Will I Feel Pain
Pain management is important for healing and a smooth recovery. There will be discomfort after your surgery, including burning during urination. This should go away gradually over several weeks.
Your doctor will give you clear instructions for managing pain. This may include prescription pain medication and acetaminophen . Call your doctor if your pain gets worse or changes because it may be a sign of a complication.
Rezm Relieves Enlarged Prostate Symptoms
Rezm is a minimally invasive, in-office procedure that relieves BPH symptoms safely and effectively, with minimal side effects. The procedure is done in one office visit and takes about 15 minutes with little, if any, discomfort to patients. Men typically return to their normal activities within a few days.
The treatment is an alternative to BPH medications and the traditional Transurethral Resection of the Prostate or roto-rooter treatment that is done in a hospital operating room with general or spinal anesthesia and requires one or two nights stay in the hospital.
Rezm uses the natural energy stored in water vapor, or steam, to treat the prostate gland. When delivered into the targeted prostate tissue, the steam turns back into water, releasing all of the stored energy. This injures the prostate cells, which are then absorbed into the body. Loss of the dead cells shrinks the prostrate.
I love this procedure because the water vapor travels only within the prostrate capsule and there is no risk of injury to surrounding tissues, Dr. Fronczak explains. When the prostate shrinks, the urethra opens, and most patients begin to experience symptom relief in as soon as two weeks, with maximum benefit within three months.
As an added benefit to patients, Rezm is considered medically necessary by Medicare and most private insurances.
Less Common Side Effects Of Turp
Less common unwanted effects of surgery include:
- urinary symptoms do not change sometimes surgery does not cure your urinary problems. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely, and nocturia
- erectile dysfunction some men are unable to get or maintain an erection sufficient for sexual intercourse after surgery. This is more of a problem for men who had erectile difficulties before their operation. This problem may be treated by medication
- urethral strictures when scarring occurs in and around the urinary tract, it can cause further blockage to urine flow. Strictures may need to be dilated or need further surgery
- urinary incontinence sometimes surgery results in being unable to hold or control the flow of urine. This may be due to continuing bladder problems or, less often, to sphincter muscle damage
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Why Is This Important
An enlarged prostate can cause two main symptoms of the lower urinary tract: voiding and urinary retention. Prior to this research, some experts believed surgery did not help men with urinary retention. However, the trial found both prostate procedures are effective for treating both voiding symptoms and urinary retention.
Although previous research suggested that the laser procedure would lead to fewer complications and a reduced hospital stay compared to TURP, this was not seen in the study. The new findings from Bristol suggest hospitals who already perform TURP do not necessarily need to invest in equipment and training for the ThuVARP laser procedure. Patients can be reassured that either surgical option is safe and effective. The researchers say new treatment approaches should continue to be compared with TURP, as NICE guidelines recommend.
Fast Facts On Bph Surgery:
- Surgery is rarely the first line of treatment for BPH.
- A doctor who specializes in the urinary tract does most TURP surgeries.
- TURP is considered a fairly safe, effective procedure for treating BPH.
According to the American Urological Association, transurethral resection of the prostate or TURP is the most common type of surgery used to treat BPH. Every year, doctors perform it on around 150,000 American men.
Surgeons perform most TURP procedures when the patient is under general anesthesia and unconscious or asleep.
Alternatively, they use spinal anesthesia, where a needle is placed in the spine to stop any sensation below the waist.
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
What Happens Before Transurethral Resection Of The Prostate
Although TURP doesnt use incisions, you need general anesthesia or spinal anesthesia during the procedure. Your healthcare provider will discuss which anesthesia option is best for you.
To prepare for anesthesia, you may need to stop eating and drinking several hours before your procedure. Tell your healthcare provider about all the medications and supplements you take, including blood thinners. Ask your healthcare provider whether you should stop taking any of them before your procedure.
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What Is The Recovery Time After The Turp Surgery
Most men have uneventful recovery after TURP. Usually, the patient will have a catheter in their bladder at the end of the TURP procedure. Many men with office jobs may be able to go back to work within 2-3 days after the procedure. The catheter is usually removed anywhere from 2 to 10 days after the procedure.
We advise avoiding strenuous activity for 2-3 weeks after the procedure. Activity such as biking should be avoided for 4-6 weeks after the procedure to allow for complete healing.
After catheter removal, men may experience frequent urination and a burning sensation in the urethra for 2-3 days. Medications such as Pyridium and Uribel are helpful during this time period. It should be noted that Pyridium can stain urine with orange color-there is no need to worry. Uribel can stain urine blue again, no need to worry about blue urine.
Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
Where To Get Turp Surgery In Nyc
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
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What Are The Risks
In most cases, TURP is a safe procedure and the risk of serious complications is very small.
Many men also temporarily lose the ability to control their bladder , although this usually passes in a few weeks. In rare cases, it may be persistent and need further treatment.
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Figure : Greenlight Procedure
When prostate enlargement obstructs the flow of urine , a relatively new laser technique may be used instead of TURP. In a photoselective vaporization of the prostate , or GreenLight, procedure, the surgeon threads a thin tube known as a cystoscope into the urethra and up into the enlarged prostate. The surgeon then threads a fiber-optic device through the cystoscope to generate high-intensity pulses of light, which simultaneously vaporize the obstructing tissue and cauterize it to reduce bleeding . After surgery, a catheter may be inserted temporarily to allow urine to flow while the area is healing. This technique creates an enlarged, uniform channel for urine to flow through .
When is it time to consider surgery for BPH?
MORGENTALER: For the most part, it really comes down to patient choice about how to handle the symptoms of BPH. The only situations that are major indications for treatment include acute urinary retention, bladder stones, maybe recurrent urinary tract infections, or a high post-void residual.
SANDA: Surgery is also worth considering if a man isnt responding well enough to any of the drugs used to treat BPH, or if he cant tolerate the side effects. In the past, patients really had only two options when it came to surgery for BPH. If the patient had a reasonable-sized prostate, he could undergo a TURP, and if he had an especially large prostate, then perhaps an open prostatectomy. But today a man considering surgery has many more options .
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How Turp Is Performed
TURP is carried out using a device called a resectoscope, which is a thin metal tube containing a light, camera and loop of wire. This is passed along your urethra until it reaches your prostate, which means no cuts need to be made in your skin.
The loop of wire is then heated with an electric current and is used to cut away the section of your prostate that is causing your symptoms. A thin tube called a catheter is then inserted into your urethra to pump fluid into the bladder and flush away pieces of prostate that have been removed.
General or spinal anaesthesia is used during the procedure so you don’t feel any pain while it’s carried out.
Bph And Bladder Health
The bladder is a muscle and storage unit for urine. The kidneys filter our blood and generate urine every day, which then travels down the ureters and is stored in the bladder. As the bladder fills we get the sensation of urinary urgency and when we are ready, the bladder squeezes the urine through the urethra so more urine can be stored.
The prostate gland is a walnut sized structure that is located at the opening of the bladder. As men age, the prostate enlarges and may eventually obstruct the flow of urine out of the bladder. This condition is often referred to as benign prostatic hyperplasia or BPH. About 60% of men will have BPH by the age of 60 and almost all men as they approach age 80.
The bladder tries to overcome the obstruction by contracting more forcefully. Over time this leads to permanent damage to the bladder which can be seen during a procedure called cystoscopy. A cystoscopy is a procedure during which a urologist introduces a very small camera into the bladder to evaluate and diagnose bladder and prostate disease.
All other minimally invasive options for BPH involve the cutting, heating, or freezing of the prostate which all carry similar risks and do not measure up to the gold standard of the TURP procedure.
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Prostate Surgery And The Psa Test
A prostatectomy has at its core the goal of completely eradicating cancer. As long as the tumor remains within the boundaries of mens prostate, then the surgery has a high chance to remove all the cancer cells. After successful prostate surgery, the cancer can be cured, meaning that any signs of cancer are no longer within the body.
On the other hand, this perfect scenario rarely reflects real cases. Its possible that, by the time of the procedure, cancer cells might have spread outside the prostate gland. In other cases, the surgery couldnt eliminate all cancer cells. These situations urge doctors to take further steps in order to achieve the complete eradication of prostate cancer, leaving the patient cured.
This is the reason why PSA testing right after surgery is an essential part of cancer observation. Any regular PSA test allows doctors to measure and analyze the impact of prostate surgery. Whether the surgery worked or there is still a need for further treatments, PSA readings allow doctors to understand the progression of a patients health.
Why Might I Need Turp
TURP is most often done to relieve symptoms caused by an enlarged prostate.This is often due to benign prostate hyperplasia . BPH is not cancer.It is a common part of aging. When the prostate gland is enlarged, it canpress against the urethra and interfere with or block the passage of urineout of the body.
Sometimes a TURP is done to treat symptoms only, not to cure the disease.For example, if youre unable to urinate because of prostate cancer, butsurgery to remove the prostate isnt an option for you, you may need aTURP.
There may be other reasons for your healthcare provider to recommend aTURP.
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When To See A Doctor
Most people begin to feel better and have an improved urine flow within 4 to 6 weeks after TURP surgery.
Overall, the risk of serious complications after TURP surgery is quite low. But as with all surgeries, there are some potential health risks associated with the procedure that require medical attention and intervention.
Reasons to seek medical attention after TURP surgery include:
- reduced urine flow or urinary symptoms, such as incontinence or urinary urgency 6 weeks post-surgery
- blood in the urine that is severe or lasts longer than 4 to 6 weeks
- severe clots of blood in urine or urine that is entirely red
- weakness and fatigue that does not improve after 4 weeks
- impotence or erectile dysfunction
What Happens After Transurethral Resection Of The Prostate
After your procedure is done, you go to a recovery area. Some people stay in the hospital for one to two days after TURP, others might be discharged the same day.
During your hospital stay, you have a catheter in your urethra. The catheter helps ensure that urine flows freely after your surgery. Usually, your healthcare provider removes the catheter before you go home.
How Do I Get Ready For A Turp
Some things you can expect before the procedure include:
- Your healthcare provider will explain the procedure and you can ask questions.
- You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything isnt clear.
- Your healthcare provider will review your medical history, and do a physical exam to be sure youre in good health before you have the procedure. You may also need blood tests and other tests.
- You will be asked not to eat or drink anything for 8 hours before the procedure, generally after midnight.
- Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, iodine, tape, contrast dyes, or anesthesia.
- Make sure your healthcare provider has a list of all medicines herbs, vitamins, and supplements that you are taking. This includes both prescribed and over-the-counter.
- Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines , aspirin, or any other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
- If you smoke, stop as soon as possible to improve recovery and your overall health.
- You may be given a sedative before the procedure to help you relax.
Based on your medical condition, your healthcare provider may request otherspecific preparation.
Other Things To Consider
Before you have one of these procedures, talk with your doctor about whether youâll be given something to numb the area or whether youâll be given something so you wonât be awake during the procedure. What you get and where you have it depends on the procedure.
Your doctor will give you instructions on how to prepare for any of them.
Surgery can ease many BPH symptoms, but it may not relieve them all. If there are certain complications, such as a weak bladder, there may still be urinary problems after surgery, although this is rare.
The best treatment for an enlarged prostate is not the same for every man. Talk to your doctor about the risks and benefits of each procedure.
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Questions To Ask Before Surgery
As you think over the options for surgery, ask your doctor these questions:
- Is there a good chance my condition will get better?
- How much will it improve?
- What are the chances of side effects from a treatment?
- How long will the effects last?
- Will I need to have this treatment repeated?
With newer technologies, doctors can do some minimally invasive procedures with tiny cuts or use tube-style instruments that they insert into you. These procedures may not treat the symptoms to the same degree or durability as more invasive surgical options, they do have faster recoveries, less pain afterward and have reduced risks.
Other times, the traditional and more invasive surgery may be needed. It all depends on your case and what you and your doctor decide is best for you.
Doctors can choose from these minimally invasive procedures, endoscopic, or open surgeries to treat moderate to severe symptoms. These procedures are also used if tests show that your ability to pee is seriously affected.
Table : Reoperation Rates
The federal Medicare program tracks data on the need to have a repeat operation for BPH within 24 months after a first procedure. This provides one indicator of how effective the procedures are. The figures below are based on Medicare data for 2003.
Procedure PVP laser 2.05%
MORGENTALER: Im not saying that microwave and TUNA are equivalent to TURP or the GreenLight laser. Theyre not. But I think a heat-based treatment can be viewed as an intermediate intervention more effective than medication for BPH, but not as effective as TURP or GreenLight. So I think heat-based treatments are actually a wonderful advance, in that they can be performed in a doctors office, involve less fear on the patients part, and have nice results, in my experience.
LOUGHLIN: I agree that a patient needs to understand that a TURP is going to require that he be in an operating room. It also involves longer recovery than microwave or TUNA. But, to me, the 2003 Medicare data are extremely persuasive, in that youre looking at a 2% reoperation rate versus a 12% to 14% reoperation rate.
What other factors might influence a patients choice of surgery for BPH? Or the recommendation that you make as doctors?
Good point. The Journal of Urology included a study three years ago about the way reimbursement rates affected treatment recommendations for BPH as well as for other conditions .
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