I could'nt believe what I was hearing -

For some months now I have been having some trouble with my Prostrate Gland which had enlarged abit,, giving me problems with Urinary Retention , resulting in me having to wear a Catheter, which I might add is Bloody painful being inserted and retracted when it has to be changed after a few months etc. It used to be called "The old man's disease", but NOT anymore - the patient sitting next to me at the Urology Clinic with the same condition was TWENTY SEVEN . NOW we get to the COPD BIT folks - I asked the Urology Consultant if I could have an operation on this Gland if the pills I have been taking every day , IE, "Finasteride" fail after six months to reduce the enlargement , as it apparently does with some patients. Here was his reply = " Oh no, with COPD you could NOT have a General Anesthetic - with lungs in that condition , I could'nt guarantee you SURVIVING THE OPERATION "

What ? - so on this basis , I or anyone else with COPD could never have an operation FOR ANYTHING THAT REQUIRES A GENERAL ANESTHETIC - that does'nt bode well for any of us if this is true, AND I would be stuck with this damned Catheter etc for the rest of my life.

Any thoughts on this folks ? please....... I 've just just had one ! IF what he said is true, then what keeps you breathing then, when you have a Lung Transplant - , when your old lungs are not functioning at all , - REGARDLESS OF THEIR CONDITION .....?

20 Replies

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  • HI VITTORIO,

    I HAVE HAD C-O-P-D FOR THE LAST FIVE YEARS AND HAVE HAD ABOUT FOIR OPERATIONS IN THAT TIME INCLUDING 9 MONTHS AGO AN MASTECTOMY AND LST MONTH HERNIA ALL UNDER GENERAL ANESTHETIC.

  • I think it depends on how serious your lung problem is. I have just gone into the moderate from the mild stage and don't think I would have any problems having an operation. If you are severe then it would probably be a different story. Any surgeon has to balance the risk of having or not having an operation. If you needed one to save your life then you would probably get it. But while having a catheter must be awful and painful it will not kill you. I suspect that is the surgeons reasoning. x

  • Hi Vittorio, think the decision on op's when you have COPD is very much dependent on how severe it is and whether you have a severe cough, plus your general health in other respects. Some consultants say no because of the risk unless it is life threatening. Some operations can be done without general anaesthetic so it's worth probing further if you dislike the catheter way. My late father- in - law had an heart condition but still had a prostrate op when he was 86, came through the op but died of old age three months later. So I would say your the patient and it should be your choice even if there is a risk. Good luck with questioning it.

  • Hi my father had this operation years and years ago with an epidural take care x

  • I don't think it's how severe your COPD rather than how well your lungs work. I'm very severe but only sometimes need 1/2 litre/ min oxygen now and again.

  • Hi see how things go if the you do not improve then I would make a fuss as it is affecting your quality of life.

  • I have a heart condition too. I was due a Pace and Ablate but they cancelled it and have said that they will not do any further operations as they do not think I will survive. My last Ablation they had to give me O2 as soon as I got on the bed and did not take it away until they let me go.

    But you did make a very good point on what do they do when you have a lung transplant. I was on a Oscillator for 10 days as I could not breath on my own some years ago.

    Be Well

  • I have COPD, Severe stage 4 and needed a vaginal repair but I didn't want to risk a general anesthetic so I was given a spinal block which was very good, I was sedated and don't remember a thing about the actual operation. When I came round I had to stay in bed overnight because I had 'dead' legs but apart from that I felt so much better than if I had a load of anesthetic pumped into me. As your operation is in the same sort of area I would have thought a spinal block would have been possible. Keep smiling

    Carole x

  • Was just going to ask the same Carol - why can't they use a spinal block during surgery? cx

  • Thanks folks ! - as you say it does depend on the condition of the lungs - BUT I can see a bit of a difference of opinion between the two Consultants ! - My Chest Consultant has recently described my COPD as "Moderate " , This Urology Consultant describes them as "Severe" ( Love to know how he came to that conclusion , when COPD is NOT his speciality ) --- oh dear ! - This should be an interesting outcome ! - Thanks again folks .

  • trying to save money thats all it is demand what you want has our other friends say spinal block what is wrong with that I had that no problem

  • I have similar issues but I am 67. Lazar can burn away excess size inside prostrate and all one needs is a local at most and not cause ED problems. Certain hospitals can handle COPD complicate surgeries better than others.

  • The following are taken into consideration ;

    How severe is your COPD

    Where is the site of the op? The closer to your lungs the more risky it becomes - the further away the less risk ie. if it is a knee/ hip op ,it is far less risky than a bowel/ bladder op.

    How necessary is the op to your wellbeing / survival

    How long would the op take

    Is therereally no other option - eg spinal block or local anesthetic

    There is no guarantee for anyone or any method really. My sons lungs stopped working and he temporarily died on the operating table during an abdominal procedure - the surgery was stopped just after they had made the incisions for keyhole surgery. He was otherwise healthy, in his early thirties and never had any problems with breathing in his life. They held an inquiry into what had gone wrong and came to the conclusion that his lungs had had a reaction to the type of anestetic used - it just didn't suit him. The op was performed again six months later using a different type of anesthetic and all went fine.

    As for transplants, perhaps the following will be of interest - though I am sure you can find much more info if you google it:

    The diseased lung(s) will be carefully removed and replaced by the donor lung(s). Depending on your underlying lung condition and the type of transplant being performed, you may be placed on a cardiopulmonary bypass machine (heart-lung machine) to maintain circulation and provide oxygen to the body during the procedure.

    hopkinsmedicine.org/healthl...

  • Thanks too Parvati , for your answer, so professional ! - are you in the Medical Profession ? - and so pleased all worked out well for your Son, Will be putting these points to the Consultant Surgeon when I next have to face him - Blast !!, by the way , when I had the first Catheter inserted IN HOSPITAL during an Exacerbation of COPD, would you believe TWO STAFF NURSES failed to do it properly IN FRONT OF MEDICAL STUDENTS , and actually GAVE UP ! - the Consultant turned up unexpectedly and Blew up ! and really tore these supposed qualified Nurses off a strip, HE then inserted the Catheter in himself - and told these Nurses "He wanted to see them both in his office in an hours time " - he was furious ....Oh dear, I was sorry to be the cause of this trouble, but it really was'nt my fault !!! ... "CARRY ON NURSE "!

  • Good morning Vittorio,

    Two things occur to me.

    One: when you are having a catheter inserted usually the doctor/nurse puts Instillagel, or some similar local anaesthetic, into the urethra first. Perhaps, if you have another catheter, they might need to wait an extra few minutes before they continue the procedure, to give it a little more time to work ? Or even put in a second Instillagel - if that is allowed.

    Two. Could you ask about prostate surgery under a spinal anaesthetic ? That blocks the nerves below the waist. It's used all the time for caesarian sections...

    Here's a link to a professional article ceaccp.oxfordjournals.org/c... which also states 'Spinal anaesthesia is regarded as the technique of choice for TURP' (Trans-urethral resection of prostate)....

    'Spinal anaesthesia may offer several advantages over general anaesthesia. It is particularly useful for patients with significant respiratory disease. It confers good postoperative analgesia and may reduce the stress response to surgery.'

    Obviously, talk to your doctor. It's easy to find things on the internet but they may not apply to your individual circumstances.

    Best wishes

    Polly

  • Wow ! - that was an impressive reply ! lots of thanklies - When I go for the dreaded next visit to the Urology Clinic will put these points to the Consultant- who by the way , I found out recently is a "Mr", so presumably is a Surgeon ! - why on earth did'nt he come up with the points you have made ? - INTO BATTLE ! - THANKS AGAIN !, And those District Nurses who change the Catheter all seem to be in such a hurry - hence the Instillgel not working properly - thanks for that one too ! - this is turning into a real "CARRY ON MEDICINE " !! - Bring back Hatti Jaques !!. ....

  • Hello Vittorio,first point. If consultant is referred to as Mr rather than Dr it means he is a professor in his speciality.I,m glad you broached this subject as I am currently having prostrate problems,the thought of a permanent catheter does not appeal.I have a enlarged incision hernia from a previous op and asked about getting it sorted and came across the same thing ,surgeons did,nt want to take responsibility for me surviving and lung consultant said it was,nt worth the risk but none wanted to be the one refusing the op.Ended up just putting up with a minime trying to escape from my belly(lol)Let us know how you get on ,good luck! D.

    Ps.Check out the epidural line that may solve your problem.

  • The answer is very simple ..... have an epidural.

  • The title Dr is used for medical Doctors. Mr is the title used for Surgeons. It sounds crazy but the extra study loses them them the Dr title. It dates back to the barber-surgeon era. A Prof is one who teaches.

    If you cant agree with the views / suggested treatment that your current consultant is giving you, go back to your GP. Tell the GP and ask for another referral to another hospital.

  • You can have a prostatectomy without general anaesthetic. They can either give local or epidural and operate trans urethrally . So you won't have a scar. I have nursed hundreds of patients after prostatectomy and they recover more quickly without GA. Maybe the consultant is confident the medication will be successful

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