I live in Las Vegas and PVP is not available here.  I had a TUNA in 2000
and a TUIP in 2002, neither one of which worked.  My uro does TURPs, but
he did not push me to have the TURP, saying he understood my reluctance,
but the Roto-Rooter was what he did.  I had a PVP done by Dr. Laub in
Santa Barbara on Oct. 14.  So far, I have not had the immediate relief
that I and Dr. Laub expected.  His routine for out of town patients is
to do the preliminary visit with him and the hospital pre-admits one day
and the procedure the next.  I talked to him on Mon. Oct. 13 and he did
a cystoscopy and an uroflow before he would commit to the procedure.
Obviously, I wanted to find out if he thought I was a candidate for the
PVP before we committed to it.  He looked at the reports from my uro and
listened to me talk and asked a number of questions.  He said that he
wanted to do the cystoscopy, because he wasn't sure that the lasers
would necessarily solve my problem.  He showed me on the TV screen
during the cysto where the blockage was and he said that he felt that
the PVP would be appropriate for my situation.  The main blockage was at
the bladder neck, and there was prostate tissue to be removed there as
well as the central part of the prostate.  He did say that he could not
guarantee that the problem was prostate, that it might be bladder as
well or alone.  After the PVP, he told me that my prostate, although
small, was very fibrous and tough and more difficult to vaporize than
some he had worked with.  The procedure took less than 30 minutes.  I
elected for general anaesthetic, which he prefers and I was glad,
because I had a spinal with the TUNA, and I will never willingly have a
spinal again.  My body was paralyzed from the waist down for almost 6
hours after the surgery and even though it may have been a mistake on
the part of the anaesthesiologist, it was a very bad experience which I
will not repeat except as an absolute last resort.  I was Dr. Laub's
first patient that day which meant I had to get to the hospital, Cottage
Hospital, at 5:00 am.  We stayed at the Best Western Motel which is
within walking distance of the hospital and Dr. Laub's office, which is
directly across the street from the hospital.  I was able to walk to and
from the hospital to our motel room with no problem.  I woke up from the
surgery at about 9:30 am and was moved to a hospital room shortly
thereafter.  The surgery was over just before 8:00 am and the nurse
removed the catheter before I was moved from the recovery area.  I first
tried to pee at about 11:00 and was not successful.  The nurse put in
another catheter which was in overnight.  Dr. Laub told me to remove the
catheter myself in the morning and come to see him around noon, which I
did.  The catheter was easy to remove and not even the least bit
uncomfortable.  I was able to pee, but with BPH type symptoms.  Dr. Laub
did an ultra-sound and said that I had quite a bit of retention, a
couple of cupfulls.  He gave me a prescription for Vioxxin and Cipro and
said to come back at about 3:30.  I did and he repeated the ultrasound
with better results.  He said my retention was still above normal, but
not bad.  He started me on Urecholine for the bladder and said to come
back in the morning at 8:30 since my wife and I were returning to Las
Vegas on Thursday.  I went back in the morning and we talked and he said
it was OK to go home, but to stop and stretch every couple of hours.  He
didn't need to say that, because I had to stop and pee almost every
hour.  The stops were due as much to a sense of urgency as to a full
bladder.  Although the trip was long and tiring, it was not painful and
I was pleased that what I felt was only slight discomfort.
 
At this point, I am experiencing BPH symptoms similar to before the PVP,
except that the sense of urgency is greater.  I have no pain and have
seen no blood since the day afer the procedure.  I am optimistic that
things will improve over the next few weeks.  Dr. Laub said not to lift
anything over 10 lbs. for two weeks.  I will report back after a couple
of weeks and let you know of my progress.  I was very impressed with Dr.
Laub.  I feel that he is caring and devoted to what he is doing.  I am
sure that other doctors in the Santa Barbara area will now learn the PVP
procedure, because Laserscope has authorized him to train doctors to do
the procedure.  He has done about 50 now.  I think I was number 49, so I
felt like he knew what he was doing.

I am more convinced than ever that each person's story is different and
there is no "one fits all" solution to the prostate problems which men
have.  I encourage all participants on this board to keep posting,
whether it be to talk about problems in general or report on procedures,
be it PVP, TUNA, TUIP, TURP, or whatever.  We don't want to be perceived
as a rooting section for PVP, even though it was my procedure of choice
and I still look on TURP as a last resort.

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