To recap on my history, I have had an elevated psa since the late ’90’s and around 2002 my psa went quite quickly from around 5 to around 10. In 2007 it leapt again to around 20. Since then psa has varied between 20-25. I have had four (or is it five?) biopsies over that time and all of them negative for cancer.
In the past few years it was clear my prostate was getting much larger as indicated by DRE (finger!) and ultrasound scans. Once the latest biopsy (24point) showed no cancer, I was offered TURP surgery.
My wife delivered me to the surgical center where I waited around for a while, but also was able to have a chat to the urologist whom I had met many times before. He explained to me what was about to happen and an hour or so later I was wheeled into surgery. Although general anesthetic is an option, I was given an injection in the back – an epidural so that I was numb right to the toenails. It is a weird feeling. I was asked if I wanted to have a sedative which helped patients to relax and usually puts them to sleep. I decided against tha,t because I wanted to watch the procedure on the television which was just above my head.
Being totally numb from mid back down, there is nothing to feel. A tube goes into the head of the penis and makes its way along the urethra and into the prostate. Along the prostate is fed a wire with a small tool called a rectoscope. It is basically a combined visual and surgical instrument with a loop at the end which I understand is both sharp and hot. I was able to watch it slicing off tissue as it moved around the inside of the prostate. After that was done, the wire was withdrawn and replaced with a tool which looked like a small roller.
I watched as the surgeon deftly moved it around the inside of the prostate using the heated tool to cauterize the blood vessels. The view was fairly clear, but while this was going on, the area is also being irrigated with water and the tissue removed is kept for analysis. Quite a lot of the inside of the prostate is removed It’s amazing what they can get down a smallish tube.
Recovery was fairly quick as the numbness slowly went as I lay in my hospital bed and guess I was in surgery for about 90 minutes. Checking down below I was astonished at the size of the tube (catheter) and that one tube kept washing out the prostate and another went into the bladder and down the side of the bed I could see a big plastic collection bag for the urine. It was a bit disconcerting to see that the fluid in the bag was reddish in color, but it had been explained that I would be passing some blood for a few days.
For the next two days I lay in some slight discomfort and only painful at times when the catheter moved. All through the day and night, hospital staff would come and empty out the bags and replace them. The morning after the operation, my urologist dropped by to see how I was, said that it all went well and that my prostate was pretty big. During the next days blood pressure and temperature were regularly monitored and pain killing medication given (not that the pain was much). I was given lots of water to drink and I could eat meals normally.
On the morning of the third day at about 6am one of the nurses came in to remove the catheter. As you can imagine, this was not a pleasant feeling but she had done it all before, and it all went well. What a relief to have it out. I was told that when I was ready I could try to pee. I would need to have to go three times and after each they would monitor how much urine was left in the bladder by using a small mobile ultrasound.
I was more fortunate than others because I was able to urinate quite soon and with only about 30ml retention in the bladder. I recall the first pee was almost out of control because the stream went off in a sideways direction. It was also disconcerting to see that it was blood red, even though I had been warned it would be like that. After another hour or so, I can completed two more urination’s. The urologist came in to give the all clear and I was able to call my wife to get a ride home.
For the next days and weeks I felt various symptoms. Some days I would feel great, other days really crappy. I felt a bit sore when sitting but a big cushion helped a lot. I was pleased to see that I had a good stream of urine, even though it went from red to pink to clear to pink again for the next two weeks. For the first three weeks it also stung when I urinated, and sometimes the pain from the stinging was enough to put my teeth on edge. I was given some Ural sachets (urinary alkalinizer) which helped a lot. Sometimes I felt like a red hot needle was going down or up my penis.
One of the major problems was trying to avoid constipation so I had to eat lots of fruit and vegetables. Any pressure caused discomfort and a couple of times I was caught out and had to revert to using a laxative (microlax). I no longer have to take any medication, so goodbye to terazosin (Hytrin) etc. I have been advised to take it easy for the first six weeks and that it could take 6 months before the prostate is healed. I will have an appointment with the urologist at the 6-8 weeks point to see how I am going and also to get results from the histology (prostate tissue) to see if there is any cancer or other cause for concern.
I typically only have to get up once in the night and sometimes not at all. This compares with 3-7 times before the TURP surgery. The only remaining symptom I have now is urgency on occasions, but I am told this will improve over time and as the bladder is retrained.
Be sure to also read:
Stan’s Prostate Story No 4 – Prostate Biopsy Results
Stan’s Prostate Story No 1 – High PSA
Stan’s Prostate Story No 2 – Prostate Biopsy
Life After Turp Surgery
Bob’s Prostate Story – Getting a TUMT and Green Light Laser