Worst outcomes with PVP?

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Rob Marks - 16 Jul 2003 07:09 GMT

Am I correct in understanding that to date the worst scenario outcomes
of PVP laser surgery has been either (1) no improvement; (2)
retrograde ejaculation; (3) both?

I ask this question because there is no reliable data available and I
am extremely risk aversive, knowing of the great risks involved in
TURP, including death and permanent incontinence.

My impressions from keeping abreast of this forum is that there have
been no deaths reported and no cases of impotence or incontinence.

If I find that the only risks are either no improvement or retrograde,
I believe I will proceed with PVP. I consider such risks minimal.

Anyone have any thoughts or information that can help? Thanks.

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Patrick - 16 Jul 2003 13:15 GMT

Rob,
I am not aware of anybody reporting no improvement.

As for retrograde, probably the most accurate statement would be that
retrograde is caused when bladder neck tissue is damaged in the process of
removing the bladder neck obstruction due to an enlarged prostate. Any
surgury that damages the bladder neck muscles may result in retrograde.

My view is that Laserscope PVP damages less bladder muscle tissue than TURP
for several reasons.
1. It is more precise that the cutting loop of a TURP. Therefore the
skilled surgeon has more control to avoid bladder muscle tissue.
2. The laser wavelength is not very effieceient at vaporizing muscle tissue
than prostate tissue.

Both of these reason combine to result in less likelihood of retrograde with
PVP than TURP.

Patrick

> Am I correct in understanding that to date the worst scenario outcomes
> of PVP laser surgery has been either (1) no improvement; (2)
[quoted text clipped - 11 lines]
>
> Anyone have any thoughts or information that can help? Thanks.

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XS11E - 16 Jul 2003 18:30 GMT

> My impressions from keeping abreast of this forum is that there
> have been no deaths reported

I doubt that anyone who dies during prostate surgery will be posting
here. ;-)

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bnd777 - 16 Jul 2003 20:02 GMT

Gordon Muir the PVP Doc in the UK says he would not do another TURP and most
definitely will not recomend TURP to his brother, brother in law etc
I think that says it all

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