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AF, Apixban and laser surgery for enlarged prostrate.

Beckyboodle profile image
11 Replies

Yesterday my husband was informed by Urology consultant that tests show he has an enlarged prostrate gland and he said he would be willing to operate using laser.

He said there were risks as there is with all surgery.

As he has AF and on Apixaban, also heart failure he has an assortment of drugs and is also in remission from Non Hodgkins Lymphoma.He is 80.Main problem is he has to urinate about 7 times every night so does not get much sleep.

I am very worried about the operation due to his existing conditions.

I know you do not give advice but I would be grateful to have your opinion please.

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Beckyboodle profile image
Beckyboodle
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11 Replies
CDreamer profile image
CDreamer

Hi Becky - a very difficult dilemma for you and I am sure the type of dilemma we will all face as we age.

I think as in any procedure or treatment you need to consider the risks and balance them against the benefits and quality of life. I don’t think anyone could possibly offer you an opinion but hopefully we may be able to offer support to help you both to make the decision.

What may be the prognosis if it is left?

Would the surgery involve a GA and what are the associated risks?

Has the surgeon consulted with your ur husband’s cardiologist and what was the outcome?

So many factors to consider but at the end of the day I guess it is your husband’s decision as to just how much discomfort he is in.

Best wishes and do know we are here to support.

CD.

Hello Becky, I can’t add anything to CD’s reply. One of my friends who is in his late 70’s and has AF, diabetes and heart failure had a similar procedure earlier in the year and he sailed through it. CD’s point about getting the surgeon to talk to his cardiologist has to be key....every good wish for a successful outcome....

beardy_chris profile image
beardy_chris

I have permanent AF, am on apixaban, and had an operation for an enlarged prostate (HoLEP) about 18 months ago. I had to stop apixaban for 48 hours beforehand. The operation was carried out under GA and was no problem. I stayed in hospital for two nights and felt fine immediately afterwards.

I subsequently had a major problem but that was so rare it needn't influence your husband's decision. I am quite a lot younger than he is (64 at the time) but the operation itself was very straightforward.

secondtry profile image
secondtry in reply to beardy_chris

Hi Chris, I am seeing my urologist today to discuss enlarged prostate, can I ask what your op actually did and what the main improvement was afterwards. Comforting to know the procedure went well for you! Thanks for posting

beardy_chris profile image
beardy_chris in reply to secondtry

The Op was a HoLEP - Holmium Laser Enucleation of the Prostate. Essentially what they do is use a laser via the Urethra to remove a significant part of the enlarged prostate under General Anesthetic. There is a youtube video that shows the process but don't watch it if you are at all squeamish! There can be side effects and risks (as with any procedure) but after a week or two I was able to sleep all night without having to get up at all. Some nights I have to get up once but by no means always.

secondtry profile image
secondtry in reply to beardy_chris

Thanks Chris great to know.

Beckyboodle profile image
Beckyboodle

Thank you so much for your lovely posts,dear CD,Flapjack and Chris.

Yes it would involve GA and there has been no consultation with cardio .

We get the impression that they do not want to discuss any thing other than their own field even though we know that all the other issues need to be considered!

Thank you Flapjack it is good to know about your friend.

Thanks Chris ,very helpful. This op would be HoLEP too.

Husband seemed to decide very quickly that he would agree to the operation but now that we have discussed every thing he is wavering and seems grateful for my 'knowledge is power' attitude !

We both appreciate the kindness and compassion received from lovely folk here.

Among all the drugs he has he takes 2 40mg Furosemide each morning!

Starting today he is going to reduce to 1 Furosemide and cut back on tea and drink still water in place of sparkling water. We shall see if things improve but it may be that the op is the way to go!

Good luck Secondtry I hope your appointment today goes well.

Thank you all and I shall of course keep you informed.

Beckyboodle profile image
Beckyboodle in reply to Beckyboodle

Hi again,

I am very sorry I have taken so long to come back to let you know the out come.We have both been poorly and energy low but much better now.

Well about 2 weeks ago consultants secretary phoned to say that due to a cancellation hubby was to be admitted to have his surgery next day !

He reminded her about Apixaban and they had forgotten! Did not inspire confidence so he declined the offer.

Glad to say he is now much better as reducing the furosemide 40mg from 2 a day to 1 each day and reducing drinks has made a big difference and he only gets up once or twice during the night which is wonderful and he actually feels much better.

GP also thought this was a good thing.

Thank you very much for your kindness and understanding.

May you all be well and happy.

MarkS profile image
MarkS

I'd be very interested to see how the HoLEP works out. There are various procedures for enlarged prostate now. This site is good at explaining advantages and disadvantages of HoLEP:

theprostatecentre.com/prost...

Could you/secondtry/Chris let me know how it goes? You can always private message me. I see HoLEP is recommended if you're on anti-coags as the laser causes little bleeding.

I hope it goes well.

Mark

seasider18 profile image
seasider18

I've had laser surgery twice for BPH once when I was 71 and the second time when I was 79. I had been taking warfarin the second time and stopped it two days prior. Each procedure went well and life was back to normal in a couple of days. The first time I travelled from Newcastle to Edinburgh on day two and went to the races the next day. The second time I came home by bus. As the urologist who did my first procedure said it is a very gentle procedure and he had operated on a man of 92 with a massive prostate.

The Anesthetist is well used to dealing with such conditions when I had my pre assessment prior to my first procedure he did not like my ECG and I had to have an echocardiogram to put his mind at ease.

philologus profile image
philologus

I'm 73 and have heart Failure and arrythmia and my prostate grew and eventually blocked my pipe completely. The danger then is that the bladder will overfill and will back up and damage the kidneys. I was in a lot of pain so called an emergency doctor out at midnight one Friday and had a blue light ride to hospital. I was fitted with a catheter which I wore and hated because it kept blocking and getting airlocked. I also got a lot of infections.

There was an eight month waiting list to have the Holep treatment on the NHS so I had it done privately.

I met the surgeon, had the op (April 3rd this year) and was home - all within a fortnight. It cost £4,000. (Toby Page, Urologist, Newcastle.)

Oddly enough, my wife paid for this as an anniversary present!

I have had no problems. Just the opposite in fact - I've got my life back. After a two-week rest period I was able to drive again and we have hardly been at home since. We have just come back from a two-week trip round the Highlands in our campervan.

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