Because this group has been so helpful to me in assessing the benefits of
PVP, I would like to describe my own recent experience with the procedure.

Background:  Age 68 -- Slowly worsening BPH symptoms for at least 10 years -
need to urinate 4-5 times during the night, week stream with ending dribble
for ? a minute, a very strong, urgent need to urinate that was almost
impossible to control sometimes, and often needing to urinate again within
20 minutes.  In other words, the usual, and very annoying/uncomfortable
symptoms that were forcing me to make many lifestyle adjustments.  I had put
off getting a traditional TURP for several years, although that was what my
urologist recommended - but  recently he bought a TUNA machine and wanted me
to try that first!  I had briefly tried Hytrin, but quickly stopped due to
the lightheadedness it created.  Due to some slight blood in the urine this
spring, a cystoscopy and ultrasound were done, with negative findings.

Following the many positive results reported in this newsgroup, I started
looking for a urologist in the Boston area that was using the Laserscope -
alas, none!  Hard to believe - one of the medical centers of the country,
and no one using it.  The nearest to me was Dr. Barry Stein in Providence.
A reply, to a post I made to this group, came from a California (!) resident
(who had relatives in this area) who had had the procedure with Dr. Stein
and was very pleased with him.  So I contacted him for an evaluation, and
saw him in June.  He did an ultrasound indicating a 110 gram prostate.  He
said I had 2 options:  a traditional prostatectomy (the full surgical
abdominal procedure thing) which would be able to remove 80 grams of tissue,
bringing the prostate back to normal size, BUT, with a 37% rate of serious
complications, several months of recovery, etc etc.  Or, the PVP, which has
very low risk of complications, but would  probably only remove about 60
grams.  He said he removes about 1 gram per minute using the Niagara PVP.
He said he had done about 50 PVP's so far, and had had no problems, and
excellent patient satisfaction with the procedure.   So I scheduled a PVP
for late July.

The procedure was done on an outpatient basis at Rhode Island Hospital,
which is right across the street from one of Dr. Stein's offices.  And,
because I was traveling some distance (over an hour) from home, I could, if
I wanted to, plan to stay overnight in the hospital in order to be able to
deal with any problems should they occur.  I accepted that suggestion.
According to the surgical records, I was under general anesthesia for 1:44,
and the surgery itself took 1:00 hour. The cystoscope revealed an 'extremely
long prostate with at least a 70-80 gram BPH in the lateral lobes, with no
median lobe. The Niagara was set at 80 watts, and at total of 141,000 joules
was used.'

Surgery was in the morning, and by early afternoon I was urinating (thru a
catheter) with some blood - pinkish, but no profuse bleeding.  The catheter
was only slightly uncomfortable, but caused no pain.  I was given vicodin as
I desired, for some tenderness and soreness.  I was glad I was staying in
the hospital for the night, even though I probably could have managed at
home.  At midnight the catheter was removed, and there was some brief
burning pain during the extraction.  I was able to urinate normally after
that - still some blood showing in the urine.

I went home the next morning - no pain, but definite tenderness in the
scrotum.  During the next 3 days I first used a little vicodin, and then
switched to Tylenol.  It was uncomfortable sitting for long, and I had to
use a soft piece of foam, with a 'cutout' for you know what.  The bleeding
quickly diminished to almost nothing, though there would be brief amounts
during the next 3 weeks.  There was no burning during urination. The
tenderness slowly subsided, but it took several weeks.

Now, 6 weeks later, I'm a very happy camper.  Much stronger stream, no
dribble, no sudden overpowering urge to urinate, nighttime frequency reduced
to maybe 2 times per night.  There appears to be partial retro during
ejaculation - nothing that bothers me.  As Dr Stein said during a follow-up
visit, it generally takes a good 3 months before everything is stabilized
and the full benefits are realized.

So, what did this all cost?  Well, I was faced with the problem of being in
the Harvard Pilgrim HMO plan for seniors, which I anticipated (and my
primary care physician agreed) would give me a real hard time getting
approval for an out-of-area (actually, out of state) procedure. So I dropped
them in May, and went on to straight Medicare.  This turned out, I believe,
to be a wise move.  As seen below, my total cost was $602.  An absolute
bargain as far as I'm concerned.

Would I recommend the PVP to other suitable candidates - absolutely.

Would I recommend Dr. Stein - whole heartedly.  (Incidentally, my urologist
in the Boston Area also strongly recommends Dr. Stein - he has been a
pioneer in laser surgery for urology uses for a long time, apparently, and
was involved in the 2nd multi-center PVP study that was recently published).

    Billed
    Medicare Paid
    I Paid

     Rhode Island Hospital
    8285
    1416
    354

     Anesthesiologists
    1040
    178
    45

     Dr Stein

        Surgery
    4032
    469
    117

        Office visits and testing
    965
    462
    86

    ____________
    ______________
    ____________

     TOTAL
    14322
    2525
    602

Larry