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Medical Forum / Diseases and Disorders / Prostate BPH / March 2005PVP, TUVP, or TUIP?
I have a small prostate with very reduced flow, and would like to compare treatment options. Mostly I've seen PVP discussed in this newsgroup. Is anyone doing TUVP (aka TUEP) or TUIP anymore? How do they compare to PVP? I read that PVP cooks to a depth of ~2 mm beyond what is vaporized. Doesn't that leave tissue to slough off? Does TUVP/TUEP have this problem? Thanks. Doug I also had a small prostate with very reduced flow. But I had a TURP (September of 2004). My doctor had performed this operation 2,000 times, so I went with his experience. No complaints. He did a good job. Phil >I have a small prostate with very reduced flow, and would like > to compare treatment options. Mostly I've seen PVP discussed [quoted text clipped - 10 lines] > > Doug >I also had a small prostate with very reduced flow. But I had a TURP >(September of 2004). My doctor had performed this operation 2,000 times, so >I went with his experience. No complaints. He did a good job. > >Phil My neighbour had a TURP recently and sings its praises. Nothing unusual there you may say. True, until you learn that he is 94 years old, >>I have a small prostate with very reduced flow, and would like >> to compare treatment options. Mostly I've seen PVP discussed [quoted text clipped - 10 lines] >> >> Doug >I also had a small prostate with very reduced flow. But I had a TURP >(September of 2004). My doctor had performed this operation 2,000 times, >so I went with his experience. No complaints. He did a good job. A friend of mine with whom I share prostate knowledge had one of those last year. He was going to the dunny about 6 times a night to pee not much at all. This was reduced, within a couple of weeks, to once or twice a night. He was very pleased. I waited to see what would happen. Yesterday he told me he is back to 4 times a night. In other words, while it has an immediate beneficial effect, it seems it doesn't last. > A friend of mine with whom I share prostate knowledge had one of those > last year. He was going to the dunny about 6 times a night to pee not much [quoted text clipped - 4 lines] > In other words, while it has an immediate beneficial effect, it seems it > doesn't last. Maybe in some cases but that can happen regardless of the procedure you have. I had a traditional TURP in 1998 which is still working just fine for me. Don in Tracy, Calif. That's great news! I keep reading the TURP is the "gold standard." I'm 46, and whichever procedure gets done, I only want to do it once. > I also had a small prostate with very reduced flow. But I had a TURP > (September of 2004). My doctor had performed this operation 2,000 times, so [quoted text clipped - 16 lines] > > > > Doug Hi Doug, I too have a small prostate. I was diagnosed with bladderneck hypertrophy and had a TUIP last September. The procedure took 20 minutes. I spent more time recovering from anesthesia. I had a catheter until the following morning when it came out. Very little pain- -great flow. It has worked out very well for me. Mike >I have a small prostate with very reduced flow, and would like >to compare treatment options. Mostly I've seen PVP discussed [quoted text clipped - 10 lines] > > Doug Best regards, Michael Berkowitz Mike, That's very encouraging. How did they diagnose it as bladderneck hypertropia? Did they give any idea as to how permanent the TUIP would be? Thanks. Doug > Hi Doug, > [quoted text clipped - 24 lines] > > Michael Berkowitz Doug, I tried medication but it either did not work or the side effects were too great. I was actually seen by two doctors because of doctor changes by the medical group. BPH was ruled out by both doctors. Diagnosis was based on: DRE Cystoscopy Flow Study/EMG DRE and Cystoscopy were OK. Flow study showed I had decreased flow. EMG indicated hyperactive muscle response (I am not sure which muscle group). The flow study showed my bladder was distended and my "full signal" kicked at 700cc's. I know I should have paid more attention to the details of his explanation but at that time I just wanted relief. I didn't ask him about a time frame and I wonder if he would be willing to offer an opinion about that. Everyone is so different. However he told me that performing the TUIP would not preclude me from having other procedures at a later time. I chose this option because he said it would offer me the best way to get maximum flow. He told me he would make 2 deep incisions and that as a result I had an 85% chance of retrograde ejaculation. My flow if great and I do not have retrograde ejaculation. Remember, as we are individuals, treatment results may vary. My uro. is well thought of in the Sacramento, CA area. Mike >Mike, > [quoted text clipped - 34 lines] >> >> Michael Berkowitz Best regards, Michael Berkowitz Thanks for the information Mike. It looks like I might not have to do anything right now after all. My uro diagnosed me with a prostate infection and put me on Cipro, Advil, and Flomax, and things seem to be getting better already. I may have to have something done in the future, but for now things look good. What a relief! > Doug, > [quoted text clipped - 68 lines] > > Michael Berkowitz Mike: Very little has been written here about TUIP for bladder neck hypertrophy, a procedure my URO is presently recommending. I was wondering if you could tell us a little more about your recovery. My URO said to expect to be catheterized for about 5 days. Does this mean 5 days off work? Can you tell us more about any pain you experienced during your recovery? Did you require medication for pain? Thanks so much... Nick I posted some info back in May 2002 about my TUIP. Bottom line - if I had it to do all over, I would do the PVP first. I have had a TUNA, TUIP, and a PVP, none of which worked. The PVP recovery was the easiest. Nick, This is not a topic normally discussed here. I am not sure why. Severity of symptoms must be a factor as to what procedure should be performed. Age may be a factor; I am 50. My Urologist did not go with any of the other procedures because cystoscopy showed my "pipe" was clear. DRE showed my prostate was normal sized. Also, the flow study/EMG showed that the bladderneck was the most likely culprit. I was concerned about it not being "enough" as was my PCP but when I discussed this with my urologist he made it clear that if this did not work, he would consider the other options. I am 6 months out and still going strong. It was the right choice for me. Remember, we are all different with different symptoms. Here is how it went for me: I had the surgery on September 13 in the afternoon. Went home around 5:00PM. Catheter came out the next morning; I pulled it out. Relief was almost immediate. Minimal pain, minimal bleeding. I used T3 for pain. Honestly my flow study caused me more pain than the TUIP did. I also used AZO tablets - one 95mg. 3x/day for two days. I did take it easy for a week or so. At about a month out, I thought I had made the wrong choice and that the procedure might not have worked as my flow would slow from time to time. When I discussed this with my urologist on a follow up visit he reminded me that it could take up to three months for swelling to diminish. He was right. Off and on the flow would slow but around December it got strong again and has stayed that way ever since. Five days seems like a long time to have the catheter in after a TUIP. I'll bet blood clotting factor has something to do with this. My urologist told me my two cuts would be deep because of the flow restriction. I still did not have a lot of bleeding after the catheter came out. I had some bleeding on and off for about three weeks but it was mostly clots. No pain when urinating. >Mike: > [quoted text clipped - 11 lines] > >Nick Best regards, Michael Berkowitz Mike: Thank you for your extensive and considered comments on your TUIP for bladder neck hypertrophy. I am about your age (54) so your comments are most helpful. With regard to catheter time, it sounds like my URO is being very cautious. I will have to return to his office to have the catheter removed, self removal was not offered as an option although I didn't mention it. Recovering from my flow test was very painful... I'm talking about "cry out" pain during urination for two days. The third day was painful as well, but bearable. T3s couldn't touch the pain. Without exaggeration, I had my appendix out will less post-op pain. Still on the topic of the flow test, following it my symptoms were much reduced. In the days following the test, my AUA symptom score dropped from 23 to 13. My URO is at a loss to explain this. For this reason my TUIP has been put on hold pending an increase in my AUA score. Nick Nick, Yes the Flow Study was way more painful than the TUIP! My pain also lasted for about 3 days. I actually tried to avoid urinating it hurt so much. My TUIP was a breeze compared to the Flow Study. Here's hoping things get better! Regards, Mike >Mike: > [quoted text clipped - 18 lines] > >Nick Best regards, Michael Berkowitz Mike: About post flow (urodynamic) test burning. Although it's hard to do when urination hurts so bad, I found that the best solution was to drink plenty of water. You have to empty more often, but the additional water seems to reduce/dilute the burning power of the urine. Nick Doug, just a thought...consider the post-op and rehab time as well. PVP is almost zap and leave. >I have a small prostate with very reduced flow, and would like > to compare treatment options. Mostly I've seen PVP discussed [quoted text clipped - 10 lines] > > Doug |
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