Suggest treatment for enlargement of prostate

Posted on Mon, 8 Jun 2015 in Urinary and Bladder Problems
Question: I have BHP and the doctor has suggested surgery. He said that my gland is large( not sure what size) but the said he does TURP and laser ablation methods. He said he cuts the ladder neck( thus retrograde ejaculation will occur) but I read that using the HOLAP the bladder neck is not cut thus reducing the probability of this condition. Or, what methods are there for a large prostate with reduced incidence of the retrograde issue? i also had a test to ensure urine was not backing up into my kidneys. He is leaving it up to me whether or not I want surgery but lately my stream is getting weaker so that is why would like some relief .Thank you
Answered by Dr. P. T. Patil 45 minutes later
Brief Answer:
You need surgery

Detailed Answer:
Thanks for your query,based on the facts that you have posted it appears that you have Benign Enlargement of prostate with significant post void residue of urine .

In view of above findings and weaker urine stream it is advisable to get endoscopic surgery done to resect the enlarged prostate and improve urine flow and stream.

As regards your doubt about retrograde ejaculation It is practically impossible to avoid cutting bladder neck irrespective of method or modality being used to resect the prostate even in a hands of experienced urologist .

It is unavoidable complication of this surgery .However it does not affect your sexual potency and improves quality of your life .

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.

Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. P. T. Patil 20 hours later
Specifically, what procedures by name are you referring to when you say to proceed with endoscopic surgery? So, when I read that the HOLAP procedure mentioned that their was only a likelihood of retrograde, it is not necessarily true then from what you said. Also, I read of a new procedure" ejaculation preserving trans resection of prostrate and bladder neck". Can you comment on this?
Answered by Dr. P. T. Patil 37 minutes later
Brief Answer:
Read Detail answer below.

Detailed Answer:
Hello thanks for follow up.
All the different modalities practiced for removal of Enlarged Prostate are defined by a broad term as Endoscopic Surgery .

Equipments and techniques used during surgery are identical and only the source of energy used to resect the prostate are different .

In TURP normal electric current is used to resect the Prostate where as in laser resction various laser energy source like N.D Yag laser or Holmium Laser is used is to resect the prostate .

In all these surgeries one can not differentiate landmark between bladder neck and prostate precisely hence there is every chance of resecting bladder neck to some extent resulting into retrograde ejaculation.Hence no Urologist will be able to authentically guarantee that you will not have retrograde ejaculation after surgery.

Thanks and Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. P. T. Patil


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