Routine Followup after PVP..what is usual practice?

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Chockman - 10 Apr 2005 16:46 GMT

Had PVP 2/23/05. Saw URO for followup at 2 weeks, 6 weeks, and now
scheduled for 2 months from the 6 week checkup. Wondering what has been
the experience of others in the PVP club as far as followup? Is there a
pattern when they want to redo the flow test, or other tests? How long
do you keep going back to the URO before they release you from further
appointments? Or is it a matter of doing checkups which are dependent
on the individual patient's condition and outcome?

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Rich256 - 10 Apr 2005 17:27 GMT

> Had PVP 2/23/05. Saw URO for followup at 2 weeks, 6 weeks, and now
> scheduled for 2 months from the 6 week checkup. Wondering what has been
[quoted text clipped - 3 lines]
> appointments? Or is it a matter of doing checkups which are dependent
> on the individual patient's condition and outcome?

Interesting to follow how you are doing. I am the one whose doctor
recommended trying TUMT first. I still wonder if I made the right decision
following his recommendations. Of course I can always do the PVP later.
Had it done 3/16. About a week ago I started to note some blood and tissue.
The blood has stopped again . I just had an appointment with the URO.
Still some retention but significant change was is expected until 6 to 12
weeks.

Previously I was getting up almost every hour to start with (e.g.: 12 p.m.,
1 a.m., 2 a.m.) and then about every two hours from then on (4 a.m. 6 a.m.).
Now it is about 2 hour intervals until about 3 a.m. and then sleep through
until 7. I consider that a vast improvement already.

Only comment on the TUMT procedure is that since you are wide awake through
the whole thing it is probably the most painful (and least dangerous?).
Fortunately a nurse called the night before and gave me a very detailed
explanation of exactly what would happen throughout the procedure. She said
I could expect bladder spasms and a sensation of heat during the procedure.
I had none of that. It was the preparation that was uncomfortable.
Particularly the injection of the pain deadening stuff into the prostate
via the rectum (the instrument felt about the diameter of a baseball bat!).
Then again it was certainly no worse than having a tooth pulled.

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Chockman - 10 Apr 2005 18:15 GMT

I find it fascinating that we can have the same procedure done in
dissimilar ways. I had a Prostatron 2.5 TUMT 7/2/04. What kind of
equipment was used on your TUMT? I was given Ativan to take one hr
before the procedure, along with Levaquin, & Ditropan. They put
lidocaine up the urethra prior to the cystoscopy and waited 15 minutes
for it to take effect. Uro came in and did the cysto and then put in
the TUMT device. Put a temp probe in the anus, but no pain medication
of any kind in the anus. Tell me more about what pain medication they
put in your anus and how they did it. I had a feeling of fullness and
need to urinate during the 30 min procedure, but no heat or pain. The
penis was cold to touch during the procedure. I had to self catherize
for the first week. Had the frequency and urgency for about a week til
things started to settle down. At 3 months my AUA score had decreased
from 21 to 10. Had another cysto 2/2/05 where we found the distal half
portion of the urethra will still mostly occluded. Uro said we would do
a bladder neck sparing PVP on 2/23, but when he got in there he had to
put a cut into the bladder neck at the 5 pm position. I never have
figured out why the difference between his findings on the first cysto
2/2 and the date of the PVP 2/23. As a result, at this point 6 weeks
after PVP I have retro. He doesn't know if it will resolve or not. I
achieved my main goal of getting off the Uroxatrol which was killing me.
I have even dc's the saw palmetto and seem to feel so much better. I
think that after 6 weeks I am beginning to see the light at the end of
the tunnel....Thanks for your response...chockman@canby.com

>>Had PVP 2/23/05. Saw URO for followup at 2 weeks, 6 weeks, and now
>>scheduled for 2 months from the 6 week checkup. Wondering what has been
[quoted text clipped - 26 lines]
> via the rectum (the instrument felt about the diameter of a baseball bat!).
> Then again it was certainly no worse than having a tooth pulled.

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Rich256 - 10 Apr 2005 20:05 GMT

The URO did the cystoscopy on my first visit. At that time he told me that
I was a candidate for either PVP or TUMT. He put something in the urethra
but I don't think that he waited 15 minutes. Kind of hard to say just what
they were doing when you are up in the stirrup!!

He told me he had done 30 PVP with excellent results but still recommended
trying the TUMT first (Maybe that is a financial thing for him - He owns the
TUMT equipment and perhaps the hospital owns the PVP).

I didn't think to ask what the medication was that was injected through the
anus.

I had the TARGIS Microwave Therapy.

Both Targis and Prostatron are made by Urologix.

http://www.urologix.com/html/aboutpros.htm

http://www.urologix.com/html/abouttargis.htm

I notice their site says the physician my use either an oral or local
medication.

They also had me take a Celebrex 200 mg 24 hours before the procedure and
one 2 hours before.

One Levaquin 2 hours before the procedure and another 24 hours after.

One Detrol for the next two days.

They also recommended taking two 220 mg Aleve every 12 hours for a week. I
did not need that.

I had a catheter for 5 days. No problem there but it sure stung when they
took it out. Seems it could be a bit smaller!! I don't think I really
needed it but got some good nights sleep while using it.

The nurse that called the night before said they had done 500 TUMT. In 80%
of those cases the patients said they would do it again. Only two said they
would never do it again.

The Urologix presents a slightly different picture:
http://www.urologix.com/uro_Targis.html

I see they recommend Prostatron for patients with bladder neck obstructions:
http://www.urologix.com/uro_Prostatron.html

I am in the Denver, Colorado area. I had previously been going to a URO who
offered only TUMT and TURP. After watching this site for a while I
concluded I wanted to have the option of PVP and switched doctors. The
first Dr was only 2 miles away and the new one is about 10. Not a big
difference. I suppose the main difference of what is offered is the
hospital they work out of. I expect that my local hospital does not have
PVP equipment and the one used by the new Dr. does.

Although I was "getting along", I am still relatively healty (age 75) and
decided I should have something done. I tried Flowmax with little effect.
Got past the dizzy stage but the muscle aches convinced me it was not good
for my body.

> I find it fascinating that we can have the same procedure done in
> dissimilar ways. I had a Prostatron 2.5 TUMT 7/2/04. What kind of
[quoted text clipped - 51 lines]
> > via the rectum (the instrument felt about the diameter of a baseball bat!).
> > Then again it was certainly no worse than having a tooth pulled.

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Bob Fritts - 12 Apr 2005 15:44 GMT

In my case, there was the next day removal of the catheter, a two week
followup and a scheduled 4 month followup. No flow test or other test,
just how am I doing, etc. I had ThermatRX TUMT 3 years ago, and the
recovery from TUMT was much more of a hassle than PVP.

My uro says that one of the most important reasons he prefers PVP is
that the patient gets better right away, but with TUMT the patient gets
worse first and better later.

I had some blood at initiation of urination, but it cleared up quickly
during flow and bleeding stopped entirely at about 20 days.

I am now at 1 month and just about to see if I have retro or not.

Age 68, 50 grams, no cancer.

Bob Fritts

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Chockman - 12 Apr 2005 17:58 GMT

I sure agree with you that recovery from TUMT is much more of a hassel
than recovery from PVP. I would also have to agree with many from this
newsgroup that the TUMT may be a relatively ineffective long term
alternative. At 7 weeks post PVP, things are going well with me except
for the retro. I am still optimistic that Spread deMocracy was right
and that things will resolve with the retro by 3 months. Interestingly
I had blood in the urine with the PVP only for the first 12 hrs; none
since. I find the urgency decreasing and things starting to settle
down. Am a satisfied customer.

Age 61, 35 grms. PSA at 6 weeks 1.7 which is similar to the last 5
PSAs. Off Uroxatral and saw palmetto; feeling so much more alive
without the alphablocker.

> In my case, there was the next day removal of the catheter, a two week
> followup and a scheduled 4 month followup. No flow test or other test,
[quoted text clipped - 13 lines]
>
> Bob Fritts

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