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Medical Forum / Diseases and Disorders / Prostate BPH / December 20084 year 3 months post PVP and 2nd thoughts
I had a PVP July 31, 2003. I recovered quickly and have been functioning well. Prior to the PVP I was told that I had a large 150+ gram prostate. Since then a lot of other stuff has happened in my life that included a blood cancer unrelated to the PVP. The chemo used to treat the cancer left me impotent and depressed. I fixed that problem by using a Testosterone gel that I rubbed on my upper arms every morning for a year. This turned me into a happy muscular 68 year old stud. Recently my PSA jumped to 5. My urologist, Dr Shen (The famous doctor who sewed John Bobbet's penis back on him after his wife, Lorana cut it off), did a needle biopsy on my prostate this past week to look for cancer. While doing this he remarked that my prostate is fairly large at 121 grams and I should consider getting a TURP. I told him I would prefer another PVP. He said he does not do PVPs but has seen the messy results of prostates that have had PVP performed on them. He then showed me an image of my prostate on a screen. I could see a funnel shaped channel that was cut thru the prostate with a lot of meat still left between the side of the channel and the outer walls of the prostate. Dr Shen explained that a TURP would have cleared ALL that tissue out. The green light LASER PVP is touted as automatically stopping the burn once it hits the non-red wall of the prostate and able to clear out all the other tissue. To me, it looked like the doctor who did the PVP never got near the outer walls. Is it true that a PVP only cuts a funnel shaped channel as apposed to a TURP that gets it all? I'm still very happy with the results of my PVP. Last night I slept thru the night without getting up to pee. I'm off the testosterone pending the results of the biopsy. I have been off it for 9 days now and have not yet noticed a big drop in my libido or mood. Maybe I no longer need it. Dr Shen mentioned all the drugs I could take to shrink my prostate. I know of the side effects these drugs have and have recently started to take Pumpkin seed oil and Nettle Root extract in an attempt to prevent new prostate growth. These herbs were very effective when I was on Testosterone in turning off the sensitivity in my nipples that the Testosterone replacement was causing. When I told Dr Shen that I had been on testosterone replacement for a year he lifted my testicles and bounced them in his gloved hand to measure the heft and remarked that they were still very "meaty". I don't think mine ever shrank the way some do when on Testosterone replacement. Dave >I had a PVP July 31, 2003. I recovered quickly and have been functioning >well. Prior to the PVP I was told that I had a large 150+ gram prostate. [quoted text clipped - 13 lines] >between the side of the channel and the outer walls of the prostate. Dr >Shen explained that a TURP would have cleared ALL that tissue out. Hi, Dave. It seems that PVP can remove tissue differently depending on who does it and how aggressively it is applied. Someone else (can't remember who) on this NG talked about the very odd pattern that PVP carved into his prostate. But his results were good, and so are yours, and that should be the important thing, right? Well, what is also important is how long these procedures are effective before you have to have another one. And some say that TURP has better success there compared to PVP. But I don't think the statistics for PVP are well established yet. Good luck with the biopsy results. Ed > >I had a PVP July 31, 2003. I recovered quickly and have been functioning > >well. Prior to the PVP I was told that I had a large 150+ gram prostate. [quoted text clipped - 30 lines] > > Ed Ed, Dave: No need to recount my experience with PVP except in the sense that after I had the anesthesia and had me prepped for PVP they decided my Prostate was too large (at 158 grams) to do the PVP to address my BPH and AUR. Key word there being after I was on the table. Ed will recall I then had open surgery a few weeks later for a (thankfully) benign retropubic prostatectomy (4 days in hospital--that was 2 months ago; feeling/urinating quite well). All of that was a prelude to my confusion about "regrowth" of the Protate and/or the need (or absence of need) for "redos" years later. I raised that issue with the uro/surgeon who did both the abortive PVP and the thus far successful open prostatectomy. When I asked him will the Prostate (I still have "remnants" of the gland) regrow necessitating more surgery, he looked at me, almost laughed and said "yes we'll need to do this again in about 30 years" (I am 63 years old, the uro is older and we both smiled HOPING we're around in 30 years). Yet I've seen indications on this MB (at least regarding PVP or TURP surgery) that it is quite conceivable that (e.g.) 8-10 years later the Prostate will grow large enough again to require a re-do. Can someone(s)--probably Ed!!--clarify these issues for me? Although there are far worse surgeries in the world, I would not be anxious to have my benign protatectomy done again...ever!!! Thanks. Stay/be well. >> >I had a PVP July 31, 2003. I recovered quickly and have been >> >functioning [quoted text clipped - 73 lines] > > Thanks. Stay/be well. Michael, Yikes, an open prostatectomy!!! I'm glad you lived thru it and are doing well. I had a very similar experience to you. During my first attempt at having PVP performed on me, the doctor left the tent that my knee were holding up and stood near my head. He also said my prostate is too big and I should come back and have an open prostatectomy. He then described the procedure and warned me of the risks that included death, incontinence, and impotence. I found another doctor (Dr Lin) who did it with a PVP. I think a big part of the problem is the time it takes the doctor to do the procedure. A PVP is a slow burn and it could take the doctor hours on his feet to burn away 150+ grams. He could do three smaller ones in that same time. $$$ An open prostatectomy is faster. It's hell on you, but easier on the doctor. I hope I'm wrong but that was my take. Another doctor wants to do a TURP on me now because my prostate is 130 grams. I only get up once per night if that often. When it becomes a real nuisance, I'll go back to Dr. Lin for another PVP, if he is still around. The results of my biopsy came back today. I do not have prostate cancer, just a little infection that drove up my PSA. Dave >All of that was a prelude to my confusion about "regrowth" of the >Protate and/or the need (or absence of need) for "redos" years later. [quoted text clipped - 15 lines] > >Thanks. Stay/be well. Michael, I have heard different statistics about this. ...And forgotten them all. Thankfully there is Google. According to http://www.revolutionhealth.com/forums/prostate/prostate-gland-enlargement/2037, 5% of TURP patients will need a repeat in 5 years due to prostate regrowth, plus another 10% due to the TURP not being done right the first time. In http://tinyurl.com/ywqet3 it says that there is a 6.6% repeat rate for TURPs, and 3.3% for open prostatectomy. My own uro told me something like a 15% repeat rate at 10 years for TURP... not sure if my memory is accurate, though. Ed > >All of that was a prelude to my confusion about "regrowth" of the > >Protate and/or the need (or absence of need) for "redos" years later. [quoted text clipped - 29 lines] > > Ed Ed, Dave Thanks as usual for the feedback. I will hit Google after today's Eagles loss, I mean game. Dave I'm sorry you went through what I went through but congratulations on the thing that matters most: no cancer!!! I have no doubt that "time" factors in to the doc's decision not to do PVP on a large prostate, but they explained it (in part to me) that me prostate in addition to being 158 grams, was wrapped around my bladder in a very unusual/intertwined way (as they discovered when I was on the table for the aborted PVP. The docs (after I almost passed out from this "news") said these complications (size, other organs, etc.) are more appropriately addressed with open surgery. Let's hope they were correct!!!!! And Ed I'll take the 3.3% open surgery regrowth probability at my age!!! Honor our Veterans (it's 11/11) >> >I had a PVP July 31, 2003. I recovered quickly and have been >> >functioning [quoted text clipped - 73 lines] > > Thanks. Stay/be well. I'm happy to report that my Biopsy report was negative. There was not any cancer discovered in my prostate but some infection was seen that explains the rise in my PSA. Now my ejaculate is deep dark red like old blood. Gross! I guess this is normal after a biopsy. I'll be glad when this clears up. Also my urine stream slowed after the biopsy. I was told this is normal and will soon return to normal. I'm sleeping thru the night now so things are OK. Dave >No need to recount my experience with PVP except in the sense that >after I had the anesthesia and had me prepped for PVP they decided my [quoted text clipped - 24 lines] > >Thanks. Stay/be well. Does a prostatectomy leave one impotent? .> > Does a prostatectomy leave one impotent? It can, but not normally. It depends on how its done and the skill of the surgeon and the luck of the draw. You have a lot more reading to do! An open prostatectomy is very risky and current thought seems to be that a PVP is the least dangerous. Don't take my word on this Read more opinions in this NG. Talk to several doctors. Use Google. Ultimately decide for yourself what you think is the best way to go. A few years ago I was planning my life around the bath room. I was peeing tiny amounts and very frequently. I would need to get up DURING sex and pee, lose my erection and try to start over again. This was horrible! Now I sleep thru the night and consider myself a 68 year old stud. I had a PVP. Good luck, Dave
On Mon, 05 Nov 2007 13:50:34 -0800, Michael <Temprock@hotmail.com> wrote: >> >I had a PVP July 31, 2003. I recovered quickly and have been functioning >> >well. Prior to the PVP I was told that I had a large 150+ gram prostate. [quoted text clipped - 61 lines] > >Thanks. Stay/be well. Hi, Michael. Two months ago? I thought it was more than a year ago. As far as I have heard, an open prostatectomy gives the best results -- better peeing, less chance that it will need to be redone. The downside is that it is the most severe of the operations and recovery time is longer. More pain, more gain. You are over the recovery, so should be okay for quite a while. Do you have any residual effects from the operation? Incontinence? Hospital bugs? Ed > …On Mon, 05 Nov 2007 13:50:34 -0800, Michael <Temprock@hotmail.com> > wrote: [quoted text clipped - 77 lines] > > Ed Don't forget that some of the 'choice' rests with what the care managers at the insurance company will encourage or approve. ...larry Can you explain these terms - I'm not familiar with them. Is one of them complete prostate removal due to positive needle biopsy? PVP = photo-selective vaporization of the prostate TURP = trans urethral resection of the prostate. Both are used to treat BPH. You will find more information about PVP at laserscope.com. The American Urological Association has quite a lot on information on their site about the various methods of treating BPH from watchful waiting to TURP. Very informative. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cf m?sub=bph > Can you explain these terms - I'm not familiar with them. > > Is one of them complete prostate removal due to positive needle > biopsy? > Can you explain these terms - I'm not familiar with them. > > Is one of them complete prostate removal due to positive needle > biopsy? PVP stands for photoselective vaporization of the prostate. I find it difficult to get detailed information about the equipment that is used. To the best of my knowledge a neodymium laser (infrared) is frequency doubled to produce green light. This green light is absorbed by hemoglobin which is red. As a consequence prostate tissue id destroyed. Look up TURP using Wikipedia or Google. Bill  SignaturePrivate Profit; Public Poop! Avoid collateral windfall! > In article <talqk45p49343j1ndp8q48lk9r36e70...@4ax.com>, > [quoted text clipped - 15 lines] > -- > Private Profit; Public Poop! Avoid collateral windfall! Dr. Sancha has some interesting videos of the procedure: http://drgomezsancha2.blogspot.com/ One of his videos on youtube: http://www.youtube.com/watch?v=wKrKWfy3sjU |
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