Re: Which way to go?

Phil wrote:
Sorry, I've been away a few days. Re the cystoscopy, no I haven't had
one. I had a flow test, an ultrasound scan to measure retention (at
least I think that's what it was for) and the slightly embarrassing
but inevitable prostate anal examination. He was in and out in about
two seconds but if thats all it takes to conclude the prostate was
'small and flat' then so be it.

I forgot to mention that the consultant prescribed some meds for me;
Xatral (Alfuzosin hydrochloride). I felt they helped a little
(certainly in the first day or two). Having said that, when I told my
GP I was nearly out of them, he asked if I thought they were
benefiting me. Thinking about it, I told him I thought they did for a
few days but not much after that, so he said "well, see how it goes
and if you need to start them again let me know". Within two days of
stopping them I was having quite severe difficulty passing water
again; it took a huge effort of will to start and then not much came
out. So, I'm back on it again and things seem better - whether there's
any placebo effect going on here I have no idea.

Now, my understanding was that something like Alfuzosin relieves the
muscle of the prostate gland widening the urethra and so making it
easier to pass water. If there's nothing wrong with my prostate (small
and flat remember) then how come I feel better for taking the drug? I
suppose it could work to relax the muscle of the bladder neck too so
maybe thats the answer.

A few more questions while I'm at it: I know what a TURP is and PVP,
but I've see some people here talk about a TUIP and a TUMT. Can
someone tell me what these are please. Oh and finally, the risks of
retrograde ejaculation are pretty high from what I've read with a
TURP; is this also true with a PVP, and what about with a BNI?

From what I'm reading I figure I should ask for a cystoscopy before
giving any consent to an operation, but having said that, I guess if
something needs doing then it needs doing.

Thanks for all your comments btw, it all helps.


Phil...I will try to address some of your comments/questions below.

- First, I would absolutely ask for a cystoscopy before agreeing to any type
of surgery. I consider that a must. Is the consultant in the hospital that
you referred to a urologist, or just some king of generalist. He or she
doing a digital, and flow test, and a ultrasound for retention, is not
enough to warrant surgery IMO. Furthermore, I do not believe a urologist
would perform surgery on you without a cystoscopy being performed first.

- TUIP (Transurethral incision of the prostate) and BNI (bladder neck
incision) are basically the same thing. Don't forget you can always google
anything (TUIP, TURP, TUMT, PVP, etc) - it is usually best to start with
google first :-) . TUIP is kind of like cutting a couple of slices in a
large rubber band when it is stretched - imagine that, and how the slices
would create a relief mechanism (so to speak), and open things up. I
remember the old timer who did my TUIP in 1995 told me something like that,
and I thought it was a good analogy - lol .

- If the alpha blocker (Uroxatral) helps you, and you don't suffer side
effects, then you may want to just stay on them, and forgo the surgery (but
it may be better to get it over with and avoid the meds - that has been
discussed at length in here in the past - you must decide of course). I
don't know why they helped for a few days and then seemed to abate, but then
they helped again after you started them back again after quitting them.
They will relax the bladder neck muscle also, like you surmised.

- May I ask how old you are. I don't recall you telling us. Derek has
addressed some of your questions also. Please keep us informed as things
develop. I wouldn't worry about getting a TURP or TUIP if that is all you
can get.

Pete


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Relevant Pages

  • Re: Which way to go?
    ... I had a flow test, an ultrasound scan to measure retention (at ... A few more questions while I'm at it: I know what a TURP is and PVP, ... but I've see some people here talk about a TUIP and a TUMT. ... is not enough to warrant surgery IMO. ...
    (sci.med.prostate.bph)
  • Re: Heading for a TURP on Oct. 8
    ... My prostate is big so this TURP ... I've had retention episodes every year or so, ... Good luck with your surgery. ...
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  • Re: BPH
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  • Re: Heading for a TURP on Oct. 8
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    (sci.med.prostate.bph)
  • Re: 4 year 3 months post PVP and 2nd thoughts
    ... and the thus far successful open prostatectomy. ... surgery) that it is quite conceivable that 8-10 years later the ... Prostate will grow large enough again to require a re-do. ... plus another 10% due to the TURP not being done right the ...
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