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  • When your BPH surgery fails

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    Old 03-27-2019, 09:08 PM   #1
    KimmeyG
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    When your BPH surgery fails

    Had Greenlight Laser surgery 2 weeks ago, and the results are depressing. Very poor urine flow, actually worse than before surgery. Had a catheter in for 5 days due to inability to urinate after the procedure. Flow still abysmal. Doctor is dismissive, claiming it takes time to heal. I say no way, things should be better by now. Any suggestions on how to proceed?

     
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    Old 03-28-2019, 01:38 PM   #2
    JohnR41
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    Re: When your BPH surgery fails

    Research I have done indicates recovery time is 4 to 6 weeks. But I don't know if that means urine flow will get better over that period of time.

    Healing time is not going to be the same for everyone because everyone is different. It depends on age and overall health status. Try to eat the healthiest diet possible and get moderate exercise. Drink plenty of water.

     
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    Old 06-22-2020, 12:52 PM   #3
    Mstrunn
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    Re: When your BPH surgery fails

    kimmey; I don't know if things got better but yes 2 weeks is not enough time to heal, you had surgery not a tooth extraction, if things did not clear up you should go with Bi-Polar TURP I had it 12 weeks ago and it went well, Green Light is good but is new only a 5 year guarantee, Turp has a 7-15 year guarantee, I hope things got better and yes, John is correct, drink, drink, drink!

     
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    Old 06-28-2020, 11:31 PM   #4
    guitarhillbilly
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    Re: When your BPH surgery fails

    Quote:
    Originally Posted by KimmeyG View Post
    Had Greenlight Laser surgery 2 weeks ago, and the results are depressing. Very poor urine flow, actually worse than before surgery. Had a catheter in for 5 days due to inability to urinate after the procedure. Flow still abysmal. Doctor is dismissive, claiming it takes time to heal. I say no way, things should be better by now. Any suggestions on how to proceed?
    Hope you heal up soon and get the flow you desire.
    If you need a second procedure I would recommend finding a UR that does the HoLEP Procedure and has done at least a 100 HoLep procedures. Most recent research data shows that HoLEP is the Best Method for treating BPH and Urinary Retention Issues.
    Not sure if another UR would do HoLEP behind another surgeon that has already done green light.

    Green Light Info:

    https://www.healthcheckup.com/general/green-light-laser-surgery-for-prostate-beneftis-and-side-effects/

    "Side-Effects Of Green Light Laser Surgery On The Prostate

    Despite the fact that the green light laser surgery is considered to be safe and minimally invasive, there are still some potential side-effects that happen within a small percentage of the patients. Each patient who is about to undergo green light laser surgery needs to be educated about the potential side-effects so that he will be able to notice them and ask for help in time.

    1. Incontinence
    Urinary incontinence is rare, but a potential side-effect. What happens is either a temporary or a permanent inability to control urination, and it results due to damage to the sphincter of the bladder. Note that this side-effect affects only about 0.05% of the patient, so there is not much that you should be worried about.

    2. Bleeding
    After the procedure, you might experience mild bleeding. Your urine will be colored dark due to the blood, and there might be some blood clots present. If the bleeding is more severe, you should contact your doctor right away.

    3. Pain
    Due to the catheter that is placed after the surgery, pain, burning sensations, and an urgency to urinate might be experienced. The same symptoms might go on after the catheter is removed. Usually, an over-the-counter painkiller helps with the pain and the other symptoms. If not, please contact your doctor right away.

    4. Retrograde Ejaculation
    One of the most common side-effects that occur within 80% of the patients is retrograde ejaculation. When you experience an orgasm, during the ejaculation, the semen will not be ejaculated through the penis, but rather in the bladder itself. Although this is not a life-threatening symptom, it does alternate with the possibility of you fathering a child in the future since this is a permanent side-effect.

    5. Urinary Infection
    Patients who have had a medical history of urinary infections and/or have been using a catheter before the procedure are exposed to the risk of urinary infection. The patient will have to use antibiotics to fight the urinary infection.

    6. Difficulty Urinating
    If during the procedure, scar tissue is formed on the prostate or on the tip of the penis, you might experience difficulties urinating. This will require further surgical procedures to fix the issue
    .
    7. No Relief To The Symptoms
    Unfortunate but true, in about 10% of the patient, no improvement of the symptoms is recognized after the procedure has been done.

    Conclusion

    As you can see, urinary infections, no relief to symptoms, bleeding, and difficulty urinating are some of the most common side-effects of green light laser surgery on the prostate. Your doctor will surely explain these side-effects as a part of your green light laser surgery post-op instructions, but it is good that we have covered them now so that you have your questions ready when you head to your doctor’s office."


    HoLEP


    "https://www.cambridgeurologypartnership.co.uk/urology-info-for-patients/prostate/holep-urolift/

    "HoLEP is one of the most extensively researched procedures for BPH. 16 HoLEP randomised trials (the highest quality of clinical trial) have been published up to Dec 2014. The clinical trials comparing it to the previous “gold standard” of TURP, consistently show advantages for HoLEP that include: Less bleeding, fewer blood transfusions, shorter time with a catheter in place after surgery, and shorter hospital stay (90% of men having HoLEP are able to leave the hospital without a catheter the day after surgery, and in some cases there is no need to stay in hospital overnight). Meta-analyses which are studies analysing the results of large numbers of randomised trials, suggest that HoLEP relieves urinary symptoms and improves urinary flow rates more effectively than all other endoscopic procedures for BPH. The average symptom score improvement after HoLEP is 70-80% and flow rate improvements of up to 600% have been reported. Recent studies have shown that HoLEP is extremely effective at treating men in urinary retention. 98% of men with catheters before surgery are freed from their catheter dependence after HoLEP. This compares to 70% with green light laser and TURP surgery. Unlike all other endoscopic procedures for BPH, HoLEP is suitable for men with any size prostate".

    Friends Let Friends Know About HoLEP.
    __________________
    T2a / Gleason Score 8 / PSA at Diagnosis 6.9 /
    1-5 aggressive score : 4
    12 cores= 4 positive
    NBS = Negative
    Pelvic CT= Negative
    Pelvic MRI= Negative
    Age at Diagnosis= 60-65 age group
    Completed 42 IMRT Sessions
    Lupron scheduled for 2 years

     
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    Old 06-28-2020, 11:56 PM   #5
    guitarhillbilly
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    Re: When your BPH surgery fails

    Quote:
    Originally Posted by KimmeyG View Post
    Had Greenlight Laser surgery 2 weeks ago, and the results are depressing. Very poor urine flow, actually worse than before surgery. Had a catheter in for 5 days due to inability to urinate after the procedure. Flow still abysmal. Doctor is dismissive, claiming it takes time to heal. I say no way, things should be better by now. Any suggestions on how to proceed?

    https://www.newyorkurologyspecialists.com/bph/greenlight-laser/recovery/

    "How Soon Can One Expect to See Improved Urine Stream after Greenlight Laser Prostatectomy?

    The urine stream is typically noticeably better as soon as the surgery is finished and the patient urinates on his own. Sometimes a urethral catheter is left in place for a few days after surgery. Typically, as soon as the catheter is removed a significantly improved urine stream will be evident."

    "Infrequently, patients may develop urethral stricture or bladder neck contracture. In these situations, the urine stream may become worse a few weeks to a few months after the procedure. If this occurs, re-evaluation is necessary."

    Please note that you can copy and paste the links I provide in my postings.
    In my opinion more information is better and allows one to make better informed decisions. Ultimately treatment decisions are up to You and your UR.
    __________________
    T2a / Gleason Score 8 / PSA at Diagnosis 6.9 /
    1-5 aggressive score : 4
    12 cores= 4 positive
    NBS = Negative
    Pelvic CT= Negative
    Pelvic MRI= Negative
    Age at Diagnosis= 60-65 age group
    Completed 42 IMRT Sessions
    Lupron scheduled for 2 years

     
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