GreenLight Laser Surgery Complications
Bob

Denver, CO

#1082 Apr 10, 2013
I had Greenlight procedure about one year ago. I still experience frequent urges to pee during the day and night. It is easier to pee when sitting down and there is discomfort frequently when I have gas or need to have a bowel movement. Has anyone experienced the issue with gas or BM causing discomfort...pushing on the bladder?
BobnMa

Peabody, MA

#1084 Apr 22, 2013
Very sorry to read about all the problems documented here from the GL procedure. I am now 3 months out and the minor problem with overactive bladder sysmptoms I mentioned a couple of weeks ago seems to be subsiding. Overall, very happy as I stated in previous posts. I don't know what made my experience different but I see 3 possiblities.

1. Luck

2. The skill of my Doctor.

3. I opted for the surgery early. Well before the sysmptoms became severe. There was a lot of family history between my father, grandfather, and many Uncles. My father warned me years ago when he had his TURP not to wait too long like he did. A couple of my Uncles ended up in the ER before having the surgery. I took a more aggresive approach and when I heard about the potential benefits of GL vs. the old TURP. I was using Uroxathral for years before my surgery. I went from using it as needed to every other day to every day. When I started needing it every day, I opted for the surgery.

This may be the key in my case. Don't know but I thought I would pass this on.
NJRetire

West Milford, NJ

#1085 Apr 22, 2013
Bob,
I hope yours is a success case. I am 10 months post op from a 180 watt GL that my uro said removed 70g of a 120g prostate in 70 minutes. I had 2 months of painful recovery, followed by 5 months of what seemed like a pretty successful operation, and a return of many problems over the last three months.

At this point I am back on Tamsulosin (generic flomax). I get a good stream for about 3 to 5 seconds, then a burning sensation and an abrupt stop of the stream, and then after waiting 15 or 20 seconds I dribble out the rest over the next minute or two.

To be fair this is way better than complete retention I experienced regularly prior to the GL last June of 2012. But it is an awkward and annoying way to have to pee.

Two months ago my uro claimed my bladder was fine after a cystoscope to remove some scar in the urethra by the prostate, and he recommended weekly self cathing to "keep the channel open". I tried self cathing for 5 weeks but got a UTI, and it made no difference to the flow.

Now, after 14 days of cipro and a week of Tamsulosin I am inclined to just live with the "new normal". I'm less inclined than ever to get another procedure unless and until I absolutely have to.

It strikes me that the key to success with the GL is having a condition that the GL will actually cure. If a person's symptoms are solely due to an enlarged prostate causing a blocked urethra, then the GL ought to do the trick. This after all is the model being used to convince patients to get the GL.

But if the symptoms are also due to the bladder mouth or urethral sphincter not functioning correctly, then the GL can't be completely successful, though (like in my case) it may help.

I noticed before my GL, that sometimes my stream was good, sometimes it wasn't. If that was due strictly to to an enlarged prostate squeezing the urethra shut, it would seem the stream would always be bad, but it wasn't.

I'm starting to think that just like the first protocol for non bacterial prostatitis is an often unsuccessful course of antibiotics, now the first protocol for bph is an often unsuccessful GL.

And after all, older women often exhibit the same problems (frequency, urgency, retention)as older men with bph do, but the women have no prostate. What they do have is a bladder, and now I wonder if that is what is at often a large part of problems attributed solely to bph. If so,(and I am theorizing it may be my case as well) it would explain why the GL doesn't solve all of those problems. It may not be a bad operation, it may just not be the operation that solves all of the problem.
BobnMa wrote:
Very sorry to read about all the problems documented here from the GL procedure. I am now 3 months out and the minor problem with overactive bladder sysmptoms I mentioned a couple of weeks ago seems to be subsiding. Overall, very happy as I stated in previous posts. I don't know what made my experience different but I see 3 possiblities.
1. Luck
2. The skill of my Doctor.
3. I opted for the surgery early. Well before the sysmptoms became severe. There was a lot of family history between my father, grandfather, and many Uncles. My father warned me years ago when he had his TURP not to wait too long like he did. A couple of my Uncles ended up in the ER before having the surgery. I took a more aggresive approach and when I heard about the potential benefits of GL vs. the old TURP. I was using Uroxathral for years before my surgery. I went from using it as needed to every other day to every day. When I started needing it every day, I opted for the surgery.
This may be the key in my case. Don't know but I thought I would pass this on.
BobnMa

Peabody, MA

#1086 Apr 23, 2013
My problems were not strictly the enlarged prostate. A couple of years agao my Urologoist had to go in and remove a kidney stone from my bladder. He told me then that I had a "high" bladder neck which was contributing to my problems.

Its starting to sound to me that my decision to go with the GL early, before I had problems like retention and constantly getting up at night, was a key factor. Perhaps waiting too long can cause problems that GL can't correct.

That is going to be my advise to friends and family if they ask.
Bill

Kirkland, WA

#1087 Apr 28, 2013
Had this surgery 2-14-2013
Today is April 27--2013
I am 3 times worse off than before surgery.
Before I was up 3-4 ties a night..no other issues,but no quality sleep was getting to be a problem
Now I get up 2-3 times what I used to and also have pain,incontinence,extreme urgency and then only go a couple ounces.
They tell me it my body..never had all these issues with others...really?
Now they are trying a 'cocktail' I have to go in once a week to get at his office. It is injected. DMSO,antibiotic and a couple things I can't recall are in the cocktail. It's used for 'other things' but since I am so miserable with this try are trying it. I was given medication at first..caused constipation..now I also am in pain from in and outer hemroids.
I will repost as my saga continues. I may seek a second opinion if things don't improve soon. My quality of life has significantly declined.
Jim

Paris, TX

#1088 Apr 28, 2013
Bob wrote:
I had Greenlight procedure about one year ago. I still experience frequent urges to pee during the day and night. It is easier to pee when sitting down and there is discomfort frequently when I have gas or need to have a bowel movement. Has anyone experienced the issue with gas or BM causing discomfort...pushing on the bladder?
Yes the BM and gas cause me to feel like I need to Pee.
JIM
BillR

Orange, CA

#1089 Apr 30, 2013
had the surgery two weeks ago today. The catheter for 2 days was not pleasant but once removed, things improved significantly. Blood in the urine has changed from bright red to darker and is more mixed in now than the beginning. I also have begun in the past 3 days to experience a burning sensation when I urinate, especially at the end, which I attribute to healing. I go back in two weeks for a follow up. If it doesn't get better soon, I will call earlier. overall, I have to say the improvement has been worth the process. No sex yet so can't comment on that.
Bill in CA

Sacramento, CA

#1090 Apr 30, 2013
I am now 3 months post HoLep performed by Dr. Lingeman at Indiana Univ.
Excellent results: no incontinence, very little blood, no pads, and no pain.
It took a real effort to travel to Indiana and make all the arrangements--but it was worth it especially after reading the posts on this site (which were very helpful).
The HoLep was a 'clean' procedure and Dr. Lingeman has performed about 2000 so far.
I could not agree to locals doing a TURP, Greenlight, or ablation.
BobnMa

Peabody, MA

#1091 May 3, 2013
Bill,

I had that burning at the end of urination but it eventually subsides and I have none now. Give it time.

My doctor said no sex for 5 weeks. Very happy when I was still able to ejaculate. Good luck on that issue.

Bob
BillR wrote:
had the surgery two weeks ago today. The catheter for 2 days was not pleasant but once removed, things improved significantly. Blood in the urine has changed from bright red to darker and is more mixed in now than the beginning. I also have begun in the past 3 days to experience a burning sensation when I urinate, especially at the end, which I attribute to healing. I go back in two weeks for a follow up. If it doesn't get better soon, I will call earlier. overall, I have to say the improvement has been worth the process. No sex yet so can't comment on that.
Dwight

Massillon, OH

#1092 May 3, 2013
Had the procedure Dec 6,2012, Woke from the procedure with "NO" kidney function. Confined to hospital for 12 days with Dialisis, My surgeon had no Idea what caused the problem.(Kidneys were completely functional before surgery)but with consultation decided to place stents thru my back into my kidneys and into my bladder. this renewed the function of kidneys and stents were removed Jan 27th and my bladder was scoped and pronounced healed.Left Ohio for A California Visit with my children and ended in urgent care with a bladder infection. Returned to Ohio and my orig. urologist
and after blood work was pronounced cured. Night visits to bathroom are down to about 8 or 9 day time is impossible am alright as long as I stay seated but as son as I stand its off to the bathroom. Must sit to pee as the stream is so weak and scattered standing that I dribble all over.(like a broken sprinkler head) I am 79 years old and this procedure was the dumbest thing I ever did.
NJRetire

West Milford, NJ

#1093 May 3, 2013
I hear you about the broken sprinkler head. I keep thinking I pee like a busted leaky radiator. I had the procedure in June 2012. For the last three months I can pee good for about 3 to 6 seconds, then my sphincters snap shut and if I stand there for a few more minutes I dribble like a leaky pipe. I go 3 to 5 times a night and I also almost always have to go when I stand up after having been seated. Flow seems more restricted during the night. The feeling to go is there, but after a few seconds it doesn't come out except in drops. It's like the sphincters are asleep and won't stay open after I sleep in bed for any amount of time. Bladder throbs like a pounding heartbeat at night after the sphincters shut tight. On the plus side, at least I get the 3 to 6 seconds of a good stream before it shuts off. Before the GL I got nothing but pain when that would happen diuring the night. Also, during the day, now once I go I can last for an hour or two if I stay on my feet to go shopping or cut the grass or take a walk. Before the GL I could only last 45 minutes all day. So I had no choice, but the results, while an improvement, is nothing that any doctor would advertise to convince people to have the GL.
Dwight wrote:
Had the procedure Dec 6,2012, Woke from the procedure with "NO" kidney function. Confined to hospital for 12 days with Dialisis, My surgeon had no Idea what caused the problem.(Kidneys were completely functional before surgery)but with consultation decided to place stents thru my back into my kidneys and into my bladder. this renewed the function of kidneys and stents were removed Jan 27th and my bladder was scoped and pronounced healed.Left Ohio for A California Visit with my children and ended in urgent care with a bladder infection. Returned to Ohio and my orig. urologist
and after blood work was pronounced cured. Night visits to bathroom are down to about 8 or 9 day time is impossible am alright as long as I stay seated but as son as I stand its off to the bathroom. Must sit to pee as the stream is so weak and scattered standing that I dribble all over.(like a broken sprinkler head) I am 79 years old and this procedure was the dumbest thing I ever did.
Johnny Greenbeans

Monroe, CT

#1094 May 4, 2013
YEAH,I HAD MY GREENLIGHT 08/2011.IHAD TO HAVE IT BECAUSE MY BLADDER WOULD'NT EMPTY.THE ONLY THINGS NOW IS THE RETRO GRADE AND I'M STILL GETTING UP TWICE A NIGHT.IF I TAKE TO MUCH SALT THEN I'M UP MORE.ALRIGHT BOYZ,TRY THIS.AFTER YOU URINATE INTO THE JOHN THEN WALK IN PLACE FOR A FEW SECONDS,URINATE AGAIN MORE COMES OUT.DO IT AGAIN.MORE COMES OUT.THAT IS THE TIP OF THE DAY.
NJRetire

West Milford, NJ

#1095 May 4, 2013
Well exactly. There's more in there. Some people dribble. Some people say they never feel completely empty. It takes two or three passes, or just standing there for 2 to 3 minutes waiting for it all to come out. So if the GL made this big tunnel to allow the urine to come gushing out, then what is stopping it? I'd love to know.
Johnny Greenbeans wrote:
YEAH,I HAD MY GREENLIGHT 08/2011.IHAD TO HAVE IT BECAUSE MY BLADDER WOULD'NT EMPTY.THE ONLY THINGS NOW IS THE RETRO GRADE AND I'M STILL GETTING UP TWICE A NIGHT.IF I TAKE TO MUCH SALT THEN I'M UP MORE.ALRIGHT BOYZ,TRY THIS.AFTER YOU URINATE INTO THE JOHN THEN WALK IN PLACE FOR A FEW SECONDS,URINATE AGAIN MORE COMES OUT.DO IT AGAIN.MORE COMES OUT.THAT IS THE TIP OF THE DAY.
Jayp

Palm Bay, FL

#1096 May 4, 2013
NJRetire wrote:
Well exactly. There's more in there. Some people dribble. Some people say they never feel completely empty. It takes two or three passes, or just standing there for 2 to 3 minutes waiting for it all to come out. So if the GL made this big tunnel to allow the urine to come gushing out, then what is stopping it? I'd love to know.
<quoted text>
The explanation I was given is the bladder neck has been stretched over many years or decades of holding urine and now that the obstruction is removed after most of the urine has exited the wall of the bladder neck collapses under a lack of pressure and creates a new obstruction. hence all the dribbling and minor restarting of the stream. Not sure what to believe.Oh the joys of aging!!!
BobnMa

Peabody, MA

#1097 May 4, 2013
According to my Urologist, re-working the bladder neck is an important part of the GL procedure. Also the trickiest. Too little will mean the flow is still somewhat restricted and too much would lead to possible incontinence.
Barry

Chico, CA

#1098 May 6, 2013
Had green light surgery nearly a year ago.
left me incontinent, frequent urge to urinate with very little urine. regret the surgery ruined my sex life. urine problems worse not better.
I would like to sue before it is to late.
would like to join in any law suits.
NJRetire

West Milford, NJ

#1099 May 7, 2013
Well it's better than the alternative! What you say makes sense because I get a normal void for the first few seconds then something closes it off. Then if I stand there for a couple of minutes of dribbling I sometimes get a weak stream at the end to finish off. After a few weeks of flomax I stopped taking it as it seemed the same with it or without it. Maybe I should bring the ipad with me to the toilet and watch youtube videos while I go!
Jayp wrote:
<quoted text>The explanation I was given is the bladder neck has been stretched over many years or decades of holding urine and now that the obstruction is removed after most of the urine has exited the wall of the bladder neck collapses under a lack of pressure and creates a new obstruction. hence all the dribbling and minor restarting of the stream. Not sure what to believe.Oh the joys of aging!!!
NJRetire

West Milford, NJ

#1100 May 7, 2013
My urologist did some work on the bladder neck and that's probably why I get the few seconds of a good flow before it shuts off and starts to dribble. There's probably very little chance of getting it just right, but too little is better than too much.
BobnMa wrote:
According to my Urologist, re-working the bladder neck is an important part of the GL procedure. Also the trickiest. Too little will mean the flow is still somewhat restricted and too much would lead to possible incontinence.
NJRetire

West Milford, NJ

#1101 May 7, 2013
A few minutes prior to my Greenlight the nurse gave me a form to sign. It basically said the operation is risky and I was proceeding at my own risk. By signing that I basically acknowledged that there was no guarantee of success. I think to sue a doctor you need to prove gross negligence or a pattern of harming other patients. I don't think you can sue the people who make the laser unless there is some sort of forseeable malfunction of the equipment. If the doctor has some successes and some failures, they probably blame the patient's condition as being the reason it doesn't work out right.
Barry wrote:
Had green light surgery nearly a year ago.
left me incontinent, frequent urge to urinate with very little urine. regret the surgery ruined my sex life. urine problems worse not better.
I would like to sue before it is to late.
would like to join in any law suits.
James

Frisco, TX

#1102 May 10, 2013
So here is a fact green light laser has a specific target chromophore which is blood. So the laser interacts more with blood than water. The prostate is made up of more water than blood. When doctors perform green light surgery they are channeling out the enlarged prostate to free up your bladder flow. Because this laser targets blood the doctor is not able to get the prostate channelled all the way to the bladder neck , just at the point where the bladder and urethra meet. If the green ligth probe is pushed into the bladder area, the bladder wall can easily be ruptured which causes serious surgery. So to prevent this the docotr cannot go all the way to the neck. Because the prostate continues to grow, the prostate surgery eventually wears off, in a study green light lasers have a 50 percent reoperation rate in 5 years. Overseas, where you are only paid for surgery one time per procedure, green light is not used. HoLEP is the gold standard as it targets water and allows you to cut out the entire prostate and remove this gland. Reoperations in. 10 year study are less than 1 percent. Why hasn't America picked up on this technique.

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