Prostate :: Holmium Laser Enucleation Prostatectomy Experience
Aug 14, 2014
Well, I got home this afternoon (Thurs) after the op Tues @ 7 p.m. And things seem to be working OK. No more Tamsulosin needed, so that's one benefit right there. I'll update after a few days as the the other possible effects.
The anesthetist chose a spinal anesthetic, which I was somewhat chary of, preferring to be totally knocked out. Later I remembered that there'd been some research that found that older people who had anesthetics died earlier, so he was right on that score. He also told me that this way I had a smaller number of anesthetics (general meant 14!, this way 1 to 3).
I didn't like the thought of being awake and watching the op, but he assured me I wouldn't feel a thing; I wouldn't see anything; and I'd be able to feed and drink more or less straight afterward rather than many hours later. And so it came to pass. Just numb legs for a while. I really didn't feel anything. All over in about an hour. I even dozed a bit on the op table.
However, that night (Tues) was not good. I had a constant feeling of wanting to sh*t. However, no matter how hard I tried (and I used two laxative suppositories), virtually nothing happened. I later found out this is a side effect of the somewhat larger catheter and balloon that was put in place.
So I found it hard to sleep. But just when I did doze off once, the nurse came in for the fourth time to take my blood pressure (2.00 am?). I was really upset and told her not to do any more (all the previous ones had been OK anyway). But by then I couldn't get back to sleep. So I was wretched all the next day (yesterday).
However, last night I got to sleep about 8:30 pm; and slept right through to breakfast. Bliss.
The surgeon had come in on Weds; told me about the defecation urge origin; said I could go home today if my urine was pretty clear by then and the catheter had come out. I see him again in a couple of weeks, when the result of the biopsy will be with him. He also said only 10% need the op again in 10 years; most are fixed for good. Here's hoping.
I was apprehensive about the removal of the catheter. In the end though, it wasn't too bad. I did most of it myself, easing it and rotating it a bit when it seemed to stick. Whew! Great. Then I pee'd a couple of times to test things; told I was OK to go. I left.
Home by 3 pm today. Then did a good walk (4 miles) and all's well. Still some blood and bits, but most clear. Good flow. Now to see how I am at night.
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Just got Gleason score 4+3
PSA risen from 17.8 to 20
plan for robotic radical prostatectomy in 3 weeks - has anyone else had this surgery?
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Hello,I am 61 years old. Six days ago I had a "Green Light" surgery to core out my narrowing prostate. I was catheterization for 24 hours and stayed in hospital. When I tried to urinate the stream was very poor. Initially my bladder was holding over 300mls and it was difficult to pass urine in the day, it was virtually impossible to pass in the night. I went back to the hospital after 3 days and I was then holding 280 mls after urinating. I complained to the consultant (who I trust greatly) and he remeasured the bladder after 5 days an there was 150 mls. The worry is a man will go in urinary retention (very painful) and would need emergency catheterisation. Currently my stream is still very poor. I am upset the treatment has made me worse, but I am hopeful the stream will improve as my Consultant believes it will. I am coping at the moment and will wait. If anyone wishes to follow my progress I am willing to share my experiences.
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I am 4 weeks post op and still having frequency issues and pain when urinating. How much longer can this go on?
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I would like to share my experience with the laser tonsil reduction procedure.
I am 32 years old with small tonsils with crypts. I have been suffering from constant sore throat, BB, tonsil stones, fever since the past three years.
I discarded the traditional tonsillectomy option as I have heard that its very painful in adults with increased risk of postoperative bleeding and the recovery takes 2 weeks to sometimes a month. Instead I opted for laser aided tonsil reduction.
My ENT gave me a prompt appointment and I had the procedure done yesterday. After the anaesthetic spray to the back of my throat that somewhat stinged, the ENT fired around 3 rounds of laser to each of my tonsils.Even though the anaesthetic had numbed my throat, there was a burning pain when the laser went deeper.
The whole procedure was completed in 15 minutes and the ENT informed me that he has reduced both my tonsils as much as possible. The tonsillar area looked black and charred. I had slight difficulty swallowing but it was not that bad as expected.
I returned home in the evening and gargled with difflam mouthwash and took one painkiller around 7 pm when the pain built up. Still a 2 out of a scale of 10.
Day 1 (today): Woke up this morning, feeling much better. My throat has started sloughing and I can see white coating where it was lasered. Pain 2 out of 10. Gargled again but didn't need to take a painkiller.
I have a funny taste in the back of the mouth and the gargle is not helping.
Off to have some lentil soup and veggies for lunch. I have 6 days of sick leave from work to recover, so drinking lots of liquids and mashed food & soup to get well soon.
Note: I have read that partial tonsil reduction may not solve the problems completely. But I am keeping my fingers crossed and hoping that I am not one of the rare cases who has to go for a complete tonsillectomy after all this. I have a follow up appointment with the ENT a month later. wish me good luck.
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I just got diagnosed this year with a Cholesteatoma, after a heavy mid ear inflammation in June, following a severe cold. Before that I had no problems with my ear.
My hearing was virtually lost during the inflammation but recovered pretty well, I guess only a 30 % has gone in my right ear. I live in Spain, in the mountains, and have no problems while I am here.
But I just visited the Peruvian Jungle, and it happened two times that after 3-4 days in the Jungle, my ear starts draining liquids and my eardrum perforates. After being treated two times with antibiotics in Peru, and moving to an area where the air is much dryer, the inflammation goes away within a week.
Now, last Friday I talked with my ENT specialist, and he has put me on a waiting list to have it surgically removed. According to him, it is a 'removal' operation, with a high chance of losing my right side hearing completely, as he 'thinks' the ossicles are infected.
When I asked him if a KTP laser is being used, the answer I got was that they don't use KTP laser in these kind of interventions in Spain.
Since I do not want to lose my hearing capacity in the right ear completely, I understood from reading about Cholesteatomas and treatments that a KTP laser assisted intervention has a high chance of preserving the ossicles, and thus hearing capacity.
There is an ENT specialist who has published about this, Dr. Fairley.
Does anybody has experience with him ?
Has anybody had this type of surgery with a KTP Laser ? How were the results ? I am very interesting in your story, As I am considering paying for the intervention myself in another country.
Prices are fluctuating a lot for this procedure, so if anyone knows a good ENT specialist (Cholesteatoma & KTP Laser) I would appreciate your opinion and experiences.
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Has anyone had laser teeth whitening done. I am not talking about the gum shield things, I am talking about a gel and light system being done in a beauty salon. It appeals to me due to it not being done in the dentist ( which I hate) and the price is about half what the dentist will charge. I spoke to someone and they said the result after 45 minutes was fantastic and the 24 hours later was even better.
So just checking if anyone has any experience of laser teeth whitening.
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JUst wanted to share my experience with my turp surgery. I'm 45yrs old, too young some say for me to having prostate issues but I put it down to my father side of the family (my father and uncles all currently suffer from enlarged prostates)
For the last couple of years been suffering from weak urine stream, having a full night sleep and waking up in the morning with the urge to go wee just to wee a small trickle. I also suffered from time to time having blood in the urine.
Went to see the Urologist, he did some testing, test on the strength on my urine flow (very weak the doc said) he put a camera up my penis to see inside and we could see clearly that my prostate was enlarge and was putting pressure on my bladder which probably explained why sometimes I could see blood on my urine. I have a benign enlarged prostate, no cancer worries which is good.
While I decided if I wanted to have surgery, doctor put me on Avodart. It did help but I wasn't sure if I wanted to take antibiotics for the rest of my life. Avodart temporary reduces the size of the prostate but if you stop taking it, you will still have the same problem again and it will only get worse.
Decided to have the surgery, I had it three weeks ago. spinal block, stayed in hospital one full day with a catheter inserted. Catheter was removed the following day in the morning, had to urine a few times into a container, followed by a scan machine pressed to my belly to see how much urine was left in the bladder. Passed the test and was allowed to go home that day at midday.
I can see the immediate benefit of the surgery where my urine stream is very strong. When I get up in the morning with a full bladder, no more urine trickle, just a strong urine flow. On the other side, I'm still suffering from post surgery effects, for example, frequent urges to go to the toilet and pee ( I probably go every 40 to 60 minutes) blood on the urine and pain (burning/stinging) every time I have to take a piss. The doctor says is normal for this symptoms to happen and it will take weeks before everything is back to normal. how long? it depends on the individual. I can get an erection, it feels a bit different and I will suffer from retro ejaculation ( I was warned about this)
Anyone that had Turp done, how long it took until you were pain free? (no blood and pain) Did you take any medicine to stop the pain or the bleeding?
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I am 36. I have chronic prostatitis for 18 years, that's half my life. My experience in the disease and treatment follows:
The pain is intense and crippling. I have to be in bed all the time. Intense spasms. Symptoms move from urethra to prostate, back,ass, testicles so when you feel you finished with a symptom there starts another. I also may have difficulty urinating and some time ejaculating. This condition has remained idle for a total of 6 years out of 18 and whenever I feel it is gone I have a really good flare up the very next day. Idle means I am not in pain but I get to wet my pants after urinating.. That is the closest I can have to normal life. My sex life is not good because I get erectile dysfunction when chronic prostatitis is active. When it moves to being idle there is a tendency for restoration of erectile capacity however it is clear to me that I do not respond to visual stimuli any more . Reason for ED is venous leakage. Location of pain is as such that I frequently check both my urinary system and intestines.
Findings: High bladder neck, non typical inflammation of colon, prostate has no infection
Medical checks so far: Urethroscopy, Colonoscopy. prostate, testicular, bladder, kidney ultrasounds. urine and prostate fluid cultures.
All cultures have come back negative. Bladder ultrasound shows some urine remaining after fully urinating.
Experience with medication: I have used antibiotics, a-blockers, mesalazine for my intestines and cortisone (buddy cole). For ED I have used Viagra and Cialis.
When I have flare ups NO medication works to control the pain. Or it may work for some weeks and then all of a sudden stop working. Medication for ED seems to be effective provided my symptoms are either gone or are not too intense. Symptoms come and go and it seems I cannot really control them.
Psychological impact: I am desperate and seriously considering suicide when I have flare ups
Social impact: No friends left. I do not have the energy to move out of bed
Fertility: Thankfully no problems whatsoever. However I am extremely worried whether my offspring will have the same problems as I do.
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Since I posted a thread about self-catheterization -- more formally called Clean Intermittent Catheterization (CIC) -- there have been a few different discussions on the topic in various threads. I thought it might make sense to bring those discussions over to a dedicated thread. With that in mind, I will summarize and/or copy and paste some of what was said before into this thread for better continuity.
My story in a nutshell. 68 years old with BPH probably since my late 20’s. Watch and Wait strategy with on-and-off trials of Tamsulosin (Flomax) with poor results. Symptoms were the normal retention issues resulting in frequent urination with incomplete emptying, urgency, and having to go to the bathroom at night in increasing frequencies. Near the end, two or three uti’s per year often accompanied by gross hematuria (bleeding).
Two years ago things got significantly worse and I couldn’t urinate on my own without physically pushing against my bladder (Crede Maneuver). That led to another trip to the urologist where ultrasound showed significant retention and hydronephrosis (water in the kidneys). I was told I needed an operation (this facility primarily did Turps) but first I had to rehabilitate my bladder because at the time it was too flaccid (stretched) for a good surgical outcome. I was given the choice of wearing a Foley Catheter for six weeks, or a program of self-catheterization (CIC) in order to decompress the bladder. I chose CIC so I didn’t have to wear a Foley 24/7, and also because I felt it put me more in control.
Six weeks later my bladder was rehabilitated to the extent they could do a Turp, and the hydronephrosis was gone. After doing some research and a lot of thinking I decided to put off the Turp due to the potential of irreversible side effects, primarily retrograde ejaculation. Two years later, I am still doing CIC while waiting for newer procedures with better outcomes and fewer side effects.
I will detail my experiences with CIC in following posts -- but to summarize, once mastered, it’s a painless five minute procedure that allows you to empty your bladder completely any time you want. With CIC, I therefore have no retention issues, no urgency, and in most cases sleep 6-8 hours through the night without having to get up and go to the bathroom. No UTI’s in over 18 months. And because my bladder has been partially rehabilitated, I can urinate normally about 50% of the time without using the Crede maneuver. My IPSS Score (International Prostate Symptom Score) would be Zero (the best), albeit with a little mechanical assist.
As of now, nothing that I have read about the various current procedures has tempted me to have an operation. That could, or could not change, in the future, but the nice thing about CIC is that you can stop it any time you want with no repercussions. The caveat is that CIC should be done under the supervision of a doctor who will monitor your BPH as required. Similar to seeing a doctor on a regular basis during a Watch n’ Wait BPH strategy.
I know many of you here have already had operations like Turp, and in most cases people seem pleased with the outcomes. CIC certainly isn’t’ for everyone, and I can understand why someone does not want to carry around a urinary “tool box” with them. On the other hand, with practice, it’s not the traumatic and scary procedure some think. I can honestly say right now that for me it’s about as traumatic as brushing my teeth.
I’m offering my experiences and thoughts on CIC for any of those who haven’t yet made up their mind on an operation. It even can make sense for those of you who don’t need an operation yet, but want to increase their IPSS quality of life score. In fact, wish I had done CIC earlier while on Watchful Waiting. Didn’t realize how much BPH had been affecting me for most of my adult life until I was able to empty my bladder completely.
CIC doesn’t have to be a permanent solution, it could just part of a waiting strategy like I’m on, until better surgical operations are developed with better outcomes and fewer permanent side effects.
For any number of reasons, the majority of urologists don’t seem to offer CIC as an alternative to surgery. My current urologist doesn’t as far as I know, but he’s OK with what I’m doing because it works for me. So, either you have to find a urologist you can convince to go along, or go to some of the major teaching hospitals where CIC is probably more in use and better understood. That is where I was taught, albeit not very well, but that is another story.
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My husband had his prostate removed laparoscopically for prostate cancer. The surgery went well. He had a catheter for a week. It was removed and all seemed well. Good control, no leakage. None of the things he feared. But then urine flow slowed then stopped, and we had to go to the ER to have a catheter re-inserted, 16 hours after removal (OF COURSE this could not happen during office hours, so we could just go to the urologist). 2 days later it was removed again. This time he lasted 50 hours before it slowed to a trickle again. He had decided to go to work that day. In the interim I had read about taking hot baths to relax the urethra and bladder and taking ibuprofen to reduce swelling. The flow had already been stopped 5 hours before I knew of it and could suggest them. He tried those, but it was too late; no idea if they would have helped anyway. Doctors office said probably not.
What can he do to keep things open? All along he has been drinking a lot and urinating frequently, as instructed. The only exception has been at night (he usually gets up once, but will set his alarm more often if it will help).
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I had been diagnosed with prostate cancer in may ,2009. The only real option for me was to have a radical prostatectomy because of age (58 years old and retired) :-( . I had this done in july, 2009 and since then there has been no evidence of cancer return. All PSA's have been less than 0.1. I have noticed over this time period a gradual weight gain of 7 lbs. I've always watch my diet and walk 5.5 miles a day. I'm 6'0" and now weigh 189 lbs. I do have rheumatoid arthritis which has been under control (sed rate=10) for a number of years using 0.5 mg prednisone and 1 or 2 vicodin es to control pain and flareup. Why is this happening with the weight gain? Is there any evidence or articles out there to support weight gain after radical prostatectomy ? Is this related to testosterone levels?
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Does anyone suffer with the same severe low back, thigh and groin pain as I have been for the past seventeen months following my radical prostatectomy. I am fine for the first twenty minutes of walking or general activity before the pains starts and increases in intensity if I don't stop. I have had M.R.I's and scans. The spinal consultant said it is caused by a lymphocele which I have had drained once, but urology don't think this is the cause. Can anyone offer any suggestions please. The nerve pain can get unbearable.
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I am actually writing for my fiance (drew) we are storing here frustrated.. today is his bday and we can't even have intercourse after 15 months..
Anyways, we are curious, does this sound like a venous leak, or is this all still normal after 15 post op?
Viagra does not work, period.
Calais gives him about a 20% erection, but at 40.00 a pill, it's impossible to afford on our tight budget.
Using a pump combined with the tightest ring, only gives him about a 30-40% erection for about 5 minutes.
We did try trimex but the third time we used it we face him to much and he had to to to the e.r. and go thru the absolutely most horrible thing I've ever witnessed in my life. So to say the least we haven't tried it again and its been almost 9 months.
Morning erections are rare and only about 30-40%.
When. We use a penis pump, the base of his penis blows up like a doughnut. A good inch or inch n half is as wide as the pump. Once we slip the ring in, even if we pump his penis up almost as long as the tube, his erection always immediately drops. Without getting to graphic, his head does turn n keep blue, so we know he had decent blood flow.
Other then this he is a fairly healthy man, turned 55 today, he is about 40lbs overweight, but ask his blood work is normal, never high cholesterol, no diabetes, and his heart is fine. Ever since his prostate cancer we are insistent in getting all his blood work done every 90 days.
So i guess what we are asking, is does anyone know if this is still normal?
We know ed problems are can be an issue for a few yrs, but he had one of the best surgeons in the US and was done with a davinci robot and nerve sparing. When this is all brought up to any if his doctors, they just offer scripts for ed medications we can not simply afford.
Is this a leak or still ed problems?
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QUOTE FROM ARTICLE:
Although the idea of a clinic-based YAG laser operation is alluring for its perceived simplicity, we have the following concerns.
1. The energy delivered into the eye is not acceptable. The energy delivered to the eye in YAG vitreolysis compared with standard YAG capsulotomy is much greater. Van der Windt and colleagues state the typical required power is 2.5 mJ to 4.5 mJ, and they do not recommend exceeding 500 pulses per treatment session. They recognize multiple treatment sessions may be necessary. It is our opinion this level of energy being delivered into the eye is too great, putting the patient at unnecessarily high risk for postoperative inflammation, glaucoma and retinal tear/detachment.
2. The efficacy of YAG vitreolysis is also in question. Delaney and colleagues found that 38% of patients treated with YAG vitreolysis had a moderate reduction in symptoms while 62% had no improvement.
The alternative treatment for YAG vitreolysis, and what we recommend at Mercy in carefully selected cases, is small-gauge pars plana vitrectomy. This procedure yields much higher efficacy. In the same Delaney study, they reported 93.3% of eyes undergoing vitrectomy for floaters resulted in full resolution. By utilizing modern surgical equipment, now readily available in as small as 27 gauge and cut rates as high as 7,500 cuts/minute, very little energy is directed into the vitreous, and very little traction on the vitreous is exerted. Vitrectomy has the advantage that if a retinal tear develops intraoperatively, it should be easily identified and treated at the end of the case.
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Has anyone tried the laser treatment for trigeminal neuralgia. I have read that people have great success with it. As I understand it the laser is low level and non invasive.
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I am 39 and recently underwent cataract surgery and had Restor Lenses placed. I also had the LRI done at surgery time to correct astigmatism (in both eyes). Well the LRI corrected the astigmatism in my left eye but not my right. My vision isn't as sharp in my right eye also. I was having a lot of glare in my right eye so I had the YAG laser procedure due to a secondary cataract in that eye. I have noticed I have a lot of Starbursts in that eye now. It's really frustrating and I am nervous because in 2 weeks I am having LASIK done in my right eye to correct the "off vision" and fix the astigmatism. I am scared that these starbursts will never go away/ or get worse.? It makes Concerts or night driving bothersome. It's almost like a different version of my cataract. I paid $4,800 for both eyes... and have been thrilled with results of left eye...just not with my right?
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I had IPL laser hair removal at a local salon. The technician gave me 5 sessions (each which included a free retouch session meaning a total of 10) with an interval of two weeks. Obviously i hadn't done my research well and it didn't work. I am going to the leading laser hair removal in my country now..my concern is ...is that too much laser exposure to my area and my ovaries? Would this cause infertility or anything of that matter? It's not about the laser itself but to the amount of exposure that i am being exposed to.
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Has anyone had a co2 laser tonsillectomy? Results?
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Laser liposuction and traditional method of liposuction are both ways to obtain same results, but which method is more effective?let's find out.
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My 1st laser treatment was unsuccessful so i went to see an oral surgeon who specializes in laser ablation on soft oral tissues This time the procedure was much more invasive and treated like an actual surgery. The doctor removed the top 3 layers of epithelial tissue off the side of my tongue where the OLP was I he went much deeper than my 1st doc). I had the procedure friday and am still in considerable pain and discomfort. I am unable to speak and chew so i have been pretty much drinking my meals through a straw. Thankfully i have a supportive girlfriend who has been cooking and pureeing all the food for me I went to the doc today for a post-op exam and he said it was healing properly. I have been taking vitamin C, D, zinc, glutamine and lysine for immune support and to help heal the tissue. Right now my tongue looks like a mess but i am hoping it heals up and the OLP is a thing of the past. Unfortunately i had to cancel my weekend travel plans and missed my good friends wedding in the process, so i've been a bit stressed and sad.
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