Transurethral resection of the prostate, aka "a roto-rooter job".

For years I've had a problem urinating - all of the usual symptoms, straining to go, frequency, not emptying the bladder, getting up 3-4 times during the night, you name it. And last year, CT scans and ultrasounds confirmed it.  My prostate was enlarged (BPH, Benign prostatic hyperplasia). and the best treatment option given the size of it was TURP.

Of course, I'd read all of the pluses and minuses of the surgery, but in the final analysis, I really didn't have a choice.  And yes, I was apprehensive - any surgery as one gets older carries risk with it.  But the surgeon had done many, many, many of these, and I felt comfortable with him.

So, after midnight Sunday night, no food, no drink.  Late morning Monday my cousin arrived to take me to the hospital, and sit and wait for the post-op report so he could fill my distant sister in on the details.  As I understand it, the surgeon removed about 1/16th of an inch all the way around inside the urethra, for the full length of it (approximately 14 inches - I had no idea it was that long).  "Look at it as a doughnut - the prostate is the doughnut, the urethra is the hole in the middle, and as the doughnut has gotten larger, the hole has gotten smaller.  I'm going to ream it out a bit."

I was rolled into OR at 2:30 Monday afternoon, and at 3:50 I came to in the recovery room - instantly awake and alert, no grogginess at all.  And it didn't hurt either - maybe because of the pain meds they were giving me through an IV.  After a time they took me to my room and got me set up for the night.  My cousin came in, brought the bag with my clothes, visited briefly, said he'd call my sister again, and told me to call him the next day when it was time to go home.

About this time I noticed a small but constant pain near the tip of my penis - they were flushing my bladder with a saline solution, a process that would continue until they finally removed the catheter late Tuesday morning.  Too, I was being given antibiotics through the still-attached IV.

Finally Tuesday morning the moment of truth arrived.  The nurse was given the go-ahead to remove the catheter, and after a few brief preparation steps, she instructed me to take a deep breath, and she slowly pulled the catheter out - all 14 inches of it!  And yes, it was "mildly uncomfortable" as she pulled it out (translation - it didn't hurt nearly as much as i thought it would...).

The next few hours were, to say the least, interesting.  I was instructed to provide 3 urine samples before they'd allow me to leave the hospital (had to make sure I could pee, sometimes patients aren't able to afterwards, which is a very serious problem).  Too, each sample was bloody, but less so that the previous one, which indicated that things were slowly improving.  As the doctor had explained, the resection process is akin to skinning one's knee; the skin will grow over the abrasion, and the same will happen in the urethra - the walls of the urethra will grow back in a few days, and I'll be as good as new, just with a larger urethra.

Initially there was incontinence along with some strong pain when trying to urinate (meds available, but the insurance company wouldn't cover them - 6 pills prescribed, at about $2.00 a pill, so I paid for them myself - is this a new thing, a hint of Obamacare to come, or is it just that they never would have paid for pills to relieve the post-op problem of painful urination?).  So I wore a pad while leaving the hospital, changed it a couple of times during the evening as needed.  Frequent urination still occurring, but this will gradually go away, and I will get back to where I should normally be.  And overnight, the incontinence corrected itself.  I woke up around midnight (I slept in a chair most of the night)  needing to go to the bathroom, and discovered that I had regained control of my bladder.  I am using a fresh pad today, but so far it's remained dry.

Was it worth it?  Too early to say for sure, but I'm optimistic.  I did have a kidney infection late last year, and that's one thing that should not be a problem in the future thanks to the surgery.  And if the problem with frequent trips to the bathroom is resolved, then absolutely.  Not only has it been a long time since I was able to sleep through the night without at least 2-3 trips to the bathroom, but even day-to-day activities required being somewhat close to a restroom, and led to regular interruptions of those activities.

They always make you sign numerous forms while you're in the hospital.  One of the forms I was required to sign was one that stated that I was aware that the surgery I was about to undergo could quite possibly leave me sterile.  Now, given that I had had a vasectomy many years ago, I really wasn't concerned about that, but rules are rules (the nurse told me that even if the patient was an 80-year woman getting a hysterectomy, they'd have to have her sign the form).  I guess there are people in this world who really don't understand even the remotest part of the world around them...

Update 02-02-13

Saw the doctor's PA yesterday.  Recovery time on something like this is 6-8 weeks, so I've got a way to go yet.  She gave me a new prescription for the pain pills that supposedly help with painful urination, and a new prescription for Avodart.  The original intention of Avodart is to try to shrink the prostate; but used following surgery, it helps to reduce swelling of nerves and muscles caused by the operation, thus allowing them to resume their normal function.  This should help in reducing the frequency issues I've been having, in turn letting me return to a more normal lifestyle.  I go in an 4 weeks for a flow test, then see the surgeon two weeks after that to determine what additional recovery steps might be needed.

In the meantime, I have started to notice slight improvements, but then as I write this, it's only been 13 days since the surgery.

(See related story: Room Service)

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1 Response Jan 23, 2013

My, looks like you've given your self a good treat to the operating room after all this years. That's a big leap you did for a happy and healthy days to come. And now I know why my father has been too stubborn to take his doctors advice few years ago.
It took him long enough to decide. He's been depeding to drugs or herbals. Whatever that was adviced to him. Till his wife had him to sign those forms of agreement. And after that he gained his health and yes, his weight has been great after the operation. And became less grumpy.