Thanks for your report.

How big was your prostate? What does your uro say?

Ed

before my pvp on August, I can tell the big difference if I miss Flomax for
one day.  After pvp, I took no medicine ever since and flow is great.  My
size was 100g with median lobe and took medicine for BPH for 6 years.  Your
situation is not common.  

Buford R.   Sorry to hear of the problems you are having.   By now you must
have had a follow-up Cystoscopy?  What did the doctor say?  Since PVP merely
burns a channel through the prostate, (and does not reduce the prostate),
size of prostate is almost irrelevant, in my opinion.  The urologist would
clearly see that he has successfully burned a channel right through to the
bladder muscle...and that would mean you should have no problem urinating.
So, I'd go see the urologist or, maybe to get a second opinion,  a different
urologist and determine the success of the "channel".   You should not need
to stay on FLOMAX.  If for some reason your prostate immediately collapsed
around the PVP channel and has immediately begun obstructing it, then you
may need to go for a prostate reduction procedure...TURP.   The prostate
tends to be somewhat stubborn to treat since it kinda acts like clay and
flows a bit after the surgery.   Doctors need to be largely surgeon but part
artist to get that right.  Wishing you all the best.

Burford... I'd strongly suggest you get yourself back to the urologist or
select a different one for a second opinion.

Pete did a good job in clearing up my comments.  So, I will build on Pete's
posting a wee bit more. Before I do there is one additional thought that was
not in my original response to you...if you waited too long to have the
operation you may have some bladder wall contraction issues. If the
urologist concludes that is the case, then you may need to use a catheter
for a very long period to let the walls come back to nearly their original
elasticity.   But read on. I have more to say associated to my original
post.

Certainly there is some prostate tissue that is broken down during a PVP.
Indeed, I pissed out chunks of tissue, some from urethra and some from
prostate, just like other PVP patients.   That was not the point I was
making.   The "R" in TURP stands for "Reduction", and my urologist was clear
to point out that the SIZE of my prostate was little affected since the PVP
is not intended to be a 'Reduction Procedure"...and he clearly stated the
procedure was more like burning a channel through, not grinding down or
reducing the size of the prostate.    As Pete points out, a PVP must have
cut done some of the urethra and prostate...and for me it was certain that
it did.  The point I tried to make, though, is a PVP is sufficient and
highly effective for many prostates, but not all since a PVP is going to do
less to the Prostate than a TURP does.    And, if you read about the
prostate, you will discover that the Prostate is more like a moldable lump
of clay than a solid structure like a chestnut, though it is typically
compared to the size of a chestnut.  The moldability is not something that
is discussed on this NG so I thought I would raise that as well.   Yours may
have flowed more than some others?   Regardless, the formability,
moldability, does add a further complication to the surgeon.   But for
whatever reason, it appears that your procedure was insufficient.   This
newsgroup will not be able to answer why, for your particular case.  It
could be that your sugeon was not skilled enough, the PVP may not have
removed SUFFICIENT Prostate tissue, or your prostate flowed back somewhat...
and maybe other reasons.  In your case you may need a better urologist;
another PVP;  the more aggressive TURP, (reduction procedure); or, there is
something more important going on that needs to be tended to right away.
Nonetheless, your follow-up Cystoscopy will tell most of the story or you
may need a biopsy.   If they find that the PVP was not successful, maybe
they need to try again.   Or, they may conclude that PVPs or TURPS won't
work for you.   Or, there is something uglier  going on.    But don't wait
any longer...GO GET A SECOND OPINION, RIGHT NOW!!!...or at least get your
original urologist to look inside, (Cytoscopy), RIGHT NOW, and see what the
heck is going on in there...  Here's wishing you well.

On Mon, 31 Oct 2005 03:34:19 GMT, "Buford R via MedKB.com" <u5432@uwe>
wrote: 'a raft of problems".

I, too, have urinary problems inherited from HDR Brachytherapy for
advanced Prostate Cancer,  performed in mid July this year. I had to
wear a Foley Catheter for almost 4 wks post discharge from hospital.
I'm on 1Flomax/day and still have probs voiding, from zero at night
(Nocturia) to about 80% at high noon, plus retain approx 250ml on a
post void Bladder scan.

Going into the HDRB, my prostate was 65cc and had previously had some
"easing" done 16 yrs ago by a General Surgeon. So, in essence, I got
Prostate Cancer on top of an old BPH complaint.

Just yesterday, I saw the Uro who did the HDRB implant and discussed
either another TURP or PVP. He opted for the TURP as he said it was
more reliable, the Gold Standard, easier to remove the correct amount
of tissue, and there were some problems showing up from the newer
Laser treatments.

Anyway, he won't do a thing until he has a look at another Cystoscopy
he scheduled for me in a few wks time.
He did comment that any re-sectioning would need to possibly wait
another 3 months for the tissue damaged by the HDRB to re-stabilize.

I'm not too confident on any of these things, but will have to "bite
the bullet" eventually dependent on his opinion/s....

Anyone else in here with a similar story?

PS: I do post more regularly in alt.support.cancer.prostate

 

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