PVP for PBNO

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Eric - 15 Oct 2003 23:09 GMT

Hi,

Does anyone know if PVP would be helpful for Primary Bladder Neck
Obstruction (PBNO)? This condition is caused by a over sensitive muscle at
the bladder neck. The muscle doesn't completely relax causing low urine flow
and dribbling. Does anyone know what would be the chances of retro after PVP
for a problem like this?

Thanks

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admin - 19 Oct 2003 10:04 GMT

Greetings,

> Does anyone know if PVP would be helpful for Primary Bladder Neck
> Obstruction (PBNO)? This condition is caused by a over sensitive muscle at
> the bladder neck. The muscle doesn't completely relax causing low urine flow
> and dribbling. Does anyone know what would be the chances of retro after PVP
> for a problem like this?

I have a problem which sounds similar to yours, I have BPH along with
problems urinating, with frequency (about 20+times a day) low flow
(about 50ml a time) and urgency.

I suffer with urgency incontinence also, meaning when I have the urge to
urinate, I have to go straight away, if I do not the pain increases to an
unbearable level and I start to dribble.

The Uro wanted to give me a BNI (bladder neck incision) or a TUIP (trans
urethral incision of the prostate) 4 years ago but after reviewing the
situation and talking to patients in the hospital, it was evident that the
operation can go wrong, with half the patients back for the second time,
another for the third, almost all of them had some problem with continence,
and retrograde ejaculation, one with impotency as well. Needless to say I
refused the op!

I have suffered for years with the problem rather than have the operation,
last year things got worse, I am still on Hytrin and now on Avodart along
with Saw Palmetto, I had been unable to go out anywhere without making sure
I could find a nearby toilet, or I had to refrain from drinking before or
whilst travelling.

I now use a urinary sheath and leg bag, which has given me back my freedom,
but is not ideal, I have been advised that the PVP is possibly suitable for
me because it will increase the diameter of the bladder neck at the
prostate, if the bladder sphincter muscle is cut as the Uro wishes to do, it
is NON reversible, the muscles are weakened and possible incontinence will
follow along with the other side effects, if the excess tissue is removed
from around the bladder neck, this will have the same effect of weakening
the muscle, or so I have been advised.

However, although the Uro says the PVP is a possibility, he will not
sanction the procedure to be carried out because he does not believe laser
surgery has any advantage over the conventional, he even goes so far to say
that laser surgery is inferior to the "knife".

I now await the result from my GP as to whether the local PCT will fund the
consultation to see if I am suitable for the operation and if they are
prepared to0 fund this as well.

Regards,

Peter

peteratNOSPAMhull-me.co.uk

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Eric - 19 Oct 2003 16:17 GMT

Sorry to hear about your discomfort. You indicated you've experienced this
problem for years. Do you know what the long-term results could be if you
don't have surgery performed (i.e. bladder or kidney problems)?

I'm currently on Flomax, which makes the condition bearable but still a
nuisance.

> However, although the Uro says the PVP is a possibility, he will not
> sanction the procedure to be carried out because he does not believe laser
> surgery has any advantage over the conventional, he even goes so far to say
> that laser surgery is inferior to the "knife".

Bummer about the outcome of PVP.

If you have the PVP procedure, please let me know how things go.

Best of luck.
Thanks
Eric

> Greetings,
>
[quoted text clipped - 51 lines]
>
> peteratNOSPAMhull-me.co.uk

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