Thanks for the information.  I expect my bladder could be a significant
problem now too.  I am 75.  However, I have not had bph problems for a long
time.  Since I am in relatively good health I wanted to get treatment now.

And I would expect that it would take a while for even  PVP to heal.  After
all the urethra experiences one hell of a sunburn.

Rich,

I have had general anesthesia three times prior to pvp, twice as a child for
tonsils and adenoids and once as a young adult, 21, each time in the UK with
no bad results. The pvp was done in North Carolina, USA. I am now 53.

Regarding pvp, from my understanding, a less than satisfactory outcome can
result  from two separate issues, one, the bladder and two, the prostate.

If a person has had bph for a long time the bladder muscle can be damaged
from long term straining against the blockage. The bladder muscle thickens
and the bladder becomes less elastic and eventually the muscle just gives up.
In this situation a pvp, or for that matter, turp, tuna, tuip, tumt etc, will
remove the blockage but the bladder no longer has the power to empty itself.
A uro can determine the condition of the bladder before pvp by various
urodynamic tests.

Or the prostate causes the problem after pvp. Several things can happen but I
believe they can be corrected. The pvp can cause scar tissue to form that
blocks the urethra again. Or part of the prostate collapses into the urethral
passage. Or the prostate swells due to the trauma of the procedure and takes
a few weeks to go down which is what happened to me.

There may be factors that cannot be anticipated that cause a bad outcome but
I have no knowledge of them. Perhaps someone can add to this?

Dave

Thanks to everyone who is responding to my question. It has cleared up a few
suspicions.

The bottom line still seems to be that PVP is far superior to TURP.

However, as with any procedure it is not perfect every time or may simply
take longer to take effect.

Anesthesia often has adverse effects on patients. Dave C, is this the first
time you have had problems with an anesthesia?  Have you had been
anesthetized many times before?  Perhaps that is not as important as they
type of anesthesia that they use.

My URO talked me into trying TUMT a few months ago.  The results are
marginal but the main problem still seems to be having to get up at night.
Not much problem during the day.  The URO said that sometimes it takes up to
a year for full improvement.  He has done over 50 PVP and said he has had
good success with them too.

Of course the advantage or disadvantage as the case may be, of TUMT is that
you do are fully awake for the whole procedure and get full appreciation of
the pain involved!!  It was only momentary sharp pains and no problem what
so ever afterwards.  I did wear a catheter for 5 days and got 5 full nights
of sleep.  No bleeding.  Only a couple times did I note the tissue being
ejected.

I had endoscopic sinus surgery a few years ago.  That was the most
uncomfortable recovery I ever went through.  I did a lot of searching before
selecting a surgeon that I would allow to cut that close to my brain and
eyeballs.  A tiny slip during that procedure and you can be a vegetable or
blind for the rest of your life.

Rich,

My experience immediately after my pvp could be considered bad:

The general anasthetic left me in a mentally deranged state for a day. The
evening after the pvp I thought that if I allowed myself to fall asleep I
would never wake up again so I tried everything not to fall asleep the first
night. Funny looking back at it but it certainly upset my wife at the time,
not to mention me.

I had to wear a catheter for 7 days because of the degree of bleeding. Also,
I did not get the immediate improved flowrate that I had been expecting, so I
went though a few weeks not knowing what the final outcome would be.

My nocturia worsened for a few months and I also had  "urgency" that would
come on at a moment's notice and make me run for the bathroom.

I found I had retrograde ejaculation and diminished sensation of orgasm. Both
have now resolved.

However, at two months there was significant improvement and at three months
I was overjoyed with the results. Also my nocturia had almost gone and the
retro had diminished.

Now at over 5 months it is difficult to remember the slow urination and the
dependence on Flomax for almost a decade and the stupid urologists who told
me nothing could be done about it and that I would eventually have to
catheterise for the rest of my life.  Every now and then it hits me (usually
when I am peeing effortlessly) how normal everything is now. I cannot
remember the last time I woke up during the night to pee.

Even now there seems to be continual improvement of bladder function. After
pvp my bladder held 200-250 cc. Now it is 300-350 ccs which is fine with me.

At five months post-op I am a very happy customer.  Looking back, I can see
that the healing takes time, or at least it did in my case. From reading this
forum it seems that some people walk away from the procedure with instant
results and rapid healing, but this was not my case. However, in talking with
my uro during follow-ups, my case was typical in his opinion.

If you are considering pvp I believe it pays to find an experienced urologist
who has performed at least 100 procedures. Then ask him what problems he has
encountered in performing this procedure.

All the best,
Dave

I have been following this group for quite a while.  PVP is continuously
praised.  I just wonder if anyone has had or has heard of any bad
experiences.   One post said something to that effect but did not give any
details.

Others report good results with TURP but a few have with what might be
called horror stories.