re: Have you had TURP surgery?

I had aquablation done on 5/17 as my prostate was to big for urology.Had trouble with clots and having to put the catheter back in, been having it in for 2 weeks,go in on 7/2 hopefully to take it out for good.

There is a TUIP as well.

Umm you’re a dude? Didn’t see that one coming

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And what used to be the supreme indignity and discomfort of waking 3 or 4 times out of a sound sleep to void, is over!

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Just a point here, upwards of 80% of the nocturia I see in my office is primarily related to drinking water leading up to going to bed. If that's your most significant bother, try reducing that first.

Your prostate may be too large (>80g) for Urolift or ITind, both outpatient procedures that would not keep your snake from crawling’ up doors and windows. But TURP, HoLEP, PVP, or Aquablation—hospital procedures with relatively long recoveries that will likely keep your snake on the floor forever—are not your only alternatives. You may not have an interventional radiologist that does prostate artery embolizations (PAE) in your community, but you can certainly find one or more within driving distance. Ask your urologist for a referral for a consultation. If your urologist won’t do that, find an interventional radiologist who will consult with you without a referral. PAE worked well for me without a lengthy recovery or side effects despite having a very large prostate that extended into the bladder. You can have another PAE, TURP, or RASP if the first PAE doesn’t relieve your BPH enough after 6 months. Most urologists will not give you this information.

Interesting you brought up the Prostatic artery embolization (PAE).

Hopkins Site

• PAE symptoms related to benign prostatic hyperplasia are present in about one in four men by age 55, and in half of 75-year-old men.
• Treatment is only necessary if symptoms become bothersome.
The PAE procedure has a lower risk of urinary incontinence and sexual side effects (retrograde ejaculation or erectile dysfunction), when compared with more invasive surgical procedures such as a transurethral resection of the prostate (TURP).

Patient Forum

Go to a good one, and go to a very experienced IR to get a PAE done. The serious complications of a PAE are much rarer than the complications of the "gold standard" TURP. Don't forget that having a lot of urine back up in your bladder and kidneys can, and will, eventually, kill you. You have to look at all of the data and find the procedure that has the most benefit with the least likelihood of serious complications. For me, that was the PAE.

This thread will probably get moved to the Health/Fitness Board, but BPH will hit most of us sooner or later. A topic that should rank right up there in importance with Hawk Tuah.

Yale Site

About 50% of men between the ages of 51 and 60 have BPH, and that number jumps to 70% among men aged 60 to 69 and around 80% of men over 70 years of age.

If I'm being honest, I didn't know I had a turp.

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I wasn't a fan of the scope so I'm not eagerly anticipating this next torture.

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Urethrascope was one of the weirdest medical experiences I have ever had. You're fully awake while the doctor is manipulating a camera tube down your pee hole and around your bladder, while they're narrating it the whole time.

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The AUA changed its guidelines on PAE in September of last year. There are many relevant studies not listed in your statement 40. Many urologists seem threatened by the prospect of a different specialty infringing on their territory. Some are not. The premier urology clinic in my city is adding an intervention radiologist to its staff because they recognize the justifiably increasing interest in PAE.

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Where are these many relevant studies?

The guidelines say it can be offered, and the data is fairly equivalent in how patients feel they've benefited. However, in actual functional testing parameters and requiring repeat procedures PAE falls behind. TURP is just a more effective procedure with the data we have now. As for urologists worried about it taking patients away, the retreatment rate is high enough that we aren't really losing that many patients.

That doesn't mean everyone should get a TURP. Treatment options are largely dependent on patient preferences/goals, so that should drive counseling/decision making.

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Is what I’m experiencing a normal part of recovery.

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It is a common enough complication of many bladder outlet procedures. A bit more common in aquablation historically. The short story is that it happens, and most likely you just had bad luck.

Most of my post-op bleeding for any of these procedures is actually due to straining from constipation more than just regular old bleeding from something I missed (though that happens, I'm just a man).