Turp

It has been suggested by my urologist that I get a TURP to relieve some aggravating symtoms with my prostate. What should I expect during the procedure? Anyone reporting complications? problems post procedure with ejaculation or erections? Need to know this stuff before going ahead with this. At this point I'm leaning against the advice.

You shouldn't have problems with erections. You may have retrograde ejaculation after the procedure and your semen volume may be reduced as a result of the procedure. As far as having sex is concerned, you should have normal erections and orgasms. The procedure is generally accomplished with a laser.

Other treatments are now becoming available which are less radical and less invasive than TURP, but reportedly just as effective. One such, PVP (Photo-selective vaporization of the prostate), utilizes lasers and has been favourably reported on. Ultrasound and microwave technologies are also being more widely used for dealing with prostate problems.

It would certainly be worth asking your urologist about alternatives to TURP. But because of the relative newness of these techniques, in some areas it might be hard to find facilities with the necessary equipment or medical personnel who have been trained in their use.

What Susie said is pretty much the facts. Retrograde ejaculation is a usual side effect of both a TURP and the laser trimming. Perhaps 90-95% of men will end up shooting blanks. This is not a big deal for most.

I had the "Evolve" laser procedure about 5 years ago. It was very effective in relieving my symptoms. I do have retrograde ejaculation, but this is not a totally bad thing - it is a lot neater ;o).

The learning curve for the laser procedures is very steep, so find a doctor who has done several dozen, at least.

If I were to need a redo, I will again opt for the laser procedure as it is almost totally painless and heals quickly. Now that being said, the conventional TURP is not a procedure to fear for most men. Hospitalization and healing are a bit slower, but this is a well-proven and time-tested approach to BPH. The less invasive procedures are more temporary and I am not a fan of "do over" surgery. Do it once and do it permanently.

Doc

Some of the information available on the net refers to nerve damage as possible collateral damage from the TURP, and it is perhaps this that is the most scary. I agree that firing blanks is not a big concern, but not firing is!!

Also, perhaps too much information can be a bad thing as you can end up focusing on an area of little concern rather than the big picture.

I agree about the experience of the medical team, but how can you realistically check this?

I'm wondering if a prostate massage would improve my symtoms. Never had one but maybe that's is why the problem has developed. Sure beats going to surgery in my mind and with a lot less complications. Now just to find an attentive medfet lady with prostate skills.

What exactly are your symptoms? In my previous post I was assuming that you had been diagnosed with BPH (benign enlargement of the prostate). The treatments I suggested would only be applicable to this condition.

If like me you have been having difficulty with urination, drugs such as Tamsulosin (Flomax) may certainly help. But I doubt whether you would obtain much benefit from a prostate message.

Trans Ureathral Resection, Prostate is an old surgical proceedure. Back in the 70's, I called on a Urologist who told me he averaged 3-5 TURP's a day, 5 days a week.

After you are "under", they insert a device which has whirling blades on it and it cuts through the ureathra into the prostate and reams out excess tissue. Post-op, there can be bleeding for some time and first-time urination, without the Foley in place, can be extreemly painful.

Now days, go for the Detrol-LA, Flomax type drugs. The only side effect I feel from these drugs is a dry mouth.

Trans Ureathral Resection, Prostate is an old surgical proceedure. Back in the 70's, I called on a Urologist who told me he averaged 3-5 TURP's a day, 5 days a week. After you are "under", they insert a device which has whirling blades on it and it cuts through the ureathra into the prostate and reams out excess tissue. Post-op, there can be bleeding for some time and first-time urination, without the Foley in place, can be extreemly painful. Now days, go for the Detrol-LA, Flomax type drugs. The only side effect I feel from these drugs is a dry mouth.

That's not how it is primarily done anymore.

Lasers are typically used to open the urethra, and the recuperation is faster and has much post-op less bleeding.

There is a list of possible side effects/adverse reactions to Flomax, which aren't necessarily a reason NOT to take it, but theey are listed here in the package insert about 1/2 to 2/3 of the way down--scroll.

http://www.accessdata.fda.gov/drugsatfda_docs/label/2005/020579s016lbl.pdf

I had a turp several years ago and no complications. Doctor skill is primary. No erection problems but no semen. Recovery was quick and unevenful.

Larryd9 is right, dr skill & good postop care is ESSENTIAL, because complications can and occasionally do occur, with lasting and unpleasant results. Consider carefully whether you really, really need a TURP and if something like Avodart can't accomplish the same thing; read the following for someone with BIG regrets about having one done:

I had a TURP 9/10, was ejected in 6 hours still unable to stand or walk from the spinal block (normal stay is 1-2 nites, see WebMD, mayoclinic.com, cedars-sinai.com and others for confirmation, research before you tackle a TURP)- catheter end wasn't secured correctly, needed antibiotic was missing from the discharge bag. All this at the start of a holiday weekend, I had nowhere to turn (except ER, and avg wait times in LA are 7-8 hours on a weekday, holiday meant I never would have been seen):THREE emergency returns in the first week, including the last one at 5 a.m. due to a massive UTI (2nd visit in 2 days for the same thing), unable to stand, severe lower back/flank pain, shaking violently and completely unable to piss anything but a trickle of blood. They left the catheter in for three weeks, it was to have been in place 4 days max. they kept fending me off for months and when I was finally seen by urology in FEBRUARY, shook their heads "Scarring of the urethra. Strictures, neuropathic pain. Can't understand it, no one involved did anything wrong at anytime!" Permanent pain,some loss of function, sex is generally avoided since the entire length of the urethra feels uncomfortable to painful, almost electrified - nerve pain due to the damage and trauma.Turns out the diagnosis was wrong to start with, Cedars Sinai just diagnosed the current, and original, problem as prostatitis causing swelling of the prostate and urinary retention.; BPH was mild, enlargement was normal for a middle-aged man, they shouldn't have operated was the verdict.

Take someone with you, even for a relatively minor procedure like this as a witness, foil, combatant if need be; it's been suggested that going alone was part of my downfall, the help felt confident that they wouldn't be challenged and that there wouldn't be a second set of eyes and ears to testify later.

Try meds first, get a second opinion and if they also recommend the procedure AND confirm the original diagnosis (I erred again, my second opinion was from another KP doctor who rubber-stamped the erroneous diagnosis of the first one, I should have gone out of network and paid out of pocket to get a third reading.)

Pros? You could urinate much more freely with little or no retention, retrograde ejaculation is a strange feeling but cleanup is a breeze since little or nothing makes it out, no more worrying about how far to the next men's room.

Cons: some risk of poor outcomes (see above); a percentage of men having TURPs are impotent afterward that weren't going into it; for me and several men I know that had this done, the feeling during sex is different, and less, than before we were operated on - instead of a sharp quake, more like a mild, prolonged temblor. Less pleasurable to a degree, very different; altho several co-workers said they'd heard of that but that their sensation and enjoyment were pretty much unchanged after.

End of rant.

Good luck.

Having had prostate cancer and prostate removal I can attest to the fact that dry orgasms can be just as intense as "normal" ones and even better - when you promise not to cum in her mouth - you can be totally secure.

TURP is considered the gold standard but you should also consider laser surgery. Since the laser cauterises the wounds recovery is much quicker. In all cases consider the skill of the surgeon. I have dry orgasms now but I find them quite satisfying.

Wow, this topic has been on the board for awhile! Anyway, after six months of unsuccessful use of fanesteride, a TURP was recommended. Since so much has already been said, I promise to be brief.

My only regret is that I didn't do it sooner, when it was obvious the fanesteride was useless. I don't know which TURP method was used, frankly. But who cares? It was like miracle surgery. My case was so bad at the end, I needed a catheter to pee. Now, as it's said, I piss like a race horse four years after the surgery. I was in the hospital overnight and released the next morning. Zero pain, so I guess I was lucky.

Yes, I have retrograde ejaculation (was amply warned about it), as everyone's saying, but everything else is perfect. My pee was pink for a few days, with little pieces of crud (which I was also told about). The absolutely worst thing about the whole ordeal was two weeks with a Foley, hooked to a leg bag. The day they removed it was like a new lease on life, and I nearly kissed the nurse who did it. God bless TURPS!

EnemaGuy 4344, I had a TURP 8 years ago and my experience with it was much the same as yours except that I didn't develop any problems with ejaculation. I was told by my family doctor that the success of it depends on the urologist performing the surgery. The one he sent me to had an excellent record of success with her patients suffering no lingering unpleasant side effects after the procedure.

Hi gboy. Thanks for your comments. That's great that you have normal ejaculatory fluid. I suppose, as you said, it depends on the skill of the surgeon. Aside from that, I had zero unpleasant side effects and would definitely recommend the procedure when warranted.

As stated before try all the meds before any surgery. I had good success with the Alpha Blockers for years. You can opt for a TUNA Trans Urethral Nerve Ablation, still not an easy procedure but recovery was fast. Your awake for it they do a nerve block to the prostate and its right in the doctors office. When its all done you go home with a foley in and there is some bleeding for a month or so. Worked wonders they say it only lasts about 10 years or so not sure yet on that its only been 2 years. The retro ejaculation was already a problem for me prior to it so can not comment on that aspect. The TUNA equipment is easier for the Doctor to use so so less chance of a screw up that is why I went with it and it does go fast.