Suggest treatment for enlargement of prostate

default
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
doctor
Answered by Dr. P. T. Patil 45 minutes later
Brief Answer:
You need surgery

Detailed Answer:
Hello
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.
Dr.Patil..

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
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?
Thanks
doctor
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.
Dr.Patil.



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

Urologist

Practicing since :1971

Answered : 10157 Questions

premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Medical Procedures
Medical Topics

Recent questions on  Laser ablation

doctor1 MD

Hello: I am a 58 yr.old female who is generally in good health. I am 5'4 and 145 lbs. My weight has been stable for my adult life. For the last...

doctor1 MD

Hello. I was diagnosed with sebborheic keratosis on my right nipple, and the dermatologist sprayed liquid nitrogen on two occasions and it...

doctor1 MD

I have warts on my hands and my feet and they are multiplying. I have used salicylate on my hands to remove them and they reappeared. Is there a...

doctor1 MD

Hi, I have a lump in the back of my throat and swallowing is uncomfortable.. this came on very suddenly this afternoon. I do have HPV with cervical...

doctor1 MD

I have a couple of lumps around my anus that have little white tips. I went to the doctor to have them looked at and he said they were warts. I...

doctor1 MD

Hi. For quite sometime I have developed a random blister on my calves. It occurs on both legs either on the side or back of the calves about the...

doctor1 MD

Dear Dr. Charles S Narasi, I have also suffering with hemorrhoids, while passing stool I am having light pain. After that in morning office hours I...

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

181 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
backtotop2