T Nation

TURP Surgery - Anyone Had It?


#1

I'm hoping someone has some feedback on this subject and that this is the right place to bring it up. (I can't find another area on T-Nation that seems more appropriate for a male medical issue.)

I have urinary blockage owing to a moderate to severe case of BPH (enlarged prostate). Flomax has had little effect and the doctor says the next move for me is TURP - Trans-urethral Resection of the Prostate. This is where they insert special instruments into the urethra and remove material from the prostate in the area of the bladder neck. A hot wire loop instrument is used to widen the opening.

This is a somewhat common surgery for hard cases of BPH, and the stats are such that the risk is low for erectile side effects or negative effects on sexual sensation - although there are exceptions.

The only unavoidable side effect is that the surgery would forever cause me to have retrograde ejaculations - where the semen issues into the bladder rather than out of the penis. This is because of the weakening and removal of some prostate muscle tissue that squeezes together and prevents backflow into the bladder during orgasm. The doctor and all of the online information say this is completely harmless - though somewhat unpleasant (for obvious reasons).

I can never empty my bladder as it is now, and it has begun to have a large effect on my lifestyle.

Has anyone here had this surgery? How did it work out for you? How long has it been since you had it? Any complications or side effects worth mentioning?


#2

If would be good to have some basics about you as per this sticky:

  • advice for new guys

E2 is more of a problem for the prostate than T. Older males with lower T levels also tend to have higher E2 levels and the T:E ratio is then twice impacted.

Have you been using “herbals” for your prostate?

Can you post lab work with ranges?
Blood pressure?

I do not have any info re the surgery or outcomes.


#3

I had the surgery in 2009. The change in ejaculation was a REAL issue for me in the first year or so. Not so much now, and the wife, of course, loves that aspect. However, I cannot say that I ever saw any benefit in terms of ability to empty the bladder completely, starting stream issues etc. I have had prostatitis issues beginning at the age of 18 but rarely after ~30.

Still, my urologist did think it necessary. I do think you would be wise to consider the results\benefits you are hoping to realize from a TURP. In my case, I strongly believe that some of those issues have been improved and then “see-sawed” depending on hormonal conditions. Do yourself a favor and read the stickies KSMan referred to and post the results before doing the TURP. Good luck!


#4

I had a kidney stone, 2003, with complications, and they put a laser up my pipes to deal with it. That was all resolved. But my urine flow was greatly improved from the mechanical dilation from all of that hardware. So a mechanical therapy might have some merit. But might need anesthesia.

Today, if my urine flow is slow [might be food related], I pinch off the flow with my fingers and let the bladder pressure build up. That seems to stretch things and when release the flow is markedly improved.

Overall, I think that TRT has improved my prostrate and urine flow. You know my thoughts about E2 management.


#5

I have a very close friend (almost best friend) and my wife’s ex brother-in-law who have had prostate surgery. They both had the prostate surgery via the DaVinci robot. That is the only way to go. The analogy I’ve been given is that the DaVinci robotic surgery is precision microsurgery vs. the traditional TURP procedure being like hacking with a machete or hatchet. TURPs with scalpel or laser severs nerves and causes other tissue damage. TURPs traditionally have left men with incontinence issues and sexual function issues. The two guys I know who had DaVinci robotic surgery have had quite good results but still had to learn when to go pee all over again or they wet their pants on accident.

Prostate surgery and back surgery in my opinion have two things in common: It is better to exhaust ALL avenues of treatment before choosing to undergo surgery. Surgery should be the last stop and if you need to end up there, DaVinci robotic surgery is the only way to go nowdays.

Another option inbetween would be to self-cath to drain your bladder. I’ve had to do it after a urethral surgery in the past and I did not find it fun. However, I think it’s better than a surgery and the long-term effects that a surgery could create.


#6

[quote]deltaname wrote:
I’m hoping someone has some feedback on this subject and that this is the right place to bring it up. (I can’t find another area on T-Nation that seems more appropriate for a male medical issue.)

I have urinary blockage owing to a moderate to severe case of BPH (enlarged prostate). Flomax has had little effect and the doctor says the next move for me is TURP - Trans-urethral Resection of the Prostate. This is where they insert special instruments into the urethra and remove material from the prostate in the area of the bladder neck. A hot wire loop instrument is used to widen the opening.

This is a somewhat common surgery for hard cases of BPH, and the stats are such that the risk is low for erectile side effects or negative effects on sexual sensation - although there are exceptions.

The only unavoidable side effect is that the surgery would forever cause me to have retrograde ejaculations - where the semen issues into the bladder rather than out of the penis. This is because of the weakening and removal of some prostate muscle tissue that squeezes together and prevents backflow into the bladder during orgasm. The doctor and all of the online information say this is completely harmless - though somewhat unpleasant (for obvious reasons).

I can never empty my bladder as it is now, and it has begun to have a large effect on my lifestyle.

Has anyone here had this surgery? How did it work out for you? How long has it been since you had it? Any complications or side effects worth mentioning?[/quote]
I had a TURP about 3 weeks ago. Made a real difference; no adverse side effects; now pee like a horse. The downside: waiting time before resuming heavy lifting.


#7

[quote]XLR8MyLife wrote:
I have a very close friend (almost best friend) and my wife’s ex brother-in-law who have had prostate surgery. They both had the prostate surgery via the DaVinci robot. That is the only way to go. The analogy I’ve been given is that the DaVinci robotic surgery is precision microsurgery vs. the traditional TURP procedure being like hacking with a machete or hatchet. TURPs with scalpel or laser severs nerves and causes other tissue damage. TURPs traditionally have left men with incontinence issues and sexual function issues. The two guys I know who had DaVinci robotic surgery have had quite good results but still had to learn when to go pee all over again or they wet their pants on accident.

Prostate surgery and back surgery in my opinion have two things in common: It is better to exhaust ALL avenues of treatment before choosing to undergo surgery. Surgery should be the last stop and if you need to end up there, DaVinci robotic surgery is the only way to go nowdays.

Another option inbetween would be to self-cath to drain your bladder. I’ve had to do it after a urethral surgery in the past and I did not find it fun. However, I think it’s better than a surgery and the long-term effects that a surgery could create.[/quote]

Using a catheter isn’t a sought after remedy. After TURP, the catheter is in you for a couple of days. I put up with BPH for about 20 years using herbs, matcha, etc. which helped and then switched to Flomax which worked but then my BPH just worsened and after a cytoscopy I saw the problem and the solution was TURP. That was three weeks ago and I have no adverse symptoms – this operation is so common that a urologist should be able to perform it and minimize adverse symptoms.

Still it takes a week or so for the bladder to get back to normal. I think I need to wait at least six weeks before resuming strength-training, and then I’ll have to start with light weight and slowly work my way back up to heavy lifting – based on my research. My urologist just said to be careful and take it slow – he doesn’t have patients who lift heavy, but he did tell me that a patient of his who had just had a TURP after a couple of weeks decided to resume his P90X workout and afterwards he had to have the procedure redone because he had injured himself just doing an intensive dumbass P90X workout so that got my attention vis-a-vis heavy squats, presses, deadlifts. I just want to lift again so it is difficult being patient.

BTW, I’m 67 years old.


#8

Retrograde ejaculation is risk of a TURP but isn’t necessarily something you will encounter. It’s also entirely possible that you may have retrograde ejaculate during the first few weeks to months and then have it resolve.


#9

Thanks for all of the feedback - I was in agony and there was no resolution, so I had the TURP on Feb. 17. No choice. Severe blockage, total agony.

Overnight stay in hospital, had catheter removed just before discharge from hospital. Doc said not to resume workouts until after bleeding stopped. It stopped about 3-1/2 weeks after surgery, but I’m going to give it at least another week before I get back into the gym - just to be sure. Even then, I’ll take a few weeks to get back in to challenging lifts.

Absolutely free-flowing urine stream now. But complete retrograde ejaculation (RE). Everything else still works. The stats are that 75-80% of TURP patients get RE, and I’m one of them

But, I’m able to go hours without having to pee or experience any discomfort. So far, I’d have to say it was a success. They say TURP is the “gold standard” for urinary blockage due to BPH. (Biopsy showed no cancer. Yay.)

So, again, thanks for the feedback. I’m open to questions from anyone else facing this decision.


#10

i have just had my turp done on tuesday afternoon. i am home now and urinating more now than ever and the flow hasn’t improved either. how long was it b4 you noticed any improvements.


#11

I’ve had TURP, and I guess I was one of the lucky ones. I had immediate improvement in flow, no post-operative pain or complications, and no side effects. All I have is retrograde ejaculation. But, erections are still good and orgasms still occur with the same intensity as before. This was done in 2013 by a very experienced doctor.

But, I was cautioned by my doctor that the following two post-op occurrences were possible that could slow recovery: Post-op swelling of the prostate and scar tissue build-up. I had neither of these, thankfully.

With post op swelling, it just needs time to go down. Weeks, perhaps. But, it should go down as everything heals and seals up.

With scar tissue - and I think if you had surgery on the 3rd of May, it might be too early to see scar tissue - but scar tissue can build up and impede flow. If you have this, then that will require another procedure for a ream-out job. The scar tissue removal isn’t as involved as the original surgery - and I think it can be done in the doctor’s office (although I’m not positive).

A third possibility is clotted blood that builds up and creates blockage and is too thick to be easily flushed out by urination. I had a little of this in my case. It didn’t impede urine flow for me, but when chunks of blood shot out when peeing for the first 3 - 4 days, it was a bit unnerving. It took a total of 3 weeks before my urine ran totally blood-free.

I would recommend drinking a lot of water (>2 liters per day) so that you pee often and keep things moving down there. This’ll wear down the clots and prevent more from forming.

If you contacted the doctor and told him you’re still not flowing yet, he’d probably tell you to wait at least two weeks to give your body time to heal from the post-op stuff. If you see no improvement after, say, 4 weeks, then you have to go in and see the doc for another look.

TURP’s have been pretty successful in most other patients I consulted before I had mine. Since then, however, a new procedure has been developed that is better than TURP in almost every way. It’s called HoLEP - Holmium enucleation of the prostate. It uses a Holmium laser to completely gut the prostate from the “inside” leaving only the “capsule” of the prostate remaining. Read about it at the Mayo Clinic web site. It appears to be superior to TURP in all ways. It will probably become a replacement for prostate removal in the case of non-cancer severe prostate problems. If my TURP fades, then I’ll be seeking out HoLEP.

HoLEP has a steep learning curve for doctors, however, and the web articles I’ve read have advised going only to doctors who have experience performing it. They say you should pay cash and go to another city to have it done if you can afford it.


#12

thx for that deltaname. i don’t seem to have a problem with getting an erection( thank god :). could it be doing me harm having them of a morning