Thanks for taking the time to report to the group! This is valuable
for those of us considering surgery.

Ed

on 6/23/2008 4:19 AM Robert W said the following:

Thanks for the report. Sounds intriguing.

THANKS. Please, keep us posted as to your continued improvement,
especially sexual performance. I remain abstinent as to having/taking
any form of surgery or drugs.
Have not thrown in the towel YET.
Ramón

Robert W.

Thanks very much for the full report on your surgery. It was very helpful in
my recovery from TURP about a month ago.
I'm now experiencing some form of a mass accumulation in the scrotum near
the left testicle. It's a little painful (slight ache) something like stone
aches of teenage years. The Uro (by phone) seems to think it may be
hydrocele testis. I need to have him do a direct examination next. Just
wonder if it could have been caused by retrograde ejaculation into the
scrotum.??

I have learned and benefited greatly from reading the posts on this
group. I promised myself that I would give back by posting after I had
my operation. It has been almost 5 weeks since my GreenLight surgery.
Be tolerant, I’m never posted before.

Situation: I am a 61-year-old married male who has had almost all the
symptoms for LUTS (Lower Urinary Tract Symptoms) or BPH (benign
prostatic hyperplasia). I sounded like a TV commercial for medication—
urgency, frequent urination, poor urine stream, etc.

What I tried:  I was first scoped (cystoscopy) by a Kaiser urologist
when I was about 40. The urologist said that the median lobe of the
prostate was enlarged and pushing on the urethra. He tried expanding
the bladder neck by a balloon. The whole experience was not good and
the balloon dilation did not work. A few years later I got a new
insurance (Blue Cross/Blue Shield) and a new urologist. Over the next
15 years or so, I tried a number of conventional treatments including
Alpha blockers (Hytrin, Flomax, and Uroxatral) and Proscar. I tried
herbs like Saw palmetto. I tried Chinese medicine – herbs and
acupuncture. I tried Dr. Wise’s Stanford Protocol utilizing trigger
point release and relaxation training.

Everything helped for a while to some degree but the situation
gradually continued to get worse.  Over the years, I had a number of
prostatitis infections.

About 10 years ago, my current urologist scoped me and he confirmed
that the bladder neck did not even line up well. Unlike the first
scoping, this scoping was a not a problem.

Concerns:  I did not want surgery because I did not want to be stuck
with retrograde ejaculation for the rest of my life. I had that
experience on Flomax. Plus, I had had shoulder surgery about five
years ago for impingement of my right rotator cuff tendon. The surgery
was supposed to be no big deal but it turned out poorly and I ended up
losing my biceps tendon. If something like that happened with surgery
below the belt, well, you get the idea of what I didn’t want to wake
up and find missing.

Decision:  In part based on what I had learned on this site, I decided
to get the PvP GreenLight Laser surgery. That option had only recently
become available in Hawaii and fortunately, my urologist was one of
the few who do the surgery. Also, the day of my surgery, a
representative from the GreenLight would be in the operating room.

Outcome:  I’m thrilled. It came out better than I expected. My urine
stream has never been this good. I could work for the fire department
putting out fires.

My urologist cautioned me that about 20% of patients may experience a
heightened sense of urgency or discomfort for a couple of months. I
did not have that. Quite the opposite, urgency is no longer something
that I experience.

I did not experience retrograde ejaculation. On the contrary, the
ejaculation is more powerful—like it was in my twenties.

My sleep is improving. Some nights I sleep for five hours without
waking up. Previously, if I went for two or three hours without having
to get up to go to the bathroom, that was good. However, sleep depends
on a number of factors that are not necessarily related to urology. If
one is in the habit of getting up, that habit must be changed.

The operation was supposed to take about one hour but it took two
hours. My doctor came out and told my wife that the surgery went well
but took much longer because “it” was much bigger than when he scoped
it about 10 years ago. My wife wasn’t sure what he meant by “it”. He
meant the median lobe of the prostate, but I told her that he meant my
genitalia.

I did not experience much pain.  After surgery, I spent the night in
the hospital with a Foley catheter. That night I had a headache that
might have been from the anesthetic. Having the catheter removed hurt
for about two seconds. After the catheter was removed. I was able to
pee right away. Some blood clots came out, the stream was powerful and
there was a stinging sensation.

The next pee also stung and there was bleeding but no clots. I was
discharged. I was leaking bloody droplets on my hospital shorts, so I
had to get some pads.

I wore a pad for about 10 days. Some days I seemed to spot blood and
others days I stopped bleeding. If I went for a few days without some
spot bleeding or blood in my urine, I thought, “Great, done with
that.” But then I would bleed again. In the last week, I have only had
blood in my urine once.

After about 4 weeks, I tried surfing. I limited myself to smaller
waves and less than one hour. No problems and I guess no bleeding
because no sharks came after me. I have started working out lightly in
the gym at about 30% of what I would normally do.

You know in life that there are no guarantees and things can change
rapidly, but so far I’m thrilled with the results.

To minimize the risk of retrograde ejaculation, my urologist
concentrated on the median lobe and left the lateral lobes alone. It
is possible that in the future I might need to have this procedure
done again. After all, the prostate can continue to grow. However, now
that I have had the surgery, I would not hesitate to have it again if
I needed it; that is, as long as the surgeon/urologist who did it was
still available.

I don’t regret trying all the other things to avoid the surgery
because they bought me time. This procedure only recently became
available in Hawaii. Had I had other procedures done, I might not be
as satisfied with the results. Plus, I met and learned a lot from all
the other things that I tried ranging from Chinese medicine to trigger
point therapy.

I hope this post is useful to those considering their options.

Released from hospital today after having Green Light Laser.
Nothing worked on reducing prostate size. Could not continue with the
hematuria-clotting every month.
Looking forward to a renewed sex life, or am I fooling myself?
Ramón

RE Roberts long post

I too find these posts helpful. Even though my urologist took a lot of
time he could not explain everything that might happen, and I think he
did not want to scare me off.I had a very large prostate (100 to 135
g) which usually gets you an open TURP. Also went through 8 years of
meds end keeping an eye on where the nearest BR was. A complete
blockage and wearing a catheter for a while decided me. The surgeon
was not pushing a Laser Rx but agreed as I had a limited window when I
could recover due to another issue (I had it done in Dallas and live
in Italy). i am now 2 months out.

Had one day GL laser surgery went home with a Foley catheter and
removed it myself the next day. Do NOT underestimate recovery this is
still surgery and your body takes a beating. Blood in urine but very
little (light pink). Wore Depeds for a week. Tried sex too early and
felt "achey" for a day or two after. By the month mark it was back to
normal and very good/satisfying to me and spouse.  read I find some
women say they feel better about oral sex without "mess."  At first I
passed a number of pieces of tissue, now once in a while still pass
very small bits (size of matchhead largest) and at times feel urgency,
but decreasing. i am trying to hold off in order to stretch my bladder
and decondition the urges with little urine production. It works
usually. Once I misjudged and wet myself.

I realize the prostate still may grow, I am still on meds to keep it
in check, and I may need to redo the GL laser in 7 years or so, or
have a full on TURP. Right now it is better. My advice is not to
expect a trouble free time but to reasonably anticipate better. By the
way I have friends who have had TURPS and they are still dependent on
Depends, or dribble at times, and 2 of them are silent on sex
afterwards i notice.