I had a TURP last June, 60 gm removed. It never healed properly: bleeding started again in November, and got really bad. The urologist said I had a very large prostate, and the passage he carved had collapsed. Had another TURP Feb 9: 40 gm this time. This seemed to go much better: bleeding stopped over first couple of weeks, urine went from rusty to generally clear except sometimes after a bowel movement I see a few drops of blood. Some urgency in urination, but good stream. Slight burning or squeezing sensation on ending urination. I have tried to be very gentle with myself to aid recovery, but have to do minor walking, lifting, driving etc. Urologist saw me a week or so ago, measured urine flow and bladder emptying as OK and doesn't want me back for 6 months.
The timing and descriptions for phases of TURP recovery you see in books and on the internet are all over the place, and I'm freaked after my last bad experience. Now at 7 weeks, I have passed what may be clots and /or scabs over the past few days after an urgent urination. Are the scabs the glossy dark red things that look like thin slices of liver? Is it normal to see them this late after the operation? The recovery from a TURP seems to last forever. How long can I expect to go before I heal fully, and am able to lead my active life again? Am I just suffering from the greater wound from more tissue removal? Anybody with helpful experience out there? It's a common operation, and you'd expect good quality info about what to expect, but I can't find it!
Everything sounds normal - it takes a while for the scabs to start and it lasts a week or so. Everyone heals differently and the time frame varies, but it will take 4 months for the recovery. Check out the scabs - there might be some stones in there, too. It does make you kind of nervous during this time, but it is normal. Now, this is your second time around so it might take a little longer to heal.
Thanks, Lennie. I'm seen your calm words in other postings, and I'm sure thay have helped a lot of other people as well as me.
If it wasn't my recovery, I'd have to say that the severity of my symptoms is at least decreasing with time, but as you've pointed out before, we have too much time to worry about what is happening to us! It's too intimate to be easily objective!
I'm getting myself prepared for the next two months before I can expect to be fully healed, but I think it may well be longer than that before I feel totally at ease.
Hope your situation is also improving, and thanks again for the info.
I was wondering if your doctor had you on Avodart and if so are you still on it. Now, that will shrink the prostate and will end your future worry. If you aren't taking avodart, I would ask your doctor - it sounds like the prostate size has a lot to do with your problems and you will need another TURP down the road if you don't stay on top of things. You should start seeing improvement very soon!
No, I'm not presently taking any medications for the prostate. I tried saw palmetto and flomax for a time, but they did nothing for my urine flow. I didn't want to wait the several months it seemed to take for Avodart to kick in. In fact, one reason for the Turp was to avoid lifelong medication: I'm only 61, and some of my friends have had side effects: they complain of loss of libido and breast tissue. My slightly older brother had the operation with no problems, and I underestimated the possibility of complications. Not quite the quick "in and out, problem solved" I anticipated!
Although the enlargement seems to be a family trait, I had a much larger prostate than my brother, and that seems to have put me in a riskier category. As an aside, one friend at my health club had his TURP about two weeks after me, and is already doing step aerobics! I think he's premature, but he's happy: he was self catheterising like crazy beforehand, and now he gets a good night's sleep.
My immediate objective now is to get over this op.: two more months of caution! I have appointments lined up to monitor my PSA (which came right down after the TURP) and urine flow. Once I'm back to normal, I'll make sure I discuss future strategy with my urologist: I understand a lot of things better now, and I'll have more time to do research and talk to more people. This board is a great source of information.
It sounds like you may have experience with Avodart. Without getting into intimate details, would you say it was effective for you or people you know without side effects?
I'm looking at your situation a little different. I look at the size of the prostate and then having surgery twice to correct something that nobody is controlling, which is the size of the prostate. You will have relief, but I would ask the big question - for how long? There is a very large factor that nobody addresses and that is scar tissue. I had to have a bladder neck incision because of the scars tissue after the TURP. And then there is the stricture issue which comes from this surgery. I took avodart for a while and my cousin has been on it for years. I had a bad reaction to it for a few days, but that is the only known drug that will reduce the size of the prostate and yes it does have a few side effects like low libido, but you have to do the research and see what you want in the future. You and I are the same age and I ended up with IC from being restricted too long, but I know a few guys who ended up with strictures from the surgery and you really don't want to go down that road. Read some older post and you have to make the decision - your doctor is clueless when it comes to this stuff. All he knows is what he is being told by his patients. They really don't know nor understand the mental and physical stress you are and will encounter. I'll give you my 2 cents worth and tell you what the doctors won't and you digest the information and call the shots. My big concern is the scar tissue from the surgery so that would be my first priority. Remember, Avodart eliminates the male hormone and will also not only reduce the chance of getting prostate cancer, but is the one drug that will eliminate the chance and kill any cancer cells that are present.
thanks for the info. You are quite right: no one was controlling my prostate size. My family doctor referred me to a urologist when my PSA started to increase, and PSA and the possibility of cancer was all that the specialist focussed on. I had a couple of negative biopsies, but seemed caught in a PSA/biopsy spiral, as the specialist had no real plan to deal with what was probably BPH. I even suggested a course of Proscar for six months as a diagnostic tool, to see if the pSA fell approriately, but was pooh-poohed. I did not realise the possibilities for complications involved with an enlarged prostate, and treated it just as a nuisance, until I had to go to emergency with acute urinary retention. At that hospital, I was referred to my present urologist, who suggested the TURP.
Anyway, that's the past and done. I have an appointment in five months to monitor flow and bladder emptying, and I'll raise the issue of scarring. I must admit I do not like the idea of permanent medication, but it may be possible to at least delay starting by a regular flow and maybe prostate ultrasound monitoring program. There may even be new advances in treatment to consider, and of course I now know a number of fellow sufferers to share ideas with.
I had a TURP early in March 2010. This is the middle of August and I am still occasionally passing blood clots and blood. I have been five times to the urologist and he says this is normal for some people. If I exercise it gets worse and I start to pass clots like you described. There has been blood in my urine ever since I had the operation. About 3/4 of the time is very light, but present. If I exercise it gets dark with clots. Like most others I requested the TURP which was a terrible mistake. I am worse now than before. The doctors says it will probably clear up in eight months?! This morning I passed a lot of bright red blood. Honestly I do not know what to do.
my first attempt to reply seemed to get lost in the aether, so I'll try again. Don't be puzzled if there are two responses from me today!
Blood in the urine is a real psychological downer, especially if youíve been healthy and active before the TURP. The sources all emphasize that even a small amount of blood can look fearsome, but itís still a concern, even if they say itís not a real health problem. I think urologists tend to discount patientís observations, for this reason.
My own last post concerned my recovery from a second TURP within a year: I had scabs and clots seven weeks after the op, but was expecting them somewhat earlier. In the event, that crop of blood/clots/scabs turned out to be the last visible manifestation of the healing process, maybe delayed because it was my second op. After that, my urine became clear, burning on urination disappeared, and I now (6 months post op) have a good, painless and blood free stream, and need to pee only once per night.
Your symptoms sound more like what I experienced after the first TURP (June 2009). I initially had a very large (100gm ) prostate, 60 gm removed. I stopped bleeding temporarily after about three months, but was never comfortable, and started bleeding again after I restarted my exercise class. My urologist told me this was normal healing, but I was so concerned I went to my family doctor, who asked the urologist to reassess. I was given a cystoscopy, and ultrasound and other tests for kidney disease/stones. Eventually, the surgeon decided the passage he had carved had collapsed, causing an area that was not smooth enough to heal. My second TURP removed 40 gm of tissue, and as I said above, seems to have solved the problem. Normally, the passage even in a large prostate would hold up for years, but I seem to have been unlucky. Good practice dictates that the minimum amount of tissue be removed during TURP, and sometimes it just doesnít work for long. I understand that in years gone by, 100gm of tissue would have been removed in one fell swoop via an abdominal incision, but the approach now is to minimise trauma, hence the TURP.
I was very careful to rest up after both ops. to avoid straining the wound. It sounds like you need the same follow up checks that I had given the length of time youíve been experiencing bleeding. Perhaps you can try for a second opinion, to rule out the possibility of other issues, and check the healing visually. Having said that, itís sometimes hard to get these specialists to slow down and really think hard about your problems: they are so busy, and generally patients do heal after a time. I was lucky to get my sympathetic family doctor involved, and also some advice from yet another urologist at the PSA clinic I attend (by the way, my elevated PSA has come down to normal levels post-TURP, which is good!).
Hope this helps: I was really down after the first op seemed not to have solved the problem, but there was a logical explanation, and the second op itself was not a big deal for me. Let me know if you need any other info, and good luck!
Thanks for your e-mail and helpful comments. It does ease my concerns. I have had microscopic blood in my urine since the operation probably 3/4 of the time, but it did clear up a few times. Then it starts to be visible again and sometime large clots and color. In thinking about what I have been doing it may be that I have been more active lately which is causing this. I think I will take it easy...which is hard to do....for a couple of week and see it things clear up some.
I do appreciate you taking the time to write. I also have parital renal fail with only about 35% use of my kidneys...so I wondered if my kidneys were the source of the blood... The urologist says no...so I will just wait. I have a creatinine test next month. Oh, I had Green light lazer before the Turp which did not work. The doctor said they were not doing many of them any more because of the poor results. Oh, my PSA went down also.
Brigham City, Utah