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Medical Forum / Diseases and Disorders / Prostate BPH / November 2004First Anniversary PVP
It's been 12 months since my PVP and I'm sorry to report that the results have been very disappointing for me. Except for newfound retro and increased urgency and control problems, my symptoms are exactly the same as before the procedure. My uro scratches his head and mumbles something about how it must be lower back nerve problems that account for the lack of improvement. He also says that scar tissue may be a factor. When I described the PVP as a failure, he said with a straight face that it was not a failure, just that something else must be causing my woes. I'm still pondering this. I don't mean this to be a downer for guys looking to PVP as a solution to their problems. I just think it's important to know that PVP may not work for all. I'm happy for all the guys who are reporting success with the procedure and wish all the great posters on this board the best of luck. > It's been 12 months since my PVP and I'm sorry to report that the > results have been very disappointing for me. Except for newfound [quoted text clipped - 11 lines] > reporting success with the procedure and wish all the great posters > on this board the best of luck. Sorry to hear this. Especially since I am considering getting one myself. I can also understand what your uro is saying about the PVP being a success... if the problem was being caused by something else or had multiple causes, ablating prostate tissue alone isn't going to fix it. Unfortunately, if it is not physical obstruction due to an enlarged prostate, I don't think they usually have a clue what is causing it. In addition, I don't think they have a clue, in general, as to what causes the enlarged prostate in the first place. Do you have any reason to believe that a TURP would have been more successful? Seems to me that it is the surgery that failed, not the particular method. Uro's are surgeons and are biased to cut... when you're a hammer, everything looks like a nail :-) PVP, after all, is just cutting away using a laser rather than a scalpel. My suspicion is that in the final analysis we will ultimately find that prostate enlargement is most commonly caused by a resistant pathogen just as was found for stomach ulcers after years of the dogma that they were caused by stress or eating certain foods. What kinds of tests did you have prior to the surgery to ascertain that prostate was the culprit and the sole culprit? In my case, for example, the problem presents as a long history of a weak stream and frequency which is especially troubling at night. However, overlayed on that are flare-ups where I can't void at all and, on the other hand, comparable periods where the symptoms are dramatically reduced. Such variations are inconsistent, in my opinion, with a one-explanation cause. This coupled with the fact that DRE's are continually unremarkable. A final curiosity is that my wife has similar problems and a prostate has never shown up on any of her X-Rays :-) I'm afraid the truth is that, in my experience at least, most interaction with doctors is hit or miss and mostly miss. This is particularly frustrating because of the level of expectation we have going in, preconditioned by the media and the propaganda put about by the doctors themselves. They have been elevated to "priest" status in our society and are assumed to have knowledge and healing powers far beyond that which any rational assessment of the results would justify. I envision the whole medical-hospital-insurance complex as a giant money-sucking vampire which feeds on people who are sick, sucks the blood out of them, and then spits out their dry corpses... just so you know where I am coming from ;-)  SignatureNelson May I ask you in which state (if you do not want to specify the city) you had this PVP done? > It's been 12 months since my PVP and I'm sorry to report that > the results have been very disappointing for me. Except for newfound [quoted text clipped - 14 lines] > procedure and wish all the great posters on this board the best of > luck. > It's been 12 months since my PVP and I'm sorry to report that > the results have been very disappointing for me. Except for newfound [quoted text clipped - 14 lines] > procedure and wish all the great posters on this board the best of > luck. I had a TURP in 1989, and it initially seemed very effective. After the clot dissolved, the improvement greatly diminished. I got by until early this year, when I gave up on saw palmetto et al, and had a PVP about seven months ago. The result was not great, but moderately good until recently, with only the infrequent bad day, and I was satisfied with the level of improvement. Now I'm almost back to pre-operative conditions. I still have a few Flomax capsules and am taking one every few days, but they don't help much. I'm still not having to get up as often at night, so the improvement hasn't completely disappeared; but the stream is usually very slow, and frequency has increased during the day. I think that for at least some of us, there are other factors involved, like food sensitivities and I'm trying to eliminate things that may be involved. I've had no alcohol in several weeks, but that doesn't seem to have helped. I usually had one or two glasses of wine most days. Coffee will be next, but that's going to be much harder for me. When I saw my urologist a few months ago and expressed some disappointment over the results, he had no real explanation or suggestions, other than to come back and see him in six months. Like Terry, I agree that my results shouldn't discourage others from having a PVP. In my case I wonder if there shouldn't have been more tests before the surgery <shrug>. Life goes on and I will cope, as I did after the TURP. Patrick in St Petersburg Try cutting out dairy,coffee-- Michael > > It's been 12 months since my PVP and I'm sorry to report that > > the results have been very disappointing for me. Except for newfound [quoted text clipped - 42 lines] > > Patrick in St Petersburg Hi Terry, There are probably a number of reasons a TURP or PVP can fail. Poor diagnosis and/or execution of the procedure immediately come to mind. That leads to the recommendation that you consult a different, independent Urologist for a second opinion. Among other possibilities is prostatitis. That should be found or ruled out, too. Also, what is your current PSA? Good luck! Bob > It's been 12 months since my PVP and I'm sorry to report that > the results have been very disappointing for me. Except for newfound [quoted text clipped - 14 lines] > procedure and wish all the great posters on this board the best of > luck. If your Uro found (by doing the blood work ups) that your DHT is well above maximum, then did your uro tell you that your prostate will still keep on growing? If yes, you would have been sent to an endo. What did the endocrinologist tell you to do? OR...did they test for and rule out prostatitis? If no Prostatitis, and DHT is well within normal range, then might want to get blood glucose tests or hypertension checked out, too. These are the only ideas I have to offer. So, very best of luck to you. > It's been 12 months since my PVP and I'm sorry to report that > the results have been very disappointing for me. Except for newfound [quoted text clipped - 14 lines] > procedure and wish all the great posters on this board the best of > luck. >Thanks to you guys for the advice. I'm scheduled to see my urologist on Nov11 and will raise the questios some of you asked about DHT, prostatitis, and blood glucose tests. I'll let you know how that comes out. If I don't get some kind of reassurance, I'll take Bob's advice and shop for a new uro. As for my stats, prior to my PVP my prostate measured 25 grams, my PSA was 2.9 and steady, my bladder capacity was 372 ml. I'd had a cystoscopy, a cytology procedure, the urodynamic flow tests, and some kind of blood workup. A recent PSA came in at 2.36. I have tried hytrin, flomax, detrol, and ditropan with indifferent results. I haven't given up on coffee, but that's a hell of a thing to contemplate for this old man. Patrick, I hope you'll let me know if you manage to kick the habit and if things improve thereafter. By the way, I banged up my elbow a couple of days ago and took two advil tablets for the pain at bedtime. Funny thing is, I was able to sleep six hours without interruption. Then, last night I took one tablet and slept for five hours straight. Now I know that it is utter nonsense to think that there's any connection here, but I think it may be necessary to see what happens tonight, just for the hell of it. (Normally, I have to get up three times a night) What have I got to lose? >>Thanks to you guys for the advice. I'm scheduled to see my urologist > [quoted text clipped - 19 lines] > (Normally, I have to get up three times a night) What have I got to > lose? Today was my first day without coffee. I almost never have headaches, but today was bad. Even naproxen sodium barely took the edge off. I was also sleepy and groggy, resulting in a long nap. The day was a total waste. This seems clearly a case of withdrawal. So far no change in the urinary symptoms, but that could take days. If there's no improvement in a week, the trial is over for me. Even if the symptoms improve, I may not be strong enough to avoid coffee. To paraphrase Ben Franklin (he referred to beer) "Coffee is proof that God loves us and wants us to be happy." I've seen a few other references to NSAID drugs like advil helping with prostate symptoms. If there is an effect, in my case it has been minor. Patrick in St Pete >>> Thanks to you guys for the advice. I'm scheduled to see my urologist >> [quoted text clipped - 35 lines] > > Patrick in St Pete I don't know if any of this will be useful, but here's one man's experience with eliminating alcohol and caffeine. My symptoms have been frequency, weak flow and trouble starting, interspersed with very free flow and no trouble starting; there seemed to be no reason for either one. I also had very slight sensations of discomfort in the general location of the prostate. After several weeks of drinking no alcohol (I had been taking one or two glasses of wine most evenings with dinner), I saw no improvement in the urinary symptoms. I haven't missed the wine, so haven't resumed consumption of it. The cold turkey coffee withdrawal lasted about 5 days, with gradually diminishing headaches and sleepiness. I had been drinking two cups of strong coffee at breakfast each day. After a week there still seemed to be no real improvement in the urinary symptoms, so I have resumed coffee in the morning, although in lesser quantity. I've had complete retrograde ejaculation since the PVP; until a few days ago, that is! This muddies the water for my experiment, but I very much doubt that coffee or alcohol were causing the retro. My conclusion is that the healing is still going on 7 months after PVP. The last time I saw my urologist, I mentioned that some on this news group report changes many months after the surgery; he was quite dismissive, but he isn't highly experienced with the procedure. A clarification on the Advil (ibuprofen): I was assuming that Aleve (naproxen sodium) would be the same, since they are both NSAIDs. I generally use naproxen sodium because it last longer. Just the last few days I had some hip pain and took ibuprofen instead of the usual naproxen. I slept almost a full night without getting up, which is unusual for me. Coincidence? Don't know... Patrick in St Pete Patrick: I do hope and wish you are correct, that the healing process is merely continuing and that you are getting back to normal. Just as a precaution, though, take a look at your DHT numbers from your blood workup that your urologist did just before your PVP. If your DHT were initially high and if it remains high, (above 700), likely your prostate is continuing to grow. High DHTs or even an increased sensitivity to DHTs is what causes the prostate to grow...or so the most current theory goes. If your DHT was greater than 700 then you might want to have another blood test done again and determine if your DHT levels are continuing to increase. If so, you might want to have a chat about getting referred to an endocrinologist so you can head off another surgical intervention. Your urologist will suggest it is not necessary, but will be at a loss to explain why your DHTs are too high and will likely prescribe Proscar or Avodart to control the DHT. If that works, you may be happy with that, and that may take many months. So, after a course of Proscar or Avodart, I'd insist on another blood test after about 2 months...to see if your DHT has dropped sufficiently. If not then have that chat about seeing an endocrinologist. An endocrinologist can diagnose what gland has crapped out that in turn is causing high DHTs. Uros don't like talking about the actual cause...some don't even know so hate to show their ignorance. An endo MIGHT be able to prescribe a more effective medication to head off having to get back into Alpha Blockers, DHT inhibitors or even another operation. This information is merely offered in good faith and as something to keep in mind. ...I am NOT a doctor, just someone who is disillusioned by the lethargy of today's urologists when it comes to BPH. > Patrick Annette wrote: .... I've had complete retrograde ejaculation > since the PVP; until a few days ago, that is! ... My conclusion is that > the healing is still going on 7 months after PVP. ..my urologist, ...was > quite dismissive...,... Patrick in St Pete Prior to having a TURP in 1998, which was very successful by the way, I found that aspirin at bedtime seemed to help somewhat with the frequency of having to urinate during the night. Don > By the way, I banged up my elbow a couple of days ago and took two > advil tablets for the pain at bedtime. Funny thing is, I was able to [quoted text clipped - 4 lines] > (Normally, I have to get up three times a night) What have I got to > lose? > Prior to having a TURP in 1998, which was very successful by the way, I > found that aspirin at bedtime seemed to help somewhat with the frequency of [quoted text clipped - 10 lines] > > (Normally, I have to get up three times a night) What have I got to > > lose? Terry, Advil slows down urine production by the kidneys for hours. I use it before flying or before a long ride and for at least 6 hours I forget all my BPH troubles. Obviously it should not be used too often. I use it only about once a month. Dan. > Dan: Thanks for your take on Advil. I'm continuing to have, at most, one interruption per night. Last night I slept continuously for 7 1/2 hours. I am also noticing a change in my morning routine, in which I have a mug of coffee upon rising and then go for my walk. Usually I can't go more that 30 minutes before urgency kicks in, but lately (i.e., since taking the Advil at night), I'm good for an hour and a half. Evidence is still scant, but it's piling up. I was happy to see that Advil helps you on long flights, which I dread. I have a 5 hour trip to Mexico coming up and am already nervous about it. By the way, what is the downside of continued use of ibuprofen? I've taken it off and on for years for various aches and pains without ill affects that I know of. Terry > . > > Dan: > [quoted text clipped - 14 lines] > > Terry Terry, all I meant is that continued reduction of urine production can be dangerous. I guess that this side effect is not common to all ibuprofen users. Dan. > > . >> Prior to having a TURP in 1998, which was very successful by the way, I >> found that aspirin at bedtime seemed to help somewhat with the frequency [quoted text clipped - 21 lines] > > Dan. Be cautious Derek. Use with caution in a.. Asthma or history of asthma b.. Bleeding disorders c.. Decreased heart function d.. Decreased kidney function e.. Decreased liver function f.. Elderly people g.. High blood pressure (hypertension) h.. History of allergies i.. History of diseases of the stomach or intestines Derek, My pharmacist agrees with your list of conditions, but he reminds me that the other meds I've taken have nasty side effects also (i.e, detrol, flomax, ditropan). And they don't do a thing for me. I'll have to do a risk/reward study on this I guess. For the time being, though, it is glorious to get a good night's sleep - - every night! Thanks again for your help. Terry Do you really think Advil reduces urine production rather than diminishing the bladder urgency via its pain reduction function? Just wondering. Jim W. > Derek, > [quoted text clipped - 7 lines] > > Terry Jim, I can't be sure, but I suspect the effect is mainly on the bladder. I have been watching my daily fluid intake and output carefully and both measures seem to be unchanged, except for the timing. I have the urge a couple more times in the daylight than before. I just take one 200mg pill at bedtime, nothing during the day. For all I know, the effect is all in my head and may not last. Until then, I don't really care. Terry > Do you really think Advil reduces urine production rather than diminishing > the > bladder urgency via its pain reduction function? Just wondering. Jim W. I do. There is a remarkable reduction of the total quantity and not just the frequency. Dan. OK thanks. Jim W. >> Do you really think Advil reduces urine production rather than >> diminishing [quoted text clipped - 4 lines] > just the frequency. > Dan. Dan, This remarkable reduction of the total quantity you speak of . . . have you been using ibuprofen also? If so, why and for how long? Terry > > Do you really think Advil reduces urine production rather than diminishing > > the [quoted text clipped - 3 lines] > just the frequency. > Dan. I have been using ibuprofen for the last three years for this purpose only (reducing BPH symptoms). As I said, I take it only about once a month before a flight or a long ride. Dan. > Dan, > [quoted text clipped - 10 lines] > > just the frequency. > > Dan. > Derek, > [quoted text clipped - 7 lines] > > Terry Flomax put my BP up to 21/110 in less than five days and my pulse up to 133 bpm. Derek. |
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