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Medical Forum / Diseases and Disorders / Prostate BPH / June 2006Green Light Laser Results
I am scheduled for a Green Light Laser procedure. There are threads here that reference PVP and I'm assuming that is the same procedure, but I'm not sure. I'm interested in hearing from those who have had the Green Light (Laserscope) procedure. How was the procedure? What were the results? What did you wish you knew before the procedure that you didn't know? Any information would be helpful. Thanks, > I am scheduled for a Green Light Laser procedure. There are threads here that > reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 4 lines] > > Thanks, Hey Jonhunt -- I have the post just below yours and you might review it if you have not already done so. I have a list of questions that I bounced off my U and may be of value to you also. 1. How many of the Laser surgeries has your U performed? 2. What can I expect when I urinate the first time and there after? 3. What to look for if there might be a problem? Give me some tips. 4. How much water to drink each day? 5. I had problems with the Phenazopyrid pill -(to reduce burning when urinating) it caused me to vomit in the hospital. 6. After hours help -- where do you go to get assistance? Is doctor available, etc. 7. How much exercise, walking, etc should I do immediately after surgery and the days there after? 8. What to do if you have the urge to urinate and cannot make it happen. 9. How to handle slow or non-existent bowel movements? 10. Can he take tissue from the prostate for a biopsy? 11. Expect some tissue, clots or ?? discharging when you urinate - check on this 12. Any restrictions on your diet? Anything to avoid? 13. Ask for a thorough explanation of the specifics of the surgery, i.e., how it is actually performed, the danger zones the U has to avoid, what your prostate looks like after he is finished, what size of opening is actually left after the laser. 14. Check on remarks I have seen on this site such as: "median lobe protrusion work", "bladder neck work", "sphincter muscle too close for laser", "catheter would reduce scarring", "PVP is not a trival operation as presented on Green LIght web site", "original space removed by the laser had shrunk to 1/2 size" -- and there may be more. 15. Why aren't all or nearly all the blood vessels sealed in the procedure and minimal bleeding is assured. (See my post for more on this) 16. Make sure the U checks for infection in your urine during follow up visit. These are some of the notes I made before, during and after my surgery. I feel that the U's experience in the laser is paramount to getting a successful procedure. If you do not like what you hear from him look around. Don't be in a hurry -- this can lay you up for several weeks or, perhaps, months. Good Luck -- hope to hear how this works out for you. Cool Otis...but I have been to over 75 doctors in my life (and don't like them) and IMHO there is no way a doctor (especially a damn uro - lol) will give you the time to talk about all the 16 items you mentioned. Just my opinion. Good questions though :-) ...Pete >> I am scheduled for a Green Light Laser procedure. There are threads >> here that reference PVP and I'm assuming that is the same procedure, [quoted text clipped - 50 lines] > several weeks or, perhaps, months. > Good Luck -- hope to hear how this works out for you. M...see how skeptical I am (but honest, and I always deal in reality most of the time). Remember Melissa, I usually don't say things unless I know what I am talking about, and there is no f.cking way a doctor will let you go through all those questions at one sitting. My comments to the post are at the top :-) ...Pete > Cool Otis...but I have been to over 75 doctors in my life (and don't > like them) and IMHO there is no way a doctor (especially a damn uro - [quoted text clipped - 55 lines] >> several weeks or, perhaps, months. >> Good Luck -- hope to hear how this works out for you. Oooooooooops...Sorry guys. I meant to forward this to someone, but it reinforces what I said :-) . I hate it when that happens :-) ...Pete > M...see how skeptical I am (but honest, and I always deal in reality > most of the time). Remember Melissa, I usually don't say things [quoted text clipped - 60 lines] >>> for several weeks or, perhaps, months. >>> Good Luck -- hope to hear how this works out for you. > I am scheduled for a Green Light Laser procedure. There are threads here that > reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 4 lines] > > Thanks, If you go back through the various threads you will find that there are big differences between the results. Every problem is not the same and perhaps more important every physician's technique is not the same. Important to find one with lots of experience (perhaps having done at least 100 PVP). There have been those that report almost immediate improvement and others with problems that last for days. I posted last month. Upset me because I had to miss breakfast that morning. Had absolutely no side effects. Had a catheter overnight. Removing that was not pleasant but not bad. That night I did have pain and trouble urinating but by the next morning I was at least back to where I had been before the procedure. Continuous improvement for the next three weeks. Only a few drops of blood for the few couple weeks. Overall quite pleased with the results. Rick, Thanks to you and Otis for your replies. I had read the entire threat that Otis began, but I was obviously hoping to hear more about successes, but Otis raises excellent questions to ask. I just had the Ultrasound and Biopsy and I have the laser scheduled for mid-July, but I wanted to learn as much as I could before I go back for my followup this Friday. At that time I will hit the MD with the list of questions. Jon >> I am scheduled for a Green Light Laser procedure. There are threads here that >> reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 18 lines] >next three weeks. Only a few drops of blood for the few couple weeks. >Overall quite pleased with the results. The majority of new posters to this group seem to be "Doubters" and appear not to trust their Uro's :-) A good Uro will take time to explain the procedure to you.and give you the information as it affects your condition. Others on this NG will have much different prostates and other health problems from you. I had my PVP in July of last year in a British NHS hospital where they had only done about 40 PVP's between the three Uro's and my one was the most junior guy and had done the least. I had a long session with him before he accepted me a suitable case as at that time they were being selective in the patients they accepted. I had a bit of an advantage over other patients as I had been reading of PVP's here from the time one of the first American patients posted his experiences. They knew that I fully understood the procedure and would be to give them good feedback for their patient database. A year later I am a bit disappointed with my flow. It is twice as good as before the procedure but I really expected that I would be able to piss over the garden fence :-) All my other symptoms have gone, No urgency, a long time between needing to void, no retro and gradually less disturbed nights. This was my posting a five days days after the procedure:- Derek. My BPH symptoms were first diagnosed in 1995 (I am now 70) when my prostate was 35g. Flow and residual tests at that time showed that I had retained 400 mls.and I was advised to have a TURP as a matter of urgency. After researching TURP I turned the offer down to wait for something better to come along. TUNA and TUMP did not really catch on with British urologists and were not readily available. My symptoms did not change all that much over the years but my prostate continued to grow to 72g . My PSA was 5.2 in 1995 and latterly swung between 6.5 and 9.0 and during this time I had three negative biopsies. My test results in September 2004 showed my first void as 339 mls with a QMAX flow of 11.7 mls/sec and a residual of 411 mls. I was asked to void again 30 minutes later and passed 309 mls this time at QMAX flow of 11.7 and now a residual of 371 mls. I had been using Saw Palmetto all this time and had only briefly tried Flowmax and Proscar which caused tachycardia and headaches. I read of PVP on it's first mention on this NG and it seemed to be what I had been waiting for but it was only about two years ago that it arrived in the UK at Kings College Hospital. The NHS waiting list soon became quite long there and last year the UK representative for Laserscope Mike Degun told me that the Freeman Hospital in Newcastle (North East England) had started doing the procedure. Newcastle is only about 110 miles away from Edinburgh where I live. I contacted them last October to find how long it would take to get an appointment and how long the waiting list was for the procedure. I was told that it was about three months for the initial appointment with the urologist and probably a further three months to get it done if accepted as a suitable patient. I liked the Newcastle way of doing things as they take the patient in on a Thursday for tests, do the procedure on the Friday and let them out on the Saturday. This seems much less stressful than being done at break of dawn and out on the street by lunchtime as Kings College and America do it. The urologist in Edinburgh agreed to refer me to Newcastle as an NHS patient and I had my outpatient appointment there with the Staff Urologist John Davies on January 9th. Mr Davies was very thorough doing all the tests himself rather than getting a urology nurse to do them. He was already very enthusiastic and committed to PVP. We spent about 25 minutes discussing its merits and the benefits of it over TURP. He said that only 25 procedures had so far been carried out at the hospital as they were only doing them on Fridays if an operating theatre was available. He had performed six by that time under supervision and would do mine. The rest had been done by the consultants Phil Powell and Mr Thorpe.I reckoned that by the time my procedure was done they would all be pretty good at it and Mike Degun had said that they were a 'Red hot team' It was confirmed that the waiting time was still three months but I might lose out a bit as the NHS area accountants have to agree to pay for their patients to be done in another Health Authority area. In early June I got June 30th as the magic admission day with the usual NHS proviso that you have to phone on the day to confirm that a bed is available. I phoned at 10 am and was told that Matron was still allocating beds and that they would call me back within two hours. I explained that I was coming from a distance by train and that I would need to get the 11 am train. They called back within five nail biting minutes to confirm that a bed was available and I arrived at the hospital by 1.30. A doctor was soon on the scene to examine me, take my medical history, do blood tests and send me to get an ECG (aka EKG). Soon John Davies was round to see me followed by the anaesthetist who did his own medical exam. I have hypertension and am Glucose Intolerant. He was concerned about my heart murmur and some conflicting information on the health summary my GP had supplied so I had to go for and Echo Cardiogram. He was happy with both sets of results and he discussed the anaesthetic options. I told him that this part was my only fear as an uncle with angina had arrested and died when undergoing an anaesthetic for a fairly routine operation and my mother previously a very sharp minded 82 year old had suffered cognitive dysfunctions after major surgery. We discussed epidural as an option but I was not too keen on that as I have twice had vaso-vagal syncope, once before an angiogram and the other time when having a tumour removed from my ear. Where my body is concerned I am one of the great world cowards:-) I went down to theatre the next day at 1.30 by now convinced that the excellent anaesthetist would not kill me! I came round about 4.00PM feeling a slight pain in my penis and what felt like the need to urinate, however that feeling was probably due to the catheter being in. John Davies came round to see me pleased with how the procedure had gone. He said that they started lasing at 1.53 and finished at 2.50. He said that the Median Lobe was not bad and that the Lateral Lobes had been my problem. He described them as looking like a floppy saggy bottom pressing against each side my bladder. He said that no bladder neck resection was needed and that Mr Powell tries to avoid that as it is the cause of retrograde ejaculation. John did the procedure and said that Phil had been there at the start when they had planned what to do and that Phil had popped in a couple of times from the next theatre to see how things were going and again before John had started on the Lateral Lobes. I had been give shots of two types of broad band penicillin during the procedure and a shot of morphine.I had every confidence in John who is a lovely guy, very enthusiastic in what he does and very caring. Soon I was drinking a cup of tea and waiting for dinner. I had no pain during the night and did not need any painkillers. I kept on drinking and watching the catheter bag fill up with a nice Red Wine, it needed to be emptied three times before the catheter was removed the next morning at seven. Now for the moment of truth by peeing on my own. I was drinking plenty (the nurse said too much) but it was not until 11.45 that I passed a red 100ml. John came in to see me (on his day off) and said that he would come back in the afternoon and that if I was voiding properly could go home.He suggested that I might be dehydrated but I did not think so from the volumes passed in the night. My wife had already checked out of her hotel as we had assumed that things would be OK. 1PM 250 ml pink. 2.30 150 ml pink and a scan showed a residue of 193 ml. 2.50PM 190 ml and much lighter but the scan showed 329 ml retained. John came back in and said that as I had a long journey he would be happier if stayed overnight. My wife went off to find another hotel as the Best Western had no vacancies for that night. 5.10PM 220 ml rosy but only due to the few drops of blood at the start. 8.05PM 150 ml retained 290 ml. 11.00PM 300 ml quickly followed by another 100 ml before bed. Woke up at 2.00 AM and passed 500 ml with a decent flow and another 300 ml at 3.45 AM. 7.00AM 300 ml followed by 100 ml at 7.30. but back to my usual slow rate ending in a weak dribble. Drinking a lot but no more until 10.30 200 ml. Passed another 250 ml at 11.30 but the scan showed 416 ml retained. We went for a walk to get some fresh air and missed John's visit (He had said that he would just phone the ward to check on me) He said that I could go and that when drinking normally at home things should settle down. He also gave me a three day course of Trimethoprim. I was restless the first night at home and kept on going and passed 1700 ml in small amounts all crystal clear.During the morning I passed a total of 1000 ml in five visits to the toilet. I felt 100% well and set off for a day at the local racecourse. Just like any normal day dodging around from the paddock to the bookies and climbing up the grandstand to get a good view. With the G8 riots going on in Edinburgh we had to take an indirect route. Our journey took 90 minutes using busses rather than the usual 40. Normally I get off the bus and go straight to the toilet but not yesterday. I had two large mugs of coffee and was getting worried that I had not needed yet and tried about 4.45 and probably passed only 200ml. I seem to get a period like that every day but the rest of the time my prostate symptoms are still the same, slow flow that goes down to a trickle and only about 200 ml. Last night was better waking up at 2.50 and 5.30 passing a total of 800 ml. I have not been drinking so much today to see what that does and results have been on the low slow side and I have been forgetting to record the volumes. Not worried yet, I am sure that things will gradually adjust. John Davies did say that my sense of urgency might remain, did he mean forever I forgot to ask! Derek. > Rick, > [quoted text clipped - 34 lines] >>next three weeks. Only a few drops of blood for the few couple weeks. >>Overall quite pleased with the results. > Rick, > [quoted text clipped - 28 lines] >> next three weeks. Only a few drops of blood for the few couple weeks. >> Overall quite pleased with the results. That is a very potent device that the doctor is using. I can well imagine it can easily burn holes where it should not. As Otis pointed out as well, it is all the more reason to find someone with experience. I feel the same way about TURP or any other operation. When cutting close to other organs you want to have lots of confidence in the surgeon. I had sinus surgery about 5 years ago. I did a lot of looking around to find someone I felt comfortable with cutting that close to my brain. Jon, Some additional comments. Most posters here have had good results with PVP, which is the same thing as green light laser. The biggest hangup seems to be retrograde ejaculation. Retro seems to be directly proportional to the success of the procedure. If the uro removes enough tissue from the bladder neck to actually relieve the BPH symptoms, you will probably have retro. If the uro attempts to "spare" the bladder neck in hopes of avoiding retro, you will probably be unhappy with the results and/or need a second procedure to get symptom relief. In other words, most guys with retro are happy, and most guys who don't mention retro (which I assume to mean that they don't have it) are unhappy. Retro doesn't seem to bother most of those who have it, though there are exceptions. If it is going to be a big factor for you, you need to decide how desperate you are for relief of BPH (which affects you all day every day), and weigh that against a change in your sexual experience (which, if you're as old as most of us, is once every week or two). Most guys consider it a fair tradeoff, but you have to decide that for yourself. What you shouldn't do is look at Laserscope's website and say "Oh, well, there's only a 15 to 20% chance of retro." Just assume you will have it, and then if you don't it will be a bonus. I had my PVP almost three months ago and despite a healing process that is dramatically longer than Laserscope would lead you to believe, I am extremely pleased. >I am scheduled for a Green Light Laser procedure. There are threads here >that [quoted text clipped - 8 lines] > > Thanks, This is the document given to patients at the UK hospital where I had my PVP Derek.. Directorate of Urology and Renal Services Undergoing photoselective vaporisation of the prostate gland This leaflet has been written to answer questions you may have about your operation. If you have any further questions it is very important that you speak to one of the urology team before your operation. Why is photoselective vaporisation of the prostate recommended Photoselective vaporisation of the prostate (PVP), also known as laser prostatectomy, is used to treat benign prostatic enlargement. A high powered laser is used to core out the prostate by vaporising the centre of the gland, leaving a wide channel and so relieving urinary symptoms caused by the enlargement of the prostate gland. What to expect during your pre operative consultation? As this is a new procedure within the department, a specific appointment will be arranged in order to provide you with information, to try to answer questions that you may have and to check that we have sufficient information about you. A lot of the necessary examinations may have already been carried out and therefore not require repeating. You may however be asked to: 1.. - complete a standardised questionnaire to grade your symptoms 1.. - undergo an examination of the prostate. This would entail both an examination with a gloved finger and possibly with an ultrasound probe to give the best estimate of the prostate size. 2.. - repeat a urine flow test 3.. - have a blood test (PSA) to check for prostate cancer. PSA (Prostate Specific Antigen) is a substance made by the prostate gland. Small amounts of PSA pass into the blood stream where its level can be measured. If this has been checked during the previous 12 months it may not need to be repeated. 4.. - you may choose not to undergo the PSA blood test and the ultrasound examination of the prostate and still undergo the PVP procedure so long as you are aware of the reasons behind our asking to carry out these tests. What preparation is needed? Prior to your admission to hospital you will be asked to attend the pre assessment clinic. Pre anaesthetic checks which may be carried out include blood tests, urine tests, heart tracing (ECG) and possibly a chest x-ray. A nurse will complete the relevant documentation giving you further opportunity to ask any questions you may have. As this is a new procedure you may be asked to fill in additional questionnaires or take place in research projects. This is entirely voluntary and will not in any way affect your planned surgery. Any information collected will form part of our ongoing audit and enable us to assess the effectiveness of this treatment over time. At the pre assessment clinic you will be asked about your current medication. We particularly need the details of medication that may affect bleeding. Aspirin may be continued, however if you take clopidogrel (Plavix) or warfarin the dose may need to be modified or the drug stopped for a period of time prior to your admission. You will come into hospital either the day before or the day of your operation and be seen by the nursing and medical staff on the ward. You will also be seen by the anaesthetist who will discuss with you the type of anaesthetic you will have. On the day of the operation you will be advised to have nothing to eat or drink for several hours prior to surgery, this is to enable safe anaesthesia. You will be asked to change into a hospital gown and be taken to the operating department on your ward bed or on a trolley. At several points, details (name, date of birth, etc) will be checked. How is the operation carried out? The operation itself takes approximately 45 minutes There is some additional preparation required and the time spent in the operating theatre suite is likely to be several hours. The first part of the operation is to give you an anaesthetic so that you won't be aware of anything whilst the operation is being performed. You may be completely asleep (general anaesthetic), or just the area involved made numb, and then a sedative may be given to help the time pass comfortably. Then you are taken into the theatre itself, moved onto the operating table and preparations are made to enable the operation to proceed. The bladder and prostate gland are accessed via the penis along the urethra (urinary passageway), and the operating instrument, the cystoscope, (sometimes referred to as a 'telescope'), is passed accompanied by sterile salt-water. The salt-water allows the urethra to dilate and provides a clear view. First an inspection is performed and then the size and shape of the prostate is rechecked by inserting a gloved finger into your anus (bottom). If there are no new or unexpected findings, then the laser fibre is introduced through the cystoscope and the procedure started. As the laser light is shone onto the prostate surface the prostate tissue can be seen to gradually disappear. When the surgeon is happy with the appearances, the need for a catheter (urinary drainage tube) to be passed via the urethra is considered. You will then be transferred from the operating table back onto your bed and the process of bringing you round from the anaesthetic begins. Time is spent in the recovery ward within the operating department before you return to the ward. What will happen after the operation is completed? You will wake up in the recovery area in your bed and when the nurses are happy with your condition a nurse from the ward will come to take you back to the ward. You will have a drip running into your arm or hand, this is to prevent dehydration until you are drinking. You will be given a drink when the nurse feels you are ready and able to tolerate it. You should be given a light meal soon after. You are likely to have a catheter to allow free drainage from the bladder. The catheter will be removed a few hours after surgery or the following day. The timing of the catheter removal will depend upon several factors, including the type of anaesthetic you have had, how well you recover from the anaesthetic and how much blood there is in the urine. You may go home once you are passing urine and emptying your bladder satisfactorily. What problems can occur? Before your planned surgery it is important that you understand what the surgery entails and the possible side effects. Effects on your sex life - Approximately 25% of men may experience retrograde ejaculation (semen going into the bladder) resulting in a 'dry orgasm'. If this occurs it may affect your ability to father children, but you cannot rely on this as a method of contraception. Some men report a change in sensation of orgasm. Urinary control- 7% of men experience mild discomfort of the urethra immediately after the operation. This usually lasts a few hours and painkillers can be given which will help ease these symptoms. 5% of men may have difficulty passing urine after the operation, this may result in a catheter being re inserted for a short period of time. Some of these men may then go home with the catheter in place and return as an outpatient to have the catheter removed Impaired erection- There have been no reported cases in men undergoing this procedure to date. As with any operation, other surgical complications can occur. These include infections, heart problems or deep vein thrombosis (blood clots in the legs). The risks of these will be discussed in the pre admission clinic and where necessary specific preventative measures will be taken. Are there any alternatives to this surgery? At the present time the standard operation performed for relieving symptoms caused by enlargement of the prostate gland is called transurethral resection of the prostate gland (TURP), when the enlarged prostate tissue is shaved away from the inside surface, again using cystoscopic instruments. Please refer to the leaflet 'Having a Prostatectomy'. As the PVP procedure is relatively new, it is not possible to predict the long-term outcome of this operation. However based on the currently available information it appears favourable and equivalent to TURP. What are the benefits? A shorter hospital stay. If a catheter is required following the surgery it can be removed within 24 hours. the risk of bleeding both during and after the operation is reduced. the risk of requiring a blood transfusion is minimised the surgery itself is less physically traumatic What can I do when I get home? Strenuous activity (e.g. digging, carrying heavy items) should be avoided for two weeks following your operation. Driving can be resumed after one week (some car insurance is not valid during the recovery period after an operation, it would be advisable to check with your insurance company). Sports such as golf or cycling may be resumed after two weeks. Avoid becoming constipated as straining may lead to bleeding from your prostate cavity. If necessary you can be given a mild laxative to take home after your procedure. Sexual activity may be resumed as soon as you feel ready. If you do not ejaculate, there may be some discolouration of the semen for some weeks. This is normal and soon settles. You may return to work when you feel fit which is usually between 2-7 days. Follow up You will be sent home with a letter for your GP and with any medication you need. A follow up appointment will be made for you 2-3 months after your operation. At this appointment you will be asked to provide a urinary flow rate test, so come with a full bladder if possible. You will also be asked to repeat the questionnaire you had completed prior to your surgery. Contact points If you have any problems following your discharge from hospital you may contact the ward you were on for advice. Alternatively you may contact your GP If the matter is urgent and you are unable to contact the hospital please contact the emergency medical services in the usual way. Further information and advice? More comprehensive information leaflets are also available from the department, and information is available on the Internet. The equipment manufacturer provides some information at http://www.laserscope.com. Please feel free to bring any information with you that you may have obtained from any source and we will try to answer any questions you may have. Finally In addition to the information that we ask for please do not hesitate to feed back any comments directly to the team involved. Produced by S. Burton, Matron & J. B. Davies Department of Urology Staff Grade Urologist Freeman Hospital Department of Urology Newcastle upon Tyne Freeman hospital Newcastle upon Tyne NE7 7DN 0191 2448822 Ext. 37137 September 2004 Review date September 2004 > I am scheduled for a Green Light Laser procedure. There are threads here that > reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 4 lines] > > Thanks, PVP refers to Prostate Vaporization Procedure using a laser. Could be done with a Holmium laser as well as green light. I had Holmium, which I think might be cooler than Green Light, but ask your doctor. Also, I had my PVP 11 months after seeds, whcih complicates recovery quite a bit. But I certainly do agree that in any case PVP is NOT a minor procedure with a quick recovery. I can urinate now (3 weeks out) but only with unbelievably agonizing pain that lasts 24/7 ... and the radiation had also f***** up my bowels, so I am a long ways from getting out of the woods. > I am scheduled for a Green Light Laser procedure. There are threads here that > reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 4 lines] > > Thanks, Greenlight travels through the irrigation fluid much better than the infrared rays emitted by Holmium lasers so I doubt Holmium is anywhere as good as Green for effecting vaporization even where the prostate size is relatively small. For bigger prostates, the Holmium is used like a hot wire cutter with a morcellator to remove the cuttings. The newer system just introduced by Laserscope will put Greenlight even further ahead of Holmium than before. I have early symptoms of BPH and I would choose Greenlight PVP over TURP or Holmium. > PVP refers to Prostate Vaporization Procedure using a laser. Could be > done with a Holmium laser as well as green light. I had Holmium, which [quoted text clipped - 15 lines] > > > > Thanks, > PVP refers to Prostate Vaporization Procedure using a laser. Could be > done with a Holmium laser as well as green light. I had Holmium, which [quoted text clipped - 15 lines] > > > > Thanks, > I am scheduled for a Green Light Laser procedure. There are threads here that > reference PVP and I'm assuming that is the same procedure, but I'm not sure. [quoted text clipped - 4 lines] > > Thanks, I had the Green Light procedure in November of 05. I am 74. Had BPH for 15 years with all of the usual symptoms. Up at night several times. Urgency during day. Never voiding entirely. Finally found Green Light on web. Searched for a physician who was experienced in the procedure. Found one who advised he had done dozens of Green Light procedures. After exam and testing to determine I was a proper candidate I reported to hospital a short time later. Procedure was done in one hour in afternoon. I spent the night in the hospital with a catheter. I was released the following afternoon once I was able to urinate without difficulty. Two days later I was driving and doing everything I normaly did. I was warned against lifting heavy objects for a couple of weeks and was told I would likely pass blood clots from the surgery. I did. No problem. In fact, I never had a problem from start to finish. The entire experience was without incident. Today I sleep the night through. Have no urgency during the day. Void nearly completely each time I urinate. My PSA is 2.5. Before Green Light it was in high 3's. I no longer take Flomax or any other medication. I don't have to search out men's rooms wherever I go. In a routine exam last week the doctor checked my bladder and found no obstructions or problems. Unless you have unusual physiological problems, the Green Light will change your life. It has mine. Bruce Ferguson >> I am scheduled for a Green Light Laser procedure. There are threads >> here that reference PVP and I'm assuming that is the same procedure, [quoted text clipped - 25 lines] > a routine exam last week the doctor checked my bladder and found no > obstructions or problems. Bruce...How did the doctor check your bladder for obstructions or problems. It sounds like you had a cystoscopy, which I don't consider a routine exam. Unless you meant an ultrasound, which is not very conclusive. Just curious :-) ...Pete Unless you have unusual physiological > problems, the Green Light will change your life. It has mine. Bruce > Ferguson Thanks to all for the very excellent information. >>> I am scheduled for a Green Light Laser procedure. There are threads >>> here that reference PVP and I'm assuming that is the same procedure, [quoted text clipped - 10 lines] >> problems, the Green Light will change your life. It has mine. Bruce >> Ferguson > >> I am scheduled for a Green Light Laser procedure. There are threads > >> here that reference PVP and I'm assuming that is the same procedure, [quoted text clipped - 34 lines] > > problems, the Green Light will change your life. It has mine. Bruce > > Ferguson Pete: Dr. Scott Ferguson of Harrison, Arkansas checked me out prior to procedure via cystoscope and ultrasound. He is a very thorough and dedicated man who will only use the Green Light on absolutely appropriate cases. I appreciated his thoroughness and would (and have) reccommend him to all who ask. >>>> I am scheduled for a Green Light Laser procedure. There are threads >>>> here that reference PVP and I'm assuming that is the same [quoted text clipped - 41 lines] > appropriate cases. I appreciated his thoroughness and would (and have) > reccommend him to all who ask. I understand that Bruce. But in your message above you said that in a routine exam that you had last week, he checked your bladder and found no obstructions or problems. So my question (which I thought was quite specific) is how did he do that in a routine exam without doing a cystoscopy. Pete >>>>> I am scheduled for a Green Light Laser procedure. There are threads >>>>> here that reference PVP and I'm assuming that is the same [quoted text clipped - 46 lines] > > Pete Pete, Slow down and read:-). He said the doctor used a cyctoscope. So I would take that to mean he did a cystoscopy!! >>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>> threads here that reference PVP and I'm assuming that is the same [quoted text clipped - 50 lines] > Pete, > In a routine exam last week the doctor checked my bladder and found no obstructions or problems > Slow down and read:-). > > He said the doctor used a cyctoscope. So I would take that to mean he > did a cystoscopy!! Rich...Damn it you guys are being stubborn. I am very good at reading. Here is what Bruce wrote - "In a* routine exam* last week the doctor checked my bladder and found no obstructions or problems". This is what prompted me to write my query - ie how could his doctor inspect the bladder (after the PVP, during a routine exam that he had two weeks ago) without doing a cystoscopy. I can't be much more specific than that, and I always write very specific (I hope you have been reading my posts long enough to realize that). He stated that he had the cystoscopy he talked about *before* he had the PVP (of course - duh! - everyone has a cystoscopy before any kind of prostate surgery like a TURP or PVP). I doubt very much that he had a cystoscopy when he had his routine exam a week ago. So therefore how did the doctor check his bladder during the routine exam after the PVP. Now how about you slowing down and read Rich :-) . Apparently I am the only one that notices glitches like this...Pete >>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>> threads here that reference PVP and I'm assuming that is the same [quoted text clipped - 72 lines] > > Apparently I am the only one that notices glitches like this...Pete OK, I see what you are saying. On the other hand I reported not long ago that my URO did a cystroscopy as part of a routine examination. That made two he did on me in less than six months. Not much of a deal. Took about 5 minutes for him. Nurse did most of the prep. >>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 77 lines] > That made two he did on me in less than six months. Not much of a > deal. Took about 5 minutes for him. Nurse did most of the prep. I understand that also Rich (although cysto's require pre-scheduling where I live - I have addressed this issue before in here). I don't think Bruce had a cysto for his routine exam a week ago, and that is why I asked what I did. I guess he didn't understand what I was asking. Forgive me for sounding like a picky fanatic, but I was curious regarding his statement. NBD. You and me are usually on the same page. Have a nice day :-) ...Pete >>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 85 lines] > his statement. NBD. You and me are usually on the same page. Have a nice > day :-) ...Pete Perhaps the Dr. usually will not do a cystro unless he thinks there might be something wrong or he plans to do something like a PVP within a few days. On the other hand if he is curious about what the problem might be, I don't see any reason not to do one except it is painful to the patient. The last one I am laying there squirming on the table and the Dr. is smiling and saying "We are through, you can breath again". Damn, it still hurt. Before we even started I asked him if there was anything he did that wasn't painful. He said "not much". Well, I found one that wasn't, PVP!! But obviously from other reports here, that can be a long term problem if something goes wrong. Burn too deep in the wrong place?? >>>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 22 lines] >> a routine exam last week the doctor checked my bladder and found no >> obstructions or problems. >>>>>>>>> finish. The entire experience was without incident. Today I >>>>>>>>> sleep the night through. Have no urgency during the day. Void [quoted text clipped - 76 lines] > other reports here, that can be a long term problem if something goes > wrong. Burn too deep in the wrong place?? Rich...I hate to be redundant, but Bruce said he had his PVP in November of 05, and apparently he had a routine follow up exam a week ago and he reported "In a routine exam last week the doctor checked my bladder and found no obstructions or problems". So I will repeat to Bruce - Are you going to tell us how the uro checked your bladder (a week ago during a routine follow up exam) and found no obstructions or problem. Did he do a cystoscopy or is he a soothsayer :-) ...Pete >>>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 97 lines] > PVP!! But obviously from other reports here, that can be a long term > problem if something goes wrong. Burn too deep in the wrong place?? Why do none of the dissatisfied guys ever sue ? America is supposed to be land of medical negligence law suits. Derek. >>>>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 102 lines] > to be land of medical negligence law suits. > Derek. Derek...don't get me going on suing, and I live in the U.S. I have written in here before on the subject. You can not sue a doctor (even in America - and the friggen lawyers are called ambulance chasers) unless he/she operates on the wrong side of your body, or leaves a scalpel in you. Of course that is an exaggeration (so easy on the rebuttals please), but that is it in a nutshell. In other words they have to do something serious, and blatant, and you have to suffer a provable loss. Don't ever forget that the rule of thumb for suing is that you usually have to have another doctor testify against the doctor you are suing, and that is difficult at best (ie the protect your own syndrome, just like the police, etc). A malpractice (contingency) lawyer will not take your case unless he feels he has a reasonable chance of winning so he can get his 40% or whatever. It's basically that simple. Malpractice insurance is a major problem in the medical arena as we have discussed in here several times in the past. Bottom line is it would be very difficult to sue a surgeon (ie a uro) for something like a PVP , IMHO of course :-) ...Pete >>>>>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 121 lines] > Bottom line is it would be very difficult to sue a surgeon (ie a uro) for > something like a PVP , IMHO of course :-) ...Pete Totally agree that it is the lawyers thing. May not be real easy to sue but some of the jury awards are outrageous. When doctors have to pay 200K a year it is not a trivial thing. That's over $500 for every day of the year that the Dr. has to charge just to pay his insurance. In 2004 the cost of Malpractice awards was $28.7 Billion! (as Casey would say "you can look it up"). That is about $100 medical cost to every individual in the U.S. Some awards are for more than $100 million! And remember 1/3 of that goes to the Lawyers. The number of cases are fewer than what they were 10 years ago but the awards are larger. Lawyers don't even want to bother with small cases such as injury by prostate operations when there are the ones where people are crippled - even though it was not the doctors fault. The doctor should have done something to get the expectant mother to get off drugs. A sympathetic jury will go the limit for the deformed baby. >>>>>>>>>>> I am scheduled for a Green Light Laser procedure. There are >>>>>>>>>>> threads here that reference PVP and I'm assuming that is the [quoted text clipped - 99 lines] > land of medical negligence law suits. > Derek. Not all that easy. Somehow negligence needs to be proved. However, a smart lawyer might get a jury trial and then be able to get a jury with the attitude "The insurance company can afford it". Many lawyers won't touch such a trial because it is so costly and probably of winning is so low. One nearby here a couple years ago they were going after GM for building a defective truck. The first witness testified the driver was drunk when he hit a power pole and the case went downhill from then on. The judge fined the lawyer. |
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