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Medical Forum / Diseases and Disorders / Prostate BPH / December 2005PVP for prostates greater than 75 grms
Would be interested to hear from any members with glands greater that 75 grms who have had PVPs. I am not 100%, but I think mine was. Dr. David Laub commented that I had a large gland and the surgery was about one and half hours long. He also told me he could operate on one as large as 150. Hope this helps. >Would be interested to hear from any members with glands greater that 75 >grms who have had PVPs. I had a PVP on 11/08/2005. My prostate was estimated at 91 grams. I am still healing but the flow rate is much better. I still have some recurrent pain and burning before and after voiding, not always though. I have medicine for it but don't take it. I want to know what's going on without pain being masked with medication. I love caffeinated coffee and drink 1-2 alcoholic drinks several times per week so that I am sure is not helping. They suggest lots of water but it's winter and I don't like to drink cold water in the winter. All in all, I have been happy with the decision. I would absolutely not have had a TURP which was suggested by my former uro. I found an experienced uro in Waterbury, CT who had done 140 so switched to him. Just as an aside, he did 4 other guys the day he did me. I am 62 years old. I would recommend the procedure but don't believe Laserscope's BS about quick recovery. It takes about 3 to 6 months for things to get back to normal from what I have heard.  SignatureRealtor1 I am 72 and had a PVP in March. The only pain I had was the sting at the begining of urination. I took the pills and felt no pain. My uro said get back to normal asap. I drink several cups of coffee and do imbibe. Had it done on a Friday a.m., drove to a party on Saturday, and in the office on Monday. Back to normal activity except bike riding in two weeks, bike riding in four weeks. Chokman, just make sure your urologist has perfomed more than 100 procedures and is a firm believer in being aggressive with PVP and remove a lot of tissue. All the best. http://drgomezsancha2.blogspot.com Thank you, Dr., for your many positive comments on different thread here. What a firm believer you are!! My prostate size was 100gm and had pvp by Dr. Te on August. Because of my size, the procedure took 2++ hours and one night stay in the hospital. My experience was "no pain but gain." ( Of course some burning at the end of each urination for sereral weeks.) My peak flow is 30+ vs. 5 ml/s and mean flow is 16 vs. 5 less ml/s. My PSA is 1.9 (checked 4 weeks ago) vs. 4-6 for years. Right now there is no ANY BPH symptoms but retro vs. many symptoms. I am 50++. If PVP is not a guranty to some body, I think it could be their own other problems, e.g. bladder... but it is not BS for sure. >Chokman, just make sure your urologist has perfomed more than 100 >procedures and is a firm believer in being aggressive with PVP and >remove a lot of tissue. All the best. >http://drgomezsancha2.blogspot.com Hi, Pat. Dr. Te is in NY, right? Are you also from there? Do you think it would be practical (in view of possible complications days or weeks later) for out-of-state patients to go there for PVP? Also I have heard that air travel for post-PVP patients is not advised. (Don't know for how long.) I have heard that for big prostates, sometimes more than one probe is needed -- because those laser probes burn out after passing so much energy. Was yours a single-probe operation? Ed >Thank you, Dr., for your many positive comments on different thread here. >What a firm believer you are!! [quoted text clipped - 7 lines] >I am 50++. If PVP is not a guranty to some body, I think it could be their >own other problems, e.g. bladder... but it is not BS for sure. Pat, It seems that a two hour++ operation was probably good. I can deliver about 200.000 joules per hour, so you probably received between 350.000 and 450.000 joules. That seems quite right. The biggest amount of energy I used in one patient was 800.000, and he had a 200 gram prostate. PVP Laser fibres allow to deliver a maximum of 270.000 Joules, so your operation must have needed 2 fibres at least. Bad results of prostate surgery are not always the result of a bad operation, they can be due to a bad indication (the operation was not needed or not the right treatment for the patient's symptoms), a bad bladder (bladder overactivity), chronic prostatitis symptoms, coexistent urethral stricture and so on and so forth... Also results are subjective, I have seen patients who improve their flow, their symptoms, the times they wake up at night, but are unhappy with the results, maybe their expectations were too optimistic... All the best, Fernando Gómez Sancha http://drgomezsancha2.blogspot.com Thank you Dr. Sancha for your time and caring. Couldn't ask more!! Ed, I followed your posts in May and June. It seems that you have a 150 g prostate. To answer your question: yes, Dr. Te is in NYC and phone # is 212- 746-4811. Yes, it is pratical to visit a good doctor to get a very high percentage of success to cure a chronic illness, such as BPH. Usually, it needs four checkups, urodynamics, cyctoscop, ultrasound and biopsy, prior to scheduling a PVP. You may talk to the nurse to see if she can arrange those checkups within two weeks. If you have done biopsy in past 6 months, you may not need to do it again. You shuld ask your current uro to give you a whole copies of your records, then make one copy for yourself and bring one to the new uro. If you decide to come to NYC, you can make a reservation of an economic motel for week or so as long as there is a subway station nearby. It should be ok for air travel after pvp. I had a 7-hour fly 3.5 weeks after my August pvp. I enjoyed that trip very much mainly because my BPH has been cured 95% except retro, which is minor. Best wish to you. Ed, As to "in view of possible complications days or weeks later", in my point of view, chance of complication is very rare. PVP could not make thing worse whatsoever. Althugh Dr. request me to do follow-up in one week, one month, three months..., but I only went there after three weeks till now. When I left the hospital, I asked the nurse for one urinal. I can measure and monitor my urine flow by myself with a stop watch. Thanks for your comments, Pat. I suppose there could be bleeding or total retention some days or weeks after a PVP on a large prostate. If I am back here in Canada then, who would help me? Besides Dr Te, I think Dr Sancha would be able to do a very good job. I'm wondering about the pros and cons... cost is a factor since I would be paying. (I've never been to Madrid... there are pros and cons to that too!) My condition is under control and I can wait for now. Ed >Ed, As to "in view of possible complications days or weeks later", in my >point of view, chance of complication is very rare. PVP could not make thing >worse whatsoever. Althugh Dr. request me to do follow-up in one week, one >month, three months..., but I only went there after three weeks till now. >When I left the hospital, I asked the nurse for one urinal. I can measure >and monitor my urine flow by myself with a stop watch. Ed, in most cases posted in this NG, the successful rate is very high. Bleeding or retention were rare if the patient is in normal healthy condition. As to the cost, without the insurance the hospital FULL charge is very high. It's better to get an estimate from the hospital first and try to negociate a discount before heading for the procedure if the insurance is not covered. Going abroad may be an option too. Best wish to you. >Thanks for your comments, Pat. > [quoted text clipped - 17 lines] >>When I left the hospital, I asked the nurse for one urinal. I can measure >>and monitor my urine flow by myself with a stop watch. > Thanks for your comments, Pat. > [quoted text clipped - 6 lines] > would be paying. (I've never been to Madrid... there are pros and cons > to that too!) I can't believe you guys would fly all over the world to get a PVP :-) :-). Come on your kidding right. How many flights and hotel room rentals are you talking about (1st visit and tests, schedule PVP, follow visits). And no insurance coverage. You really got to be kidding. You all must be rich and have a loving wife to go with you - lol ..........Pete > My condition is under control and I can wait for now. > [quoted text clipped - 7 lines] >> the nurse for one urinal. I can measure and monitor my urine flow >> by myself with a stop watch. > Thank you Dr. Sancha for your time and caring. Couldn't ask more!! > [quoted text clipped - 21 lines] > been > cured 95% except retro, which is minor. Best wish to you. Patrick the original PVP poster on this NG reported that he flew from America to Japan quite soon after his PVP. Derek. "Derek F" <lordpilrig@NOXbtinternet.com> wrote in message > Patrick the original PVP poster on this NG reported that he flew from > America to Japan quite soon after his PVP. > Derek. Hi Derek, all, I flew to London for my PVP and flew back the next day. I can't see how flying in a modern 'plane could have any adverse affect. Huw I had my PVP done on November 17th at UCLA by Dr. Robert Reiter. Post operatively he told me that my prostate was 92 grams. He worked on me for over an hour and told my wife that he felt the operation was a complete success. I went into surgery at 9AM and left the hospital at 4PM with a Foley catheter inserted. My only discomfort was that damned thing! Per instructions I went back to UCLA the next morning where it was removed (I could have done it myself at home so I guess they just wanted to make sure I wasn't bleeding and could pee OK). I followed the good doctor's orders and took it easy for a week and then quietly enjoyed the Thanksgiving weekend. I went back to work the following Monday. I was working limited hours, generally about half days. I had no problems other than 2 minor bouts of bleeding, both of which ended as quickly as they began. They were from straining during bowl movements. I just increased my fibre intake and the straining and problem went away. I passed one substantial clot and several small ones. I saw Dr. Reiter yesterday. I did the standard flow test (max flow, average flow, duration, amount voided, etc.) and he was very please with the results. I am going to stay on Avodart for the time being. He did tell me that I had very large lateral lobes as opposed to a large medial lobe. I also have a bladder that is less than optimal in terms of muscular strength. We both knew this going in, so I was quite pleased with the results and the quick recovery. There are several highly qualified urologists who are quite expert in PVP, so size should not be an issue. Dr. Reiter does not like to do glands that are over 90 grams but clearly he has some play in that upper limit. I think his main issue is the time large glands take, the potential to have to use more than one tip to deliver the necessary energy to remove enough material to be effective, and the rediculously small reimbursement he gets from the insurance companies. Other urologists may not have to deal with the insurance issue and may be quite willing to handle larger glands. I hope this helps. outlier48 |
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