PVP GreenLight Laser Treatment
rockman

Winter Springs, FL

#538 Nov 30, 2011
Thanks good imfo. Anyone have imfo on a Dr. lotenfoe Orlando Fl. BPH Exp. Have app. next week to see him. Did HIFU Prostate cancer. On friend in Bahamas 2 yrs ago. He had excellent results with that HIFU.
Dwight

Balwyn North, Australia

#539 Dec 1, 2011
I did alot of research on the internet (thanks GOOGLE), and listed many questions for my 1st visit to the urologist/ surgeon. I have even been studying anatomy of the prostate, and urinary bladder - trying to understand how the Laser actually works during vaporization of prostate tissues.

Also viewed many You Tubes depictions of actual surgeries using Green Light Laser (PVP), and related topics. I wanted to at least have a reasonable understanding of my own anatomy, the problem, and the process/ methods available to resolve it.

Here is my list of questions:

1. Recovery – when can I resume running, driving?
2. Risk of Bladder neck muscle damage during laser surgery and consequent retrograde ejaculation
3.% of case that result in retrograde ejaculation. Sometimes it is necessary to cut this muscle in order to achieve a good outcome from the surgery as it lies under the prostate at the bladder neck. Please explain.
4. Does PVP resolve frequency problems?
5. Why is there burning while urinating immediately after PVP
6. Does it allow total emptying of bladder?“... bladder still does not empty. The urine comes faster, but ends quickly”(quote from a blog)
7. Bladder infection complication more common in PVP than acknowledged – post surgery antibiotics, how long
8. discomfort urinating, especially near the end of the process
9. dribble after urination – why is this a common result of PVP? Is it transient and part of the recovery process whereby the stressed out bladder readjust to the new found “freedom” of not fighting against a obstructive overgrown prostate? Or is it a permanent outcome? For everyone post PVP?

10. Had the surgery Jan 26th....A little burning occured after urination but that has cleared up...No regrets...Huge stream, only get up once a night at the most, ejaculaton is normal...feel like a new person...Don't hesitate to have this surgery.... Tuscon AZ Jan 2007 (from a blog) Does this sound a plausible result of PVP?
11. Post PVC incontinence (including more frequent bowel movement post biopsy). Why?
12. Can the laser damage wall of bladder?
13. Vaporization will continue as long as the BPH tissue is painted by the laser. Once the capsule of the prostate is reached, vaporization ceases, and the procedure is complete. The prostatic capsule is fibrous and has no hemoglobin, so it is protected by the properties of the laser.
14. 120 watt laser, the HPS. A newer version is now being launched, the XPS, which is a 180 watt laser. Do you have this latest XPS 180 Laser?
15. How many PVPs done?
16. Burning in the urine (dysuria).– larger prostates post op experience longer recovery from dysuria? Why?
17. Prolonged catheterisation – explain risk of this post PVP
Dwight

Balwyn North, Australia

#540 Dec 1, 2011
ROCKMAN, if you are considering PVP Greenlight Laser for BPH, google it. It might lead you to some well credentialed urologist highly skilled in PVP. I forget to include in list of questions but ask the urologist when you see him - how many PVPs has he done? Hopefully he say he has performned at least 200.

Doctors like been asked questions. But do your research and ask questions on what you found out in research that you need clarification.
rockman

Winter Springs, FL

#541 Dec 2, 2011
Thanks Dwight. Here in the states it seams to be a different situation. Imfo is like pulling teeth. Have now been to several Dr's. Offices. Personnel tell one story. 100's all the time, We don't keep records does various types of Turps. We call that laser turp. It is listed under one figure turps. They tell you anything to get you in the office. At 100 grains. I know a 100 is min experience for me.
Get face to face with Doctors How many, I do not keep count. How long a few years, About. maybe 10-15, maybe 50-60 laser and button over 5-6 yrs.
Wasted trip after wasted trip usually 120- 250 miles round trip. It's frustrating.
See another 75 miles away monday Told by office he stoped counting at 200 specialists on large. Hopefully It's true.
Henry

Clearwater, FL

#542 Dec 2, 2011
Dwight wrote:
ROCKMAN, if you are considering PVP Greenlight Laser for BPH, google it. It might lead you to some well credentialed urologist highly skilled in PVP. I forget to include in list of questions but ask the urologist when you see him - how many PVPs has he done? Hopefully he say he has performned at least 200.
Doctors like been asked questions. But do your research and ask questions on what you found out in research that you need clarification.
Green laser was not very effective even though it was done by a very experienced urologist. At 2 years still retaining 250cc residual urine.Bladder has accomodated and only up once a night.Stream very weak. Sex drive gone.Consultation with new urologist says that repeat surgery may be performed but incontinence could occur unless extreme care is taken during surgery by a very experienced urologist who has done repeat procedures.
Dwight

Melbourne, Australia

#543 Dec 3, 2011
Day 19: Had 1st complete run post PVP. Some light blood tinge in urine (no different to the color on and off in the past 19 days). 3 hours post run, there seem discomfort sitting - some mild throbbing in prostate area. A sense of urgency developed half through the run (even though I had emptied my bladder - 465ml in 3 voidings over 38 minute period. But I overcame the urgency on finishing the run, didn't void, and started drinking more water. There was no "leakage" on run, a symptom someone reported on this site.

In my research on PVP before I went with it, I also came across "horror stories" of TURP. The more damaged one's bladder is, from an obstructive prostate (i.e. the longer BPH is left untreated, the more damage is inflicted on the bladder). This, I believe dicates the severity of one's temporary and permanent symptoms during PVP recovery phase.

It is best to avoid complete retention, and hence a dash to emergency to be cathertized, pre-PVP. The bladder, at that stage, may not recover. The bladder undergoes physical deformity from protracted chronic stress exerted by a strangulating obstructive prostate.

My urologist told me that in my case, as a very healthy 57YO with no medical history and not on any medication, I should expect not to have to undergo another PVP in this lifetime. We shall see. Note the prostate keeps growing after PVP or TURP!. He said retrograde ejeculation is 100% post PVP. Data show some patients retain antegrade ejeculation, unlike TURP patients where retro is a 100% certainty. But my urologist tells his PVP patients retro is 100% to avoid disappointment - so that if antegrade ejeculation is retianed, it will be a bonus and a pleasant surprise!

The severity of urine retention post PVP could be due to extent of damage to bladder prior to PVP (as aforementioned). The median lobe in an enlarged prostate, projects into the "mouth" of the bladder, pushing the base of the bladder up, hence creating a "sunken" peripheral of the base of the bladder, where urine is "trapped".

Henry, keep us posted on your progress.
rockman

Winter Springs, FL

#544 Dec 3, 2011
I expect problems after for at least 3-6 mo.
My blatter was distorted years ago as the prostate pushed up on it. Saw pics from scans.
Reg Uro says I over flo. he is right, wear pads now. for leakage. So If this stops it great. If not at least I did something to try.
Had I been given the truth years ago. I would of had it done then. But was told anything over 60g was impossiable with anything but open prostate op. That I refused for at least 5 yrs.
So much for trusting ???
Dwight

Fairfield, Australia

#545 Dec 4, 2011
60g doesn't sound big at all. Some of the blogs I have read refer to patients who have their 150g plus prostate downsized by Greenlight. The latest Greenlight Laser, is the XPS180. It works much faster and therefore can vaporize larger prostates without extending surgery time.

DAY 20 for me. Again, very uneventful (which is good). I am drinking much more water like I used to pre BPH, and the bladder is handling it extremely well. Voiding stream is at full force, usually when I get up in the middle of the night. But definitely a signicficant increase of bladder capacity to handle my new daily water intake.

Bladder spasms have subsided, although not totally gone.For a few moments last night (after my 1st complete run), the prostate area seemed to be throbbing while I was seated. That soon passed. Did a walk-run combination today, psuhing harder on the run part. No visible bleeding signs.

I was not on any BPH medication prior to PVP. Instead, I foolishly toughed it out for several years, which added to the bladder damage. But in the last 12 months voiding had become unbearably difficult. For my plane trips from Australia to US, I had to dehydrate myself, and avoiding drinking water on board. Air passengers are supposed to hydrate well on flights, not the other way round! If I had not taken action, I would have hit total retention, and a trip to emergency to be catheterize. Luckily I did not get to that stage.
HENRY

Clearwater, FL

#546 Dec 4, 2011
Dwight wrote:
60g doesn't sound big at all. Some of the blogs I have read refer to patients who have their 150g plus prostate downsized by Greenlight. The latest Greenlight Laser, is the XPS180. It works much faster and therefore can vaporize larger prostates without extending surgery time.
DAY 20 for me. Again, very uneventful (which is good). I am drinking much more water like I used to pre BPH, and the bladder is handling it extremely well. Voiding stream is at full force, usually when I get up in the middle of the night. But definitely a signicficant increase of bladder capacity to handle my new daily water intake.
Bladder spasms have subsided, although not totally gone.For a few moments last night (after my 1st complete run), the prostate area seemed to be throbbing while I was seated. That soon passed. Did a walk-run combination today, psuhing harder on the run part. No visible bleeding signs.
I was not on any BPH medication prior to PVP. Instead, I foolishly toughed it out for several years, which added to the bladder damage. But in the last 12 months voiding had become unbearably difficult. For my plane trips from Australia to US, I had to dehydrate myself, and avoiding drinking water on board. Air passengers are supposed to hydrate well on flights, not the other way round! If I had not taken action, I would have hit total retention, and a trip to emergency to be catheterize. Luckily I did not get to that stage.
Dwight,
You are experiencing the same thing I experienced the first 3 months after PVP.After 3 months the flow started to fall off and the microscopic bleeding did not stop until one year after the PVP.I bought a 10 parameter urine test strip kit and was able to monitor infection ,microscopic blood,ph,white blood cells etc.During the first year I was getting up at night 3 times.
rockman

Winter Springs, FL

#547 Dec 5, 2011
I am 98g. that was years ago. Saw new Dr in Orlando
this am has done 300 plus 80-100g. No beating around the bush. At your size. Cath for 2-3 days at home, Exepect bleeding urinating problems for a while 3-6 mo. Blatter Has to adjust to years of prostate pushing on it.uses Xps system removes as much as possiable not just a clear path. It does regow more in some than others. Intend on letting him do it as soon as I can.
Ken

Elizabethville, PA

#548 Dec 6, 2011
I am having the green light procedure done in a few weeks. My problem is it takes me 3 or 4 times to pee to empty my bladder. I can hold my pee for hours at a time, so frequency is not an issue with me, stream is very slow. My question is after this procedure, am i prone to maybe go alot more and not be able to hold it like i can now? I DONT GET UP EVER through the night now, i dont want to start after the procedure. I am 44 years old. My doc says I am too young to be having this problem.
rockman

Winter Springs, FL

#549 Dec 7, 2011
All depends on size. Bigger is harder. If like me you have years of bladder damage you will have more problems till body responds to new smaller Prostate. Most have some problems in begining. Goes with any operation. Have you tried Flomax or other drugs 1st. It worked for me for years. It is cheap now.
Ken

Elizabethville, PA

#550 Dec 7, 2011
tried rapaflow for a week, couldnt take any more, dizzy, headaches, nausea etc. doc said most of the meds have the same stuff in that creates the same symptoms. My flow is sloooooow, no problems going, just takes 3 or 4 times to empty. I could live with it, but doc says if it pinches urethea totally, then it could be trouble. I know most people who have problems with the procedure, post on here and im sure there is alot more people out there who have had good results dont post. If i had a bad experience, i would want people to know about it, if everything went well, i probably would never think about posting again. Just my opinion, hoping everything works out for me, just DONT want to lose that being able to HOLD my urine for 8/9 hours at a time, I have to trust my surgeon
Dwight

Fairfield, Australia

#551 Dec 8, 2011
DAY 24 POST PVP
I seem to be able to drink far more water without the FREQUENCY!!!!! Urgency is occuring much LESS often!!! But when it hits (usually happens when I am near a wash basin with the sound of running water), I MUST go! A strange thing also is occuring. When I try to void in the absence of urgency, I dopn't seem to be able to void!
Yesterday, I did some sprinting after my walk-run. There was blood tinge in the urine, but no more than usual when I am not exercising. This was my first test of being able to run freely without the shackles of the psychological burden of stirring up the surgical wound. Today I did my 2nd complete, full run in hot weather. Again, everything was fine. Looks like I continue to mend.
Ken, do not wait until total rentention occurs and you have to be catheterize at the emergecny room. That spells trouble in the sense there is a good chance the bladder has been permanently deformed and even PVP or TURP will not restore it. In such a scenario, the best that can be hoped for is being able to void. Loss of bladder control will be permanent.
Dwight

Fairfield, Australia

#552 Dec 8, 2011
Ken, you are definitely TOO YOUNG to be having BPH!!!!!!!!

Everyone has different severity of URGENCY AND FREQUENCY post PVP. It depends on how long you have let this condition go on unattended. The longer the bladder has been strangulated by an ever increasing obstructive prostate, the more deformity the bladder would have gone through, and would take longer to readjust and recalibrate after the obstruction by an enlarged prostate is removed.

I wrote a lengthy post on page 26 on my early days post PVP.
rockman

Winter Springs, FL

#553 Dec 8, 2011
Ken has your Doctor done a Cysto to get a live look inside to see what is happening. If not ask him to do one. It's fast a few minutes and most times not a problem at all. Had in past 4x. Only had some problems on the last. But he was in their a while for a bleeding problem. rest never knew it happened in a hour.
Dwight

Fairfield, Australia

#554 Dec 9, 2011
DAY 26. Definitely drinking as much water (excluding beverages) as pre BPH. The bladder is coping just as well as pre BPH, apart from occassional bladder spasms, and urgency. The urgency is far LESS frequent.
Some blood in the urine is part of healing process. The laser wound is in a "wet area". Expect some scar tissues to fall off as a continuous process of scar healing.
Dennis

United States

#555 Dec 9, 2011
"I am 52yrs, had the procedure 5 months ago.
I had the PVP done because I was getting up at night up to 6 to 7 times. During the day, I always needed to know where a restroom was. My enlarged prostate was also affecting my sex life. I am very sexually active, so I was very apprehensive about the procedure. But since it was affecting that part of my life also, I had it done. So this is my 5 month update.
The first month after, I had blood in my urine, and a strange sensation at the tip of my penis after urinating. The first time I ejaculated, it came out forcefully, but with blood in the semen. That was the last time I had external semen ejaculation "retrograde ejaculation!" Up until about one month ago, I hated the "RE". But I am now use to it, the sensation almost feels the same now. But after an orgasm I will have a strong urge to urinate about 3 time within 10 minutes. I believe this is due to semen in the urethra. My wife actually likes the RE, "no fuss, no muss!!!" I have read that RE can reverse itself within a year as the prostate reforms.
As far as urinating, I now piss like a race horse! Even as a teenager, I never had so much volume. I may now only get up once, or at the most twice at night now. I still have to stand at the urinal longer than I use to, to make sure it is all out though. I hope this can help a few people that have just had PVP done, or are thinking about it. I will post another update at the year mark."

Ok the above post was my post back in March 2011. It has now been one year post PVP. So as promised I will post my results after one year.
i. I still piss like a race horse :), so the main objective of the surgery has worked.
2. My doctor also told me that retrograde ejaculation was about 100%. And I have little reason to doubt him, but!
I have noticed my orgasms feel completely normal now. Before at the completion of the orgasm, I would get a strange sensation that I believe was the seamen going backwards. This sensation would diminish the pleasure of the orgasm. Now that I believe my prostate is starting to reform, I get about 1 to 2 drops of seamen ejaculating out. So I believe it is now starting to push the seamen in the right direction, hence the normal orgasm sensation. "Thank God!"
3. I get up about once at night to urinate.
4. No extreme urges to urinate during the day.
5. I think my bladder empties out almost completely, no way to really tell.
6. I am happy I got the procedure, I am just hoping my ejaculations will become as close to normal as possible in the near future.
I realize every one is different. So my results may not be your results. But it always seems like most people that post are either the individuals that have had complications, those that are looking for information about PVP, or those that just had it done and are worried.
I thought it would be good to post, "what I think is a positive result so far" post op one year.
Dwight

Perth, Australia

#556 Dec 11, 2011
Thanks Dennis. I am not sure why there was one antegrade ejeculation, post PVP, then followed by retrograde. But it does makes sense antegrade ejeculation is returning as the prostate fills out a bit more as it continues to grow.

At almost 4 weeks post PVP, frequency is about the same pre PVP only because I am drinking like a horse (and pissing like a horse too!) Drinking alot of water is part of the recommended healing process - to get the bladder to revert to its old working habits. My bladder was badly deformed, and it will require time to lose that deformity.

Urgency seems to gradually decline (sure sign of significant increase in bladder capacity, i.e. regaining its original capacity before BPH struck). But when urgency hits, it is URGENT - a I break the world record for the 100 yard dash to the potty!

I have gradually return to running after 3 weeks of walking, or walking-run. I tend to get a urgency sensation after about a mile. I have learnt to ignore it. When I finsih my run, the urgency prove false and I don't need to void!
rockman

Winter Springs, FL

#557 Dec 12, 2011
Tomarrow's the day. Greenlight in afternoon. Will post as able. Will spend night in motel to late to drive home. Bring my own sanitizer for the motel. they are not the cleanest places in the world.

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