Button Plasma TURP vs Wire Loop TURP

[Back2future]

Am considering having the button TURP. Anyone had either TURP can you share how long was burning, bleeding, clots, any other complications? When do they remove catheter. What is the healing time in both. I have catheter since Jan 2021 and on ADT with no radiation.

[Dont08759]

I had a green light laser TURP 4 years ago. That’s when they did the biopsies and I learned I was a Gleason 9 (pre-op PSA 4). I Had a Foley catheter in for 10 days. The only side effect I remember is retrograde ejaculation from then on…

[Tak-Druk]

I had a TURP in 2016. I wasn't aware there are different techniques... I'm not sure what buttons or lasers they used for the procedure The primary reason was to get a biopsy because of recurrent bleeding; and a visual scope of the urethra and bladder revealed tissue growth and nodules near the bladder opening, but my flow was still functional, albeit partly constricted (but I would not have had the TURP procedure yet if we didn't want a biopsy.)

They removed the catheter the next day after an overnight hospital stay and I went home that afternoon after I peed. I don't remember having a lot of trouble with recovery. Though I think there was some uncomfortable urgency and burning for a while... Bleeding and clots have continued intermittently. Biopsy was positive for PCa - though scans have still never lit up for the prostate bed/urethra/bladder opening.

Interestingly, now that I started chemo, I've had a fair bit of renewed blood in my urine with blood clots and other bits of tissue passing through as well. I've also got issues with burning and urgency... So it seems like the chemo is breaking down the cancer and also the urethra/bladder lining with it some? Initially there was a lot, but things are calming down now - two months into chemo.

Good luck.

[dougdee123]

I had a HOLEP, HOlmium Laser Enucleation of the Prostate, 5 months prior to radiotherapy in 2016.

When I discussed it with the surgeon's registrar about half an hour before the event he told me that they typically removed a conical section from the middle, about 75% of the whole.

I had no difficulty and they removed the catheter about 3-4 hours later. They encouraged me to drink water, walk around the ward and to pee when it was comfortable to do so. As far as I can remember there was no pain and the only real discomfort was when they removed the catheter although even that was minimal. I was in the taxi going home by 9.00 pm the only proviso that they wanted to be reassured that I was able to pee without difficulty.

I then had a week or so when I needed pads to deal with the lack of urine control but that passed very soon as I had been doing the kegel exercises in advance and after.

The expected benefit of being able to empty the tank fully was noticeable and I didn't have to get up in night after that. I still don't have to.

[Back2future in reply to dougdee123]

I read many places tha HOLEP is contra indicated for PCa patients. Don't know why perhaps because the shovel the sliced prostate into the bladder and flush it out later.

[dougdee123 in reply to Back2future]

I'm not a doctor so my my comments are personal. I have not seen that contra indication . The only one I've seen is on the basis of cardiopulmonary situation.

However the reduced bleeding and recovery time is very good. See ncbi.nlm.nih.gov/pmc/articl...

As for the 'shovelling into bladder and clearing later' . I believe that may happen briefly but the removed material is washed out in a few seconds. There are videos of the procedure on You Tube if you feel brave and it isn't consistent with that.

In passing, I also had flexible Cystoscopy on two occasions some years after and even I was able to see that there was nothing to worry about in the bladder.

[Back2future in reply to dougdee123]

Thanks for sharing. I was scheduled for a button plasma TURP this week but backed out. Trying to decide which procedure has less bleeding. Dr said TURP bleeding can last 4-6 weeks but I think that is the low estimate. Also, I read there are not many HOLEP experts in the US and is not covered by insurance. Did you pay out of pocket?May I ask the Dr. name to see if he or she still does HOLEP.

[Back2future in reply to dougdee123]

I read HOLEP incontinence post op is very common and HOLEP works like a prostatectomy incolving the sphincter muscles. More risky than TURP imo. youtube.com/watch?v=rDVFshn...(Not working as expected?)

[dougdee123]

I didn't pay anything because I was treated on the NHS at Addenbrookes Hospital, Cambridge, UK. The procedure was carried out by Mr. Kassner. (Surgeons in the UK are referred to as Mr. X or Mrs. X. He is of course a doctor.)

I do understand the difficulty you are looking at. All I can say is that the bleeding was minimal and for all practical effects over in a few hours. I have not heard that there is any particular incontinence side effect and intuitively feel this is more likely with traditional surgical methods.

[Back2future]

Yes, the lack of bleeding is one of the biggest benefits. However, here in the US there is a lack of talent and experienced surgeons in HOLEP which is why I tend to lean towards plasma TURP (a little less bleed than traditional Turp).