[bob22312]

15 years ago I started out on hytrin for BPH 8 years ago my flow was down to 2 ml/sec and elected to go for a TUMT at major teaching hospital under the direction of one of the early pioneers for this procedure. At that time Interstial Lasar Coagulation was being touted by UROs in private practice.
Four month later after 3 to 6 week with a catheter and several months of blatter spasims the URO pioneer said that if I was unhappy with the flow do a traditional TURP. Prior to surgery the URO check for the prsence of a median lobe??? and made certain I was off SAW Palmeto for 3 months prior to the TUMT ( prostates cooked while you wait )procedure.
The URO I see now put me on ADVODART (retrograde ejaculation resulted) and Flowmax ( 2 each 0.4 mg tabs daily) and identified that the prostate had shunk with the resultant improvement in flow. He wants to do a traditional TURP (roto rotor) but I have been thinking that I would be better off doing the Green Laser procedure until I started reading this list.
Question?
Will the scar tissue from the 9 year old TUMT create difficulties for the Green Laser?
Should I have an assessment of the damage in my uretha before the Laser procedure?
Will 5 years on ADVODART create problem for the Green laser implementation?
I have recently back off on my coffee consumption, but I have 6 to 8 Oz of red wine regularly.
I have found that the salsa at one the national chain Mexican restaurants will impact my flow and create an urgency to void with poor results. Could the salsa be destroying the flowmax functionality?

Please send me your thoughts
Better yet perhaps the UROs have some clinical evidence!
Getting off the meds and doing a TURP may improve my labedo. I am 72 and if I make the right choice I may start to frolic. The wrong choices may lead me into old age praying for an early death.

[mrcoyote]

You may have read some or all of my posts since my laser TURP about three months ago. I'll just tell you exactly what my urologist told me about using a laser instead of the conventional method on a patient who has been taking Avodart. As I said in one of my posts, he told me before my surgery that the Avodart could possibly prevent him from doing the job properly with a laser. Fortunately, I had only been on it for about three weeks. He said he would try the laser first, but if it wasn't working properly and giving him the result he wanted, he would then go right to the conventional method, no laser used. He said this is because Avodart shrinks the blood vessels in the prostate over time and it can prevent the laser from working the way it should. I agreed, telling him I really wanted the laser, but for him to be the judge and give me the best job he could give me no matter what he used. When I woke up, he said the Avodart did not prevent him from using the laser. I attribute this to only three weeks of taking it.
My results were excellent! Could not have asked for or anticipated a greater result, and I was pretty bad when I had it done. Those bladder cramps were the worst pain ever. Awful. I could not deal with that any longer. The recovery wasn't too bad. I'm told it's shorter than the conventional method by quite a bit.
How long depends on you. Oddly enough, no retrograde stuff and no ill-effects from the surgery, although before he did the operation he told me I would have the retrograde. He doesn't know yet, but I will mention it at my follow up appointment this month. I will post my discussion with him here. I still take one .4 Flomax by the way. He may or may not take me off that this month. After the surgery, he said, "We'll talk about that" later. Let me know if there is anything I left out or if you have any other questions. I would like to help people who might have the same concerns I had before my surgery.

[bob22312]

Thanks for your response. I am concerned because I may select a good practioner for the Laser only to find out he is rusty on the mechanical TURP and not the best or most practiced surgeon with Traditional TURPs. Is there any way to make that assessment before I commit to one technique or the other?
Thanks again

[mrcoyote]

In my opinion, no. The most important thing you can do is find a board certified urologist who has done lots and lots of both laser AND conventional TURP, otherwise known as roto-rooter. Then, no matter what he sees when he goes in there, he can give you the result you desire. You need to ask him how many laser TURPs he has done and how many conventional, and how often does he do them, etc. Make it like an interview, which it really is. I did with my doctor, and he told me, "I am on top of my game whether it's laser or not, early in the morning, or the last patient of the day". He was right. You don't want a urologist who doesn't do this all the time, every week of his practice. Right? Once you find this person, don't be afraid of the possibility that he will have to use the conventional method once he is in there. It's a highly successful treatment that is the "gold standard" in resections. Results are excellent
according to my urologist. Healing time longer, but who cares. You do what you have to do when it comes to your health, or at least that's my outlook on things. Laser requires no hospital stay, the other method does. But, wow, what a difference before and after the surgery. I may be mistaken, but I don't think there is any way a urologist can know for sure whether the Avodart is going to nix the laser until they get the laser in there and fire it a few times on the tissue to see if the tissue "reacts" the way he wants it to. At least, that's what my guy said. I can only go on that. Hope this helps you out.

[bob22312]

Thanks for your comments.