This is my first PVP post.  I've read this ng daily for over 2-years.  For
several years I've consumed a brew of Saw Palmetto, Beta Sitosterol, Pygeum
and Nettles.  I've been biding my time until the brew lost whatever effect
it may have had - and for Dr Laub to further hone his PVP skills.  This
first post, will of necessity, be on the long side - for the sake of
background.

The final straw occurred in Oct on a trip to Arizona.  My BPH problems
always worsened on trips.  When I needed to go, but had to 'hold it' until I
reached a gas station - things got bad.  When I finally made it to a gas
station, I couldn't pee.  It seems that 'holding it' puts the sphincter
muscles on lock position - and I can't relax the lock.  I would strain to
pee, get out a tiny bit.  Drive to next gas station, try again.  Pee a
little more {sphincter relaxed its grip a little}.  Drive to the third gas
station. This time, I'm able to achieve a fairly decent void.  By the next
pit stop, I'm back on track.  Had enough of this.  On an every day routine,
my urine stream resembled pencil lead.  When I'd get up during the night, I
would always sit down to pee.  Sitting down seems to relax the process and I
could pee with a little more force.

I live 40 miles from Santa Barbara, CA [Dr. Laub's office].  My first visit
with Dr Laub was on Oct 12th.  Dr Laub told me he'd performed 103 PVPs.
Second visit was Oct 26th.  Bad experience.  This was for my time/volume pee
test.  Again, by the time I arrived at the office, I had miscalculated and
I'd waited too long - and my sphincter muscles went on lock.  There I was,
standing over the 'machine' - and couldn't pee.  Dr. Laub was watching.  At
best, I dribbled a few drops.  Laub finally told me to come on over and set
on the table.  I asked if I could finish peeing.  I'm guessing he was
probably thinking to himself, "I don't have the time."  So, we never did
finish that test.

However, he was convinced I was indeed a PVP candidate.  Operation date was
scheduled for Nov 10th.
Operation day:  Operation scheduled for 8:30 am.  Woke up from general
anesthesia about 11:{something}.  I hurt.  Nurse added some pain killer to
IV and inserted a suppository.  Why the suppository, I don't know.  Stuff
worked, hurt kinda went away.  Was wheeled into the recovery room about
noon.  Was promptly informed, they would remove the catheter and I could try
to pee.  If I could pee about 200cc, I could leave.  Drank water and juice.
In about 45 minutes, I felt bladder was full enough to go for it.  Nurse
handed me urinal.  I hobbled into bathroom, carrying IV bag and with fear
and trepidation, inserted penis into urinal and 'let go.'  It worked!
Cranberry colored pee with a bite.  The Flow was big bore.  I'd never seen
my urine stream that big before - ever. I was happy!

I stayed at the Best Western directly across the street.  First night, I got
up every 2 hours to pee.  Each time, I peed a considerable volume - blood
tinged and large bore - with a sting added. Where was all the urine coming
from?  Drove home next day [Thursday, the 11th].  Thursday night pee was
still 'big bore,' pink-to-red and stinging.  Got up once that night.  Can't
really recall that event.  However, I DO recall Friday morning.  Took 6-8
seconds to start peeing.  I had returned to pre-PVP flow.  Urine was clear
colored and very little sting.  I was a very UNhappy camper!  What had gone
wrong?

I was upside down.  I contacted Fred Henzi.  [a genuine great guy]  He was
able to calm me down with: "Sounds 'bout normal to me."  He went on to
explain how this could happen.  Fred was a real help in my time of need.  By
days end, the flow had increased somewhat. I went back to my 'drawing board'
and attempted to make sense of what had occurred.

My speculation was/is the entire urethra had been distended [temporarily
enlarging the inside diameter of the urethra] by the insertion of the
cystoscope [and PVP fiber optic equipment].  So, upon removal of the scope,
the pee has a large caliber tube to flow through = big caliber pee.  24 to
30 hours later, the urethra had time to return to a semblance of original
size AND coupled with that, scabbing was occurring inside the injured
urethra [effectively reducing the inside diameter of the urethra
[duplicating the same kind of restriction the BPH infected prostate had
created].  Made logic to me.

Days 3, 4, 5 [Sat, Sun, Mon] were about the same:  clear urine; some sting;
flow only somewhat better that pre-PVP.  Monday night [day 5], pee turned
bloody AND the diameter of the flow increased as well as the force.  Getting
back to happy camper status.  Bloody urine contained bits & pieces.  My
speculation:  some of the i.d. reducing scabbing sloughed off, increasing
the inside diameter of the pipeline = much better flow.  One of my tests is
the sound of the urine stream hitting the water in the toilet and how many
big bubbles it makes.  This bloody pee produced more noise and bubbles.

My only contact with Dr Laub post-operation had been for maybe two minutes
in the recovery room.  I have a follow-up appointment scheduled for Nov
24th.  I will certainly have a lot of questions for him.

Oh!  I'd be remiss without commenting on the anti-biotic Laub prescribed:
500mg Levaquin for 5 days [five pills cost $75.00].  This must be one potent
pill.  After taking the 3rd pill, I came across two websites totally
dedicated to describing the 'side-effects' of the dastardly pill.  If you
plan on taking this pill - you might {or might not}, want to visit these
sites.  Wow!  The insert in the pill-box was somewhat abbreviated.  It
listed only a few of the side-effects mentioned on the websites.  I did
experience:  bloated gut [eating a sandwich felt like you'd consumed a
super-sized thanksgiving dinner];  sore muscles [I woke up feeling like I
had a total workout during the night polished off with a 1000 sit-ups];  and
of course, tiredness.  The insert did mention 'tendon-tearing'???  I did
take the two remaining pills.  I only hope the pill's side-effects wear off
soon.

One benefit I'm experiencing:  I don't need to urinate nearly as often
during the day.  It seems that my bladder's capacity has increased.  I
didn't expect this added benefit.  Nightime voids average 1 to 2 times.

Day 14 - Follow-up visit with Dr Laub.  It didn't go as I had envisioned [or
hoped].  I'd purposely arrived on time with full bladder, ready for what I
thought was to be the requisite pee time/volume test followed by the
ultrasonic roller to determine bladder residue.  Not to be.  This was to be
a 3-4 minute [at most] "How are'ya?"  I immediately handed Laub my carefully
crafted page of questions and observations. I perceived a hesitancy to even
look at it.  He did, but kinda mumbled "I'll have to answer this quickly."
I had composed 11 questions and noted 4 current observations.  I think I
encountered the all too familiar "Gotta hurry - can't spend very much time
with you - got more patients to deal with - please don't take up much of my
limited time."   I've never liked that - but have come to expect it as the
'norm' when dealing with doctors.  I definitely believe without that
type-written list of questions, I would have walked out with precious little
information. Having got that off my chest, things did go ok from my point of
view.  Wasn't too excited about the 'show me how well you can pee' demo
anyway.

I did learn:  (a) my prostate was small {I knew that}; (b) my bladder was
small, not all that flexible and scarred {I didn't have the presence of mind
to inquire as to what causes bladder scarring.  Maybe next visit - Mar '05;
(c) he did remove some of the median lobe protruding into my bladder;  (d)
he really worked on the bladder neck area {read:  retro most likely} -
that's ok by me - I wanted flow; (e) wait another week before exercising;
(f) wasn't any bleeding problem to have to deal with {during the PVP
procedure}; (g) probably no benefit to continuing Saw Palmetto {for
preventative medicine benefit};  (h) yes, flow may/should increase {to some
degree} as the healing process continues. (i) {in answer to my question as
to what %'age of the prostate had been effectively removed} Laub picked up a
plastic prostate from his desk and pointed out how much 'prostate' had been
removed. [We're looking at a shell remaining.  There's a large caliber hole
in the middle. I have a color pictures of that].

Dr Laub's 'ain't got time to sit and chat' is a very minor thing.  This is
common in the medical profession (unfortunately}. I'm really not
complaining - only commenting since it's so fresh in my mind {this morning}.
I do like Dr Laub.

That was it.  Come back next March for a PSA blood test.  He did mention
that maybe 1-2% of PVP patients experience some scarring {most likely at
bladder neck}, which can reduce flow to pre-PVP levels.  When that happens,
we fix that right here in the office.

In summation:

Do I regard the PVP as a resounding success?  Yes, with one qualifier:  I've
yet to achieve the same caliber pee as I experienced during the first 24
hours after PVP.  I may never.  But on a relative basis: very good success.
I guess there may be physical reasons why some of us fail to reach
'firehose' or 'gardenhose' results - maybe the plumbing wasn't designed with
that capacity.  But, I really don't need 'firehose' - just to be able to pee
as in days of yore.  I can.

Would I do it again {knowing how it turned out}?  In a heartbeat.

Would I consider postponing the PVP?  No.  I'm recalling Patrick's comments
relative to postponing PVP.  "You're potentially doing more damage to the
bladder."  Even if I was willing to tolerate my pre-PVP peeing problems,
performing PVP earlier rather than later might have a ring of 'preventative
maintenance' to it.

Retro?  My understanding on this subject is that {to a point}, one needs to
choose between what's most important - max flow or seeing the ejaculate.  I
talked to Laub about this.  He commented the more he worked at the bladder
neck to insure maximum flow - the greater the chance of retro. I promptly
told him, I didn't care which way the ejaculate went - I wanted maximum
flow.  So, I will likely experience retro.  But, if the truth be known,
compared to my younger days, my volume of ejaculate had dwindled
considerably.  So, what's a little more dwindling - compared to more flow?
That's why I chose PVP - I wanted flow.

Two questions for you readers:  1) Since I didn't have more room on my page
of questions, I didn't ask about sex.  Without going back to the archives,
I'm assuming this is also a  'we recommend waiting 3-weeks' proposition?  Is
that about right?;  2) Is anyone in the know about what might cause 'bladder
scarring'?

I really hadn't planned to make this post.  But, I realized, I'd taken so
much from this group - it was time to put something back.  My hope is that
maybe, someone can benefit from my PVP encounter.

James Combs - age: 67