"phillyg'...why are you having the biopsies - I hope it's not unnecessarily
(forgive the double negative).

Sometimes you have to take the board certified stuff with a grain of salt,
but it sounds like your uro may have flunked the test for whatever reason(s)

do with it.  I did a quick google and found this -
http://ezinearticles.com/?What-Does-It-Mean-If-A-Doctor-Is-Board-Certified?&id=80739

I would tend to want a board certified doc myself, but it doesn't mean that
a non certified doc can't be equally as competent.  Also as an aside, it
doesn't mean anything necessarily if one doc is a member of the AMA and
another isn't - but I think that's just a simple matter of paying the dues -
ie no test to pass.

I haven't had PVP (have had TUIP and TURP).  But I would go with the 100
procedure benchmark if I was you [and hopefully the guy will also be board
certified :-)].

I have commented in here before about stress incontinence after the TUIP
(after coughing etc)and increased dribbling in my bed at night after the
TURP.  If the uro is competent and doesn't cut the main external sphincter,
it shouldn't be a problem, although the internal sphincter at the bladder
neck can be compromised and result in retrograde ejaculation, etc (search
the ng and you will find a lot of talk about that - and just recently too).

The internal sphincter also is a backup valve for shutting off urine, and I
believe that is why I have my stress incontinence and dribbling (assuming
neither of the surgeons cut my external sphincter - which I don't believe
they did).  Our doctor Sancha in the ng has said incontinence is rarely a
problem assuming the external sphincter is not compromised.

I just wrote a little epistle in here about your health being the most
important thing (as compared to worries about retrograde).  If you are
having trouble voiding, and it is affecting your lifestyle, and making you
uncomfortable, I would have the PVP, and not be overly concerned about the
retrograde.  Of course that is your decision, but if it gets bad enough you
will have the surgery anyway, so I say why suffer.  Good luck, and let us
know what you decide later - it doesn't sound like you are in any hurry.

Pete

New here.  I've had BHP for years and its to the point that something needs
to be done.  Just had a cystocopy(sp) and my prostate is enlarged, but I
already knew that.  I've had three negative biopsies so far.  My doctor
recommends drugs or Greenlight.  I've already tried the alpha-blockers with
no meaningful improvement, although haven't tried the newer stuff.  I'm
inclined to go with the PVP but my concern with that is incontinence or
impotence after the procedure.  Any thoughts on that?

Secondly, my doctor is not yet a board-certified urologist, I guess since
he's only been in the business 12 years or so.  He does 2-3 PVPs a month.  I
saw the comment about 100 procedures as the benchmark to look for.  Methinks
he's a bit inexperienced to work on my plumbing since I'm only 57 and need to
use it, hopefully, for a long time.  Any thoughts on that?

Appreciate your comments.

Hello,
I agree with Pete's comments. Your problem will get worse and worse as
time goes on. The only question is whether to have the PVP done this year
or wait until the problem gets so bad that you will have no choice. I
believe that 12 years is enough time to have learned how to do a PVP
really well. If I was in your shoes, I would have the PVP done this year
instead of waiting until the problem gets worse. Your doctor will do a
great job.
Jason

Hi Phillyg,

Incontinence and impotence are not being reported by those who've had a
PVP. (Two important reasons that it's a superior procedure to TURP.)
Retrograde ejaculation, on the other, is a frequent side effect.  See
the current thread on that.

Bruce

"phillyg",  I just turned 57 and had the PVP done at UCLA by Dr. Reiter
last November.  I searched a long time to be certain I had found the
Uro I considered the best to do this surgery (yep, it is surgery but
its done with a laser and without making an incision).  Dr. Reiter does
many procedures so he was not pushing the PVP.  I strongly suggest that
you make absolutely certain that which ever doctor you choose is one
that you have complete confidence in for this procedure.  And, while my
results are generally better than what is touted on the Greenlight
website, I think they understate the incidence of retrograde
ejaculation.  That is the only negative side effect I have and I
decided going in that it was a risk I was willing to take.  Please do
your due diligence and find a Uro with enough experience for you to
trust to do a great job.  Good luck.

outlier48

Philly,
I've had two TUIP's plus a PVP.  I've had fair results from all three
procedures.  There were about 2 years between each procedure. The first was
98, the second 2000, the third 2004.  I first saw a urologist in 1991.  At
the time I was having problems with frequent urination especially during the
night and straining to urinate.  I tried Proscar, Hytrin, and Cardura.
Couldn't tolerate any.  All cause extreme fatigue.  I decided to delay
surgery until I had no choice.  When I had my first surgery in 1998, I was
having to strain to urinate 1-2 minutes sometimes wondering if I would be
able to.  I was up every 1-2 hours during the night.  I also would drink a
glass of water and have to urinate in ten minutes.  When I lied down to
sleep, I was up ever 20 minutes emptying my bladder.  The first TUIP by
laser eliminated the straining and urination from drinking a glass of water
also I could lie down and fall asleep without having to urinate every 20
minutes.and I was able to sleep 2-3 hours at a stretch.  In a couple of
years the excision grew together and the only symptom that reoccurred was
the sleep problem.  I could only sleep 2 hours at a stretch.  I had another
TUIP, but this time by scalpel instead of laser.  Results were about the
same.  I had the PVP done in 2004 since again I had trouble sleeping more
than a couple hours at a stretch.  The surgery resulted in improvement, but
not as dramatic as the previous TUIP's.  The problems that remain are I
sleep only 2-3 hours, but that is an improvement.  I also have the urge to
urinate shortly after drinking liquids.  In addition I often need two
urinations to empty my bladder.  This isn't much of a problem since I can
easily wait 1-2 minutes.  I had a cysto a month ago showing some blockage.
Apparently the PVP didn't get all the blocking tissue.  I say the screen
after my surgery and the hole was the size of a quarter.  Now it looks to be
about half that diameter.  My surgeon recommended waiting for a year or two
and then having a TURP.  I'm undecided between a TURP and another PVP.
   The advice I wish I had received is that delaying an operation may
result in less than ideal results.  Using drugs one always has to worry
about both near term and long term sideffects.  One has to weigh less
pleasing orgasms against the ability to urinate.  Everybody will decide
differently, but the longer you wait for surgery, the worse your results
will be.  This may be worth it to some, but I regret not having the surgery
in 91.