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Medical Forum / Diseases and Disorders / Prostate BPH / June 2005Two years since PVP
Had my 2 yr post PVP check up yesterday, as part of the Laserscope KTP (now green light) 80W laser study. Still have retro, and have resigned myself to that's the way it's going to be, but at 75 guess I should be happy just to be able to ejaculate, wherever it goes. Everything still working fine, flow rate, max 20.4 mL/sec, avg 14.2 mL/sec with a total volume of 365 mL. Pre PVP numbers were 6 mL/sec, 2.5 to 3 mL/sec and 175 mL respectively. Less than 25 mL retention., pre PVP 40 %. The only poor news is the prostate has grown to 49 gms., 75 gms before PVP. Was 33 gms 1 month after the PVP. Still get up only 1 night in 3 or 4 to urinate, before PVP 2 to 3 times a night. Rarely have an urgency to go, except when I forget to go before putting my hands in warm to hot water. Still can't figure that one out. While I was there I talked to the woman who is the research study administrator for McGuire Veterans Hospital, Richmond, VA. She told me that of the 32 people still in the study, most of them now more than one year post PVP, 27 are well pleased with the results and 5 were very displeased. Originally there were 70 in the study who had PVP done. About 55 were very pleased and 15 very displeased. She said this is only study in the 5 years she has been the research administrator, where most of the participants are at one end or the other of the spectrum, with none at or towards the middle. She said in most of the studies the people are spread over the entire range, with most in the range between somewhat pleased to somewhat displeased. Not sure how those numbers compare to this newsgroup, but seems to be in the ballpark. What amazes me is the fact that such a small number in the McGuire study could be so close to this group. Jack Jack, Thanks so much for the update. Glad to hear you're still doing so well. Mr. B > Had my 2 yr post PVP check up yesterday, as part of the Laserscope KTP > (now green light) 80W laser study. Still have retro, and have resigned [quoted text clipped - 26 lines] > > Jack > Had my 2 yr post PVP check up yesterday, as part of the Laserscope KTP (now > green light) 80W laser study. Still have retro, and have resigned myself to [quoted text clipped - 25 lines] > > Jack Jack, Congratulations on the success of your surgery! I have been following this group closely as I have suffered from BPH and its related symptoms for a few years. As my situation has gotten worse I have resigned myself to the need for treatment. The internet offers a great means of gathering information in order to make an informed decision, so I began my research on the web. While I have found the same general results in terms of quality of outcomes, I realize there are many factors that must be considered that could be hidden in these numbers. Here is a brief outline of my situation. Through medication and supplementation my prostate has shrunk by 1/3 in the past 8 months - from 108 g to 72 g measured by TRUS. I am now a candidate for PVP (i.e. I am below the 80 g threshhold that my urologist is comfortable dealing with. And, fortunately, there is no median lobe growth into the bladder. Furthermore, my urologist teaches the PVP procedure to other urologists, and, he is at UCLA, one of the leading medical centers for dealing with urological issues. I still suffer from significant post void retention. I am 56 years old and in generally good health. So, how would I fit into the results of the studies? I will not know until after the surgery, but my informed opinion is that I will be in the very satisfied group. My age, general good health, choice of an highly qualified urologist/surgeon who teaches the PVP procedure, size of prostate, and the lack of any median lobe protrusion into the bladder all point to a high likelihood of a very positive outcome. I may be wrong, but I would guess that those men who have not had satisfactory outcomes probably had one or more areas noted above that were not in their favor. Challenges with any one of these factors (health, age, prostate size, median lobe growth, skill of the surgeon, etc.) could potentially reduce the chance of a very positive outcome. Amd, if someone had challenges in more than one factor, then I would guess the probability of a negative outcome would increase. The bottom line is that we each need to dig a bit deeper than the surface statistics and try as best we can to determine if the factors that affect the outcome of a particular procedure weigh in our favor. Outlier48 "outlier48" <outlier48@earthlink.net> wrote in message > I have been following this group closely as My age, general good health, choice of an > highly qualified urologist/surgeon who teaches the PVP procedure, size > of prostate, and the lack of any median lobe protrusion into the > bladder all point to a high likelihood of a very positive outcome. Just curious, why should median lobe protusion into the bladder be contra to satisfactory outcome. Yes, it's my problem and I have my PVP next Wednesday 15th, but I haven't read of any problem with MLP other than almost certain retro, which is no big deal. (I have that anyway with Flomax) By the way I've just returned from a holiday in Crete and I was surprised to see an enormous billboard on the way to Chania airport, advertising 'Lazerline'. The advert was in Greek of course, but the photos of an initially sad, then delighted, middle aged man confirmed what the advert was for. I took it as a good omen ........... Huw > "outlier48" <outlier48@earthlink.net> wrote in message > I have been > following this group closely as My age, general good health, choice of an [quoted text clipped - 8 lines] > 15th, but I haven't read of any problem with MLP other than almost certain > retro, which is no big deal. (I have that anyway with Flomax) Hi Huw For you the retro is no big deal as it wasn't for me. But for many men it is a big deal, either their age, or the fact the want to be able to have children or maybe to them it's a loss of masculinity. Good luck next Wednesday, let us know how things went. Jack > For you the retro is no big deal as it wasn't for me. But for many men it > is a big deal, either their age, or the fact the want to be able to have > children or maybe to them it's a loss of masculinity. Good luck next > Wednesday, let us know how things went. A lot of the comments remind me of thirty years ago when vasectomies first became popular. I'm sure it's down to mental attitude rather than age - I'm 'only' 59. I can't remember whether I mentioned this in an earlier post but when I had my consultation for the PVP my Uro said that if you have retro when you take alpha-blockers (Flomax etc) then you will almost certainly have it after a PVP. He told me that I could expect retro but I feel that is a small price to pay if it enables me to stop daily self-catheterising and to come off Flomax. Thanks for wishing me well. Huw Huw, Good luck on Wednesday! I'm sure you'll be glad when it's over. Let us know how it went. Did you ask Mr Muir if he does a biopsy during the procedure to rule out cancer (as there is no tissue after pvp to test)? Do you know how many pvp's he's done now? The NHS wheels are still turning slowly for me but I may be following you later this year. Magna "Magna" <magna149@hotmail.com> wrote in message > Did you ask Mr Muir if he does a biopsy during the procedure to rule > out cancer (as there is no tissue after pvp to test)? Do you know how > many pvp's he's done now? The NHS wheels are still turning slowly for > me but I may be following you later this year. Thanks Magna. I didn't ask about biopsy, and he certainly didn't mention it. I'll try and remember when I see him. Perhaps it would be possible at an extra charge? He told me in April that he had done over 400 PVPs of which around 100 had been for similar retention problems to mine. I gave up on the NHS and raided my pension lump sum - I think it's worth paying to get a PVP! The NHS are great in emergencies but not so good for our sort of problem. In my area (Teesside) there are no plans to move on from the traditional TURP and like a lot of posters here, I didn't want to risk the possible side effects of impotence and incontinence. My local uro was very understanding and has asked me to return in September for tests to help with their own research into treatments. Thanks for the good wishes and all being well I will post about my experiences later in the week. Huw > Huw, > [quoted text clipped - 7 lines] > > Magna Which hospital are you going to? I am now scheduled for Friday July 1st at Newcastle's Freeman Hospital but have to check on June 30th that the bed is still available due to any emergency admissions. I first asked to be referred there about nine months ago. Derek. > Jack, > [quoted text clipped - 39 lines] > > Outlier48 Hi Outlier48, I like you waited until I got sick and tired of having to put up with my condition, The urgency to where I wanted to know every rest stop on I-95, 85 and 70. (the three routes I traveled most) Having to get up 2 to 3 times a night, and after doing my research decided that a PVP was the route to go for me. I had a large median lobe up into the bladder neck, and was told there was a 60 to 70% chance of retro before the surgery. But two uros told me it was 95 to 98% with a TURP. Being 73 at the at the time and my wife saying go for it, "hey for me no mess no fuss", I did. If your uro is Dr.Robert Reiter, as the saying goes your in good hands. I also understand that Dr. Jacob Raifer, also at UCLA, is no slouch either when it comes to the green light laser. Your list of challenges sure fits, but if you think about it, minus the specifics of the prostate, it would fit for just about any surgery. Good luck, but it sounds to me like you are in good hands yours and the uros. My advice is, when you say your quality of life stinks, then go for the PVP. I would say your chances of retro from what you said are less than 25% and even if you do have retro the chances are it will correct itself with 9 months. Jack |
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