HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Is TURP Surgery Better Than Laser Surgery?

default
Posted on Wed, 2 Dec 2015
Question: My BPH has totally blocked my urethra and I am self cathing for the past three weeks.
My doctor suggesting to get Turp surgery ASAP.
My question is: a- is Turp better than getting laser surgery?
b- Would you recommend removing the prostate totally at this point so that I do not have to worry about cancer later.
Do you have any experience with the Uro-lift system. Is there any merit to this solution?
c- Should I be tacking my terazosin still since I am using self catheters now.
d- If you were my doctor what would be your course of action. I believe
my bladder is some what stretched at this point.
Thanks XXXXXXX
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
Send all your reports for my advice.

Detailed Answer:
Hello xxxxxxx and welcome to HCM.
As an Urologist,i would like to know, why were you doing self catheterisation.
1.When you had catheter removal,you may had a recurrent retention.
2.The other reason would be, recurrence of retention, and urodynamic study showing, very poor urine flow rate and poor bladder muscle(detrusor)pressure.
Now if your Urologist feels,you're ready for a surgery,then you should consider it.
There're several types of prostate gland surgery for it's removal.
a. TURP remains the gold standard.
Laser surgery is also widely practised, with complete removal and same results.
b. You should mention your PSA level before surgery, which you haven't.
Cancer will be established only after biopsy of prostate gland tissue.
Personally, i've no experience with the URO-LIFT treatment.
c. Terazocin has no role, once you're doing self-catheterisation.
d. Unless you send all your reports and scans, it's difficult to give any advice.
Wish you good health.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Matthew J. Mangat (6 hours later)
Thanks for your reply Dr Mangat,

To add more detail : my PSA is around 4.5, and the reason for selfcathing is almost complete obstruction of the urine flow.
When they installed the catheter for the first time 2500 cc of urine was remained in the bladder after trying to empty it by myself. After the catheter was placed for 2 weeks there was a lot of blood in the urine present. Then the blood cleared up. After that I have been on self catheter. Basically I can not push out a drop without placing the catheter.

My question is Turp ,laser, or old fashion prostactomy.
My Dr does not think there is cancer present.

Thanks again
Si
doctor
Answered by Dr. Matthew J. Mangat (22 minutes later)
Brief Answer:
Laser is best in centres, where Urologist does it routinely.

Detailed Answer:
Hi again.
A volume of 2500ml urine is amazing for you to have borne the pain.
Usually patients scream, when retention volumes exceed 1000-1200ml.
That's one reason for the bleeding after initial catheterisation.
If you didn't get much pain at 2500 ml urine volume, you should undergo an urodynamic study, to know for sure, if surgery will help you or cause more problems after surgery.
PSA of 4.5,is nothing to worry about. Your Urologist can decide ,after the rectal examination, and seeing your TRUS report.
Old fashioned open prostatectomy is not practised by any Urologist today.
Laser surgery for prostate is best done, where it's routine.
TURP is otherwise a standard procedure.
Cancer can diagnosed only after biopsy of the prostate tissue.
Wish you a speedy recovery.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1898 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Is TURP Surgery Better Than Laser Surgery?

Brief Answer: Send all your reports for my advice. Detailed Answer: Hello xxxxxxx and welcome to HCM. As an Urologist,i would like to know, why were you doing self catheterisation. 1.When you had catheter removal,you may had a recurrent retention. 2.The other reason would be, recurrence of retention, and urodynamic study showing, very poor urine flow rate and poor bladder muscle(detrusor)pressure. Now if your Urologist feels,you're ready for a surgery,then you should consider it. There're several types of prostate gland surgery for it's removal. a. TURP remains the gold standard. Laser surgery is also widely practised, with complete removal and same results. b. You should mention your PSA level before surgery, which you haven't. Cancer will be established only after biopsy of prostate gland tissue. Personally, i've no experience with the URO-LIFT treatment. c. Terazocin has no role, once you're doing self-catheterisation. d. Unless you send all your reports and scans, it's difficult to give any advice. Wish you good health.