 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Prostate BPH / January 20041 day post PVP
I'm a 56 year old male who had a PVP performed by the Mayo Clinic yesterday January 2nd. Mayo Clinic is an amazing institution and the PVP procedure is outstanding. I've had BPH symptoms for a number of years. PSA was 0.9, prostate biopsy was negative, flow was < 5 mL/sec , average amount was 100 mL, frequency every two hours, retention 400 mL, AUA symptom score 28. The blockage created balloons on my bladder which were removed in November. Following that bladder surgery the bladder had spasms and I took Detrol LA with good results. Wore a cath for 2 1/2 weeks. Then went of Flomax (had headaches, lethargy) but it did help the flow. Removal of the blockage still needed to be done. My Uro wanted to do a TURP. With a lot of thanks to this newsgroup, I chose to get a PVP instead. Insurance initially denied coverage but a 60 page appeal resulted in approval. (Dealing with insurance companies could well be another thread!). Went to Mayo Clinic on Dec 16th for an evaluation/consult. They did urine sample, PSA and cystoscopy. Size was less than 100 grams so they were willing to do a PVP. The doctor covered all the other options such as TURP, TUNA, TUMT, etc, etc. He did say that retro could be an issue with PVP. Mayo does 6-8 PVPs a week and perhaps two TURPs (mostly on large prostates). Interestingly, they refer to the procedure as a laser TURP. Perhaps because Dr. Malek was a primary developer of PVP while at Mayo, Mayo may want some separation between themselves and Laserscope. Friday Jan 2nd at 7:30 am they did the general health check. Then went to outpatient procedures unit for a 9:00 am PVP. Had general anesthesia and was back in recovery at 10:30 with a cath inserted (size 24 - garden hose). They gave me some Cipro, stool softener, hydrocone if needed, and belladona/opium suppositories (using Detrol for a day or two instead). Walked back to the hotel room at 2:00 pm. This morning, Saturday, they removed the cath, made sure I could void, did a residual scan, and sent me home with some cautions. It takes three months for the healing and during this time urine may be pink with occasional chunks (my word). Some improvements may be immediate but others could take a while. Take it physically easy for a couple weeks. Keep off asprin/Alleve type stuff for a week. And, you still need to be vigilant about prostate cancer. I feel great. No pain or discomfort. Urine stream is much stronger. My wife commented that is sure sounded much different. Not enough time yet to comment on frequency or urgency. There is another thread in this newsgroup in which comments are being made about Laserscope's advertising. I don't believe their advertising is misleading but it is advertising. My comment is, ask your doctor about any thoughts, concerns, or questions you may have. I had a page of questions. Dennis Great post Dennis. Please give us regular updates on your progress. Thanks. Lee > I'm a 56 year old male who had a PVP performed by the Mayo Clinic yesterday > January 2nd. Mayo Clinic is an amazing institution and the PVP procedure is [quoted text clipped - 44 lines] > > Dennis Sounds like you are doing quite well there. I never read, or heard anything about a 3 month recovery. Laserscope talks about "a week or two"....'no heavy lifting for 6 weeks.' I wish everyone who gets a PVP (or any prostate procedure) well. But asking a patient to sift through the partial truths and distortions of "advertising" represents the worst of modern medicine. If I had read, or been told about a "3 month" recovery, I'd be less disturbed, and more prepared for what I'm going through... 6 weeks post. Marcus > I'm a 56 year old male who had a PVP performed by the Mayo Clinic yesterday > January 2nd. Mayo Clinic is an amazing institution and the PVP procedure is [quoted text clipped - 44 lines] > > Dennis It is very important how you define recovery. a) Does it mean when you come out the the hospital? b) When you stop major bleeding? c) When you can go back to work? d) When you can resume "normal" activities? e) When you can resume more strenous activities like running, hiking, lifting, etc? f) When your the inside of your prostate completely heals? g) When your bladder completely recovers from years of obstruction from BPH? Recovery as defined in a through e is much quicker with PVP than with a TURP. That is the primary advantage of PVP and is what is stressed on the Laserscope website. Recovery as defined in f and g is more dependent on your particular condition not on whether you had a PVP or a TURP. So each person's recovery as defined in f and g can be quite different and may in fact as in g) may never recover. I beleive that the PVP advantage is its quick recovery as defined in a through f. PVP nor TURP can't make g happen any quicker or better. That is why a PVP sooner than later is preferrable. Patrick > Sounds like you are doing quite well there. I never read, or heard anything > about a 3 month recovery. Laserscope talks about "a week or two"....'no [quoted text clipped - 65 lines] > > > > Dennis I suppose recovery should mean: when one can resume normal activities without the anxiety caused by urgency and painful urination. Marcus > It is very important how you define recovery. > [quoted text clipped - 106 lines] > > > > > > Dennis Marcus, I am sorry to say that may never happen. However, based on my own personal experience, your bladder usually improves over time. For me, I saw improvements in my bladder function for a full year after PVP. Hopefully your's will improve as well. Give it time. But note that the blockage was removed at the time of surgury. Also your prostate and the urethra will fully heal very soon, in a matter of weeks after PVP. But that is not the cause of your problems. It is your bladder that is giving you the troubles, the urgency, the frequency and the pain. You can have frequency, urgency, spasms, pain for a long time to come. This is not the result of the PVP. It is the result of bladder damage over years of having obstruction caused by BPH. Hopefully with time, your bladder will improve as the obstruction is no longer there. Best Regards, Patrick > I suppose recovery should mean: when one can resume normal activities > without the anxiety caused by urgency and painful urination. [quoted text clipped - 122 lines] > > > > > > > > Dennis Patrick, I appreciate your help in understanding the nature of the problem. But even if is the bladder that is causing these adverse, prolonged symptoms, I don't see anything on the Laserscope site that discusses this as a side-effect of the surgery, lasting for more than a couple of weeks. If you read through some of the threads on the newsgroups you'll see there are others with similar bladder issues. The bladder may be damaged from years of BPH, but Laserscope sure as hell should be discussing this in terms of a realistic recovery rate from PVP surgery...at least for the apparent minority who will experience the extended urgency, frequency and pain. Marcus > Marcus, > I am sorry to say that may never happen. However, based on my own personal [quoted text clipped - 161 lines] > > > > > > > > > > Dennis Marcus, That is my whole point, bladder symptoms are NOT a side effect of having a PVP. Having the PVP did not cause your bladder symptoms. The bladder symptoms are the result of damage caused by BPH. PVP removed the blockage so that, hopefully, no FURTHER damage of the bladder will take place. PVP does nothing to reverse the bladder damage. However, your own healing will do what ever it can to help your bladder symptoms. Think of it this way. If the bladder is totally damaged by years of BPH obstruction. Now a PVP is done to open a channel through the prostate. Did the PVP cause the bladder damage? No, it didn't. Does it restore the bladder function? No. PVP is just a way to open a channel through an enlarged prostate without much bleeding, much swelling and without much downtime. That is all it is and all that it claims to be. Patrick . > Patrick, > [quoted text clipped - 194 lines] > > > > > > > > > > > > Dennis Patrick: I think you are ignoring his point, which is that the Laserscope site should warn patients of these problems. I don't necessarily agree with that. Seems this would be up to the urologist. But, anyway, that is the point being made. Mel > Marcus, > That is my whole point, bladder symptoms are NOT a side effect of having a [quoted text clipped - 29 lines] > > Laserscope sure as hell should be discussing this in terms of a realistic > > recovery rate from PVP surgery...at least for the apparent minority who > will > > experience the extended urgency, frequency and pain. [quoted text clipped - 209 lines] > > > > > > > > > > > > > > Dennis Why just the Urologist? Laserscope supposedly tested over 11,000 recipients of PVP. If anyone has first hand knowledge of these problems, it would be Laserscope. The urologists I've spoken to are telling me that it is either prostatitis, or still some edema from the surgery. Nobody has mentioned anything about a bladder problem. I'm back on Cipro and will see my surgeon next week. Hopefully I'll receive more definitive info. Marcus > Patrick: > [quoted text clipped - 277 lines] > > > > > > > > > > > > > > > > Dennis No, Laserscope did not "supposedly test over 11,000 recipients of PVP". This year they sold 11,000 of the laser tubes used in the procedure. The Uro's who step on the trigger have the first hand info. Peer review literature shows the procedure is very good, not perfect. I choose PVP based upon Laserscope advertising, this news group, review of scientific literature, and asking lots of questions. So far my PVP has been all that I had hoped for. I hope your problems get resolved. Dennis > Why just the Urologist? Laserscope supposedly tested over 11,000 recipients > of PVP. [quoted text clipped - 312 lines] > > > > > > > > > > > > > > > > > > Dennis I say just the urologist because these problems appear to have nothing to do with the procedure itself. Mel > Why just the Urologist? Laserscope supposedly tested over 11,000 recipients > of PVP. [quoted text clipped - 312 lines] > > > > > > > > > > > > > > > > > > Dennis And having that channel opened permits the use of bladder medications that are not possible before the procedure as they tend to lock up the urinary path. > PVP is just a way to open a channel through an enlarged prostate without > much bleeding, much swelling and without much downtime. That is all it is > and all that it claims to be. > > Patrick Let me try to present it a different way. Let's say two patients go for a PVP because they each have a blockage caused by an enlarged prostate. One patient has a prefectly functioning bladder that is obstructed by an enlarged prostate. The other patient has a significantly damaged bladder that is also blocked in the exact same way by an enlarged prostate. Both patients have the exact same PVP done on them by the same highly skilled surgeon. Everything about the PVP surgury and post surgury recovery goes well for both patients. After the surgury (and a few weeks recovery), patient #1 still has the perfectly function bladder and patient #2 still has the significantly damaged bladder. Which patient is going to be absolutely delighted by the results and which patient is going to be disappointed with the results? Is the PVP the cause of these differences? I don't think so. My point is that even though PVP is the best way to remove the blockage with minimal complications and side effects, it doesn't do anything to reverse the bladder damage. That is why it is imperative to have the PVP early in the BPH enlargement process, once the symptoms become noticable, not when it becomes so severe that it can not be avoided. Patrick > Patrick, > [quoted text clipped - 194 lines] > > > > > > > > > > > > Dennis You might as well give up. He either doesn't get it or doesn't want to get it. > Let me try to present it a different way. > > Let's say two patients go for a PVP because they each have a blockage caused > by an enlarged prostate. I think I get it. Laserscope just doesn't bother to mention this issue on their site. In other words, people with BPH seek treatment. A ceratin percentage of them already have bladder damage and are likely to experience these severe symptoms. Yet, according to Patrick's analysis, Laserscope doesn't seem to think this is relevant information, since their procedure does not cause, but, in fact, may REVEAL, what may be a fairly common problem. Has American medical marketing sunk so low as to actively withold critical information from the patient simply because they are not technically liable or legally obligated to do so? Does the patient have to discover these matters via a newsgroup? Apparently so! Marcus > You might as well give up. He either doesn't get it or doesn't want to get > it. [quoted text clipped - 4 lines] > caused > > by an enlarged prostate. Marcus, Here's where I now agree with you. The Laserscope website should contain a statement along these lines: "Continuing to live with an obstructed bladder caused by BPH can lead to irreversible bladder damage, retention and/or possible kidney damage. Discuss with your doctor whether treatment with PVP is better sooner than later. Note that although PVP can effectively remove the obstruction, it will not correct the bladder/kidney damage that may have already occurred." How's that? If we agree to what our warning recommendation is, I am willing to send an email to Laserscope suggesting it. In the past they have listened to my suggestions for improvement in their website, may they will again. Patrick > I think I get it. Laserscope just doesn't bother to mention this issue on > their site. [quoted text clipped - 19 lines] > > caused > > > by an enlarged prostate. Sounds like a start!.......might add something concerning the need to be aware of the signs of post-operative urinary retention. Apparently, it does happen, and its very dangerous! Thanks, Marcus > Marcus, > Here's where I now agree with you. The Laserscope website should contain a [quoted text clipped - 38 lines] > > > caused > > > > by an enlarged prostate. Yes, going into retention is always a big risk factor after after any procedure that distrubs the bladder, i.e cytoscope, prostate biopsy, urodynamic test, even DRE, etc. I was very near retention several days after a prostate biopsy. So when you have a blocked bladder, the risk of going into retention is great and extremely dangerous. That is why the blockage has to be physically removed. But as you have experienced the act of physically removing the blockage can cause the bladder to go into retention. My BPH was so bad that if I took an over-the-counter cold table, I risked going into retention! I am so glad that the blockage is now removed and my bladder is well enough that going into retention is no longer a risk to worry about. Patrick > Sounds like a start!.......might add something concerning the need to be > aware of the signs of post-operative urinary retention. Apparently, it does [quoted text clipped - 57 lines] > > > > caused > > > > > by an enlarged prostate. Patrick, I think that is a great idea. My experiences with BPH and my interaction with this NG has caused, or is at least beginning to cause, a change in my thinking about surgery and or invasive intervention procedures. I always looked upon surgery as an absolute last resort. The reason was connected to my diseases or conditions, namely heart disease and prostate trouble. There was no way I was going to willingly submit to heart bypass. As it turned out, my wife and my cardiologist practically dragged me kicking and screaming into an angioplasty. The first one didn't work and I had a second one with two stents. Voila! The blood circulation has been acceptable to the cardio ever since as proved by a cardiolyte stress test every two years or so. The comparison of angioplasty to bypass and PVP to TURP seems like a good one to me. I have never talked to anyone who was glad they had a bypass, other than people who had no choice, i.e., bypass or die. In urology, maybe the old concept of "watchful waiting" needs to be reexamined. If your only option to waiting is a TURP, then waiting looks pretty good. If something like PVP is available, then earlier intervention starts to make more sense. It's also the old "If I knew then what I know now" game, but if the urologists will buy into offering PVP, maybe their mindset will change also. I realize this will take years to accomplish, but it can happen if the word gets out. The Doc who did my PVP, Dr. Laub, is no longer in the top 10 closest doctors to Las Vegas who do the procedure. Back to the original idea of the Laserscope site, the more information they provide which covers them and still explains the positive benefits of PVP, the better for all concerned. The real detailed information has to come from the urologist who is doing the surgery. I agree that Laserscope can do better, but look back at the sites for TUNA, TUMT, Targis, Indigo, etc and I don't think you will find much discussion about damaged bladders from too much waiting. -- Your urologist should give you all the facts prior to the procedure, he should know how much you may have been affected by your enlarged prostate. I am sure that you do not believe the blurb in adverts for food or consumer products. They may look good and taste good but will they do you good, at one time adverts used to tell us that cigarettes were good for your throat. Derek. > I think I get it. Laserscope just doesn't bother to mention this issue on > their site. [quoted text clipped - 19 lines] > > caused > > > by an enlarged prostate. Puhleeeze guys! Let's not equate advertising for consumer products with medical marketing. Why should we have to be burdened with such research and muckraking? We've got enough to deal with, and consume our time health-wise, not to mention the insurance. A bit more comprehensive presentation of information and forthright honesty should be legislated and made obligatory for these medical ad's on the web. Even TV commercials, as euphoric as they are in presenting their drugs, have to mention all their potentially serious side effects. As far as the surgeons go, I agree. They should have all the info and present it candidly. I hope they use resources beyond sites like Laserscope. Before I had my PVP, I tried, in vain, to come up with the FDA report. This is what the surgeons should be looking at and reporting back to the patients. In any case, we need a bureau of consumer ethics in this country. It may not solve everyone's prostate problem, but it might help keep us all..... more thoroughly informed. Marcus > Your urologist should give you all the facts prior to the procedure, he > should know how much you may have been affected by your enlarged prostate. I [quoted text clipped - 27 lines] > > > caused > > > > by an enlarged prostate. Marcus puhleeze. "Why should we have to be burdened with such research...?" Concerns about MY health are not burden. "...muckraking..." What???? "A bit more comprehensive presentation of information and forthright honesty should be legislated and made obligatory for these medical ad's on the web." Are you claiming they violated FDA rules? Their web info is substantially the same as their printed materials. Do you think their printed materials violate FDA standards? "...the FDA report. This is what the surgeons should be looking at and reporting back to the patients." If you mean the materials Laserscope presented to the FDA for equipment and procedure approval , I certainly hope not. That would have been done late 2000 - nearly four years ago! There is much better information available now. Did you look at any of the scientific literature available on their web site? "...we need a bureau of consumer ethics in this country." Did you mean marketing ethics as I've not heard many complaints about ethics of consumers. This news group has posters from a number of countries. Do you mean the US? If so, I don't think so!!! Dennis "Sasha Gottfried" <sashago@comcast.net> wrote in message A bit more comprehensive presentation of information and > forthright honesty should be legislated and made obligatory for these > medical ad's on the web. news:27udnfIyd8GS5GGi4p2dnA@comcast.com... > Puhleeeze guys! > [quoted text clipped - 59 lines] > > > > caused > > > > > by an enlarged prostate. Okay folks, If you agree with Dennis, that it is our responsibility, as patients, to research information that is not forthcoming from the medical industry, I understand, and have certainly spent the greater part of the last few months doing just that. After all, that's the way it is, and one would be foolish not to do such research. But what many activists are saying (not necessarily on this newsgroup) is that there is a qualitative difference between scanning the newspaper looking for the best washing machine or computer, and seeking medical help. It's great that Patrick is planning to advise Laserscope to publish some of the concerns that have come up here on the newsgroup. My point is that we shouldn't have to lobby any medical business to present a balanced, cautious and fully informative public accounting of their services. They should do this by law. Getting ALL the relevant information, impartially presented to the patient, may fly in the face of the market economy and all the hypes that go with it. But that is what the hippocratic oath demands, or should demand, of ALL IN THE MEDICAL PROFESSION! Anyway, it's time to end this thread. Dennis seems to be having a good post-PVP experience and that is what we all hope for. I rest my case........for now. Marcus > Marcus puhleeze. > [quoted text clipped - 102 lines] > > > > > caused > > > > > > by an enlarged prostate. Marcus, Okay let's end this tread. But how about an update on how you are doing? How long has it been post-PVP? Are you improving? feeling better? flow stronger? urgency/fequency subsiding a little? Let us know. It is honest and factual reporting and discussing of actual experiences that is the true medical research. None of this stuff will ever be in a medical book or on a company website. But it is the most valuable resource that we have. I am still learning a lot of BPH and PVP from this newsgroup. It is more of a hobby now than a necessity but should I or anybody in my family have a medical problem, I am convinced that newsgroup like this will lead me to the best treatments, doctors and breakthoughs. It will also tell me what to look out for. So keep the discussions going. Patrick > Okay folks, > [quoted text clipped - 146 lines] > > > > > > caused > > > > > > > by an enlarged prostate. > I'm a 56 year old male who had a PVP performed by the Mayo Clinic yesterday > January 2nd. Mayo Clinic is an amazing institution and the PVP procedure is <clip> Dohlund, Did you have your procedure in Rochester, or Jacksonville ? I was at Mayo in Rochester MN > > I'm a 56 year old male who had a PVP performed by the Mayo Clinic yesterday > > January 2nd. Mayo Clinic is an amazing institution and the PVP procedure is [quoted text clipped - 3 lines] > > Did you have your procedure in Rochester, or Jacksonville ? dohlund Glad everything seems to be going ok. Did you have Urgency pre PVP and if so how does it compare to now. Early days yet but how does the frequency compare now? Magna Pre PVP I didn't have great urgency but frequency and flow were issues. Now (4 days post), frequency is about the same. Urgency seems to be a bit higher. It's strange but the need to pee "feeling" now seems to originate from a different location- further down the urinary tract. Its a slightly different sensation that I have to get used to. Flow is significantly better. I've had to adjust my aim because of the quick start and sudden amount. Color at the start of the flow has been pink a couple times. A couple of small chucks have also passed. Dennis > dohlund > [quoted text clipped - 4 lines] > > Magna |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.