loss of desire for intercourse with my wife of 23 years. She is very understanding and we are working together to help matters. The procedure itself was easy and really not painful. It is just the long term sidefects that I will have to deal with that make it bad. I now have the urine outflow of a 20 year old man. That in itself is wonderful. On the good side, that is worth most of the side effects and I was lucky that I had a physician that explained the entire process and complications in advance.

[renegade_7]

Any reason why the Uroxatrol was not covered by your Insurance?

[boris1957]

I had the green lasar surgery done about 6 months ago. I left a topic and story about retrograde ejactulation on November 11 . Check under boris1957 and you can hear my whole story. Good luck with your surgery. Get as much information as you can and I advise as I did also, get second opinions.