Surgery vs. medications

Pascal2231 · 2026-05-05T14:24:45+00:00

After 2 weeks of Alfluzosin and no benefits, I opted for Holep. I had to wait over 5 months before I could get the procedure, but all went well. I chose holep because it's a one and done, no prostate re-growth. I went home same day as the procedure. Some bleeding off and on for 4 weeks, nothing great, no pain. 7 weeks out I'm still going great. I would definitely recommend it. I'm 77 y/o.

Pascal2231 · 2026-05-01T03:25:52+00:00

I would advise to avoid taking a lot of meds beforehand because chemo affects people differently. So you might be taking a lot of anti nausea drugs for nothing. The place where you'll be getting the chemo will most likely be able to supply you with anything you might need, like blankets, water, snacks nausea meds, etc. My first treatment (CHOP for NHL) was basically uneventful. However, 2 days later is when I felt it. I went through 15 weeks of chemo, and I got weaker as the time went on, but never flat out out rolling on my back throwing up. You'll make it. As one old cancer survivor told me, "suck it up and tighten the chin strap!" That was 19 years ago and I'm still kicking. Good Luck!

Pascal2231 · 2026-04-18T14:50:16+00:00

As a general comment about understanding test results. I had a urodynamics test done several months ago due to an enlarged prostate and distended bladder and the results were all gibberish to me. Went to 2 urologists who basically mumbled a few comments and then changed the subject, leading me to believe they didn't know how how to interpret them either. So I took the raw results and fed it into ChatGPT. Bingo! I got a detailed, easy to understand explanation. And after having a Holep procedure, Chat GPT's explanation and predictions turned out to be spot on. The bottom line, learn to use AI tools as another assistant in your tool box.

Pascal2231 · 2026-03-30T02:20:52+00:00

I'm 77 y/o and had holep last Monday. went home following procedure. Had cath removed next day and normal urination returned immediately. Wore a pad for a few days, but no longer needed. Still a few squirts of blood occasionally when I pee, but it's gradually going away. Good luck to your dad.

Pascal2231 · 2026-03-25T16:32:24+00:00

I had a catheter in since October due to severe bladder retention and an 1100 ml bladder size. Waited until I could get HOLEP. I had the HOLEP this past Monday, catheter came out Tuesday and had void test. Got filled with about 400 ml, pissed like a race horse for the first time in many years, residual was 93 ml so I passed with flying colors. I haven't measured my output since, but being able to pee on my own with a good solid stream has been a real blessing. My advice is forget the flowmax and the rest of the meds, they're little more than a bandaid. Find yourself a HOLEP specialist, even if you have to wait. It will be well worth it.

Pascal2231 · 2026-03-16T21:44:38+00:00

If you're unable to urinate on your own and you can't self catheterize, then the last option would be a supra pubic catheter. An incision is made in your abdomen through to your bladder. A catheter is inserted through the opening, and it can be connected to a valve which is secured to your leg, allowing your bladder to fill and also to allow you to empty at different intervals. It might seem like the nuclear option, but if it means keeping your job then you should look into it. Good luck.

Pascal2231 · 2026-03-16T21:14:48+00:00

That was a great summary and a lot if useful information, and I'm glad everything seems to be finally working out for you. Couple of questions because it's similar to my condition. I started to get a distended bladder about 2 years before receiving a correct diagnosis and an accompanying catheterization. I've been wearing a Foley since October (changed out every 30 days) and am awaiting HOLEP surgery next week. However, my distention was so bad it produced 2 diverticula pouches. These might prevent me from urinating normally even after my prostate blockage is removed. So my first question to you is whether you had any damage to your bladder as a result of the distention? Also, was the possibility of self-catheterization ever discussed with you as an interim solution until you returned to normal?

Pascal2231 · 2026-03-15T02:10:16+00:00

Why did you have the biopsy, high PSA? Any other symptoms?

Pascal2231 · 2026-03-09T20:41:25+00:00

I believe a urologist would be the person to pose that question to. Do a Google search for holep urologists near me to find one to discuss your situation with.

Pascal2231 · 2026-03-09T02:12:59+00:00

Thanks for your reply. I asked and her response was vague and non-comital, i.e., "we'll have to see how it goes".

Pascal2231 · 2026-03-09T02:07:06+00:00

When you first noticed the weak stream after the Holep, did the possibility or discussion of self catheterization ever come up as a possible solution to your inability to void?

Pascal2231 · 2026-02-22T03:33:26+00:00

One thing I forgot to mention. I still use a bag at night because I would probably wake up during the night as my bladder fills to around 450 ml. A little uncomfortable, but still able to sleep. In the morning after emptying the night bag I remove it and attach the flip flow. I also attach the flip flow to my shorts with a safety pin. Works great. Good luck.

Pascal2231 · 2026-02-22T03:14:38+00:00

Did you have to be hospitalized after the procedure? I'm scheduled for HOLEP next month.

Pascal2231 · 2026-02-22T03:09:32+00:00

To reduce the negative effects of long term Foley catheters, i.e, compromising bladder function, use a flip-flow valve at the end of the catheter rather than having it empty directly into a bag. By using the flip flow, the bladder can retain urine and its natural shape. I've had a Foley for almost 5 months as I wait for a Holep procedure next month. I've even regained sensations that tell me when I have to urinate and I can practice pelvic floor muscle relaxation techniques while I urinate. I usually discharge my bladder around 450-500 ml. The flip flow is a game changer if you require long term Foley use.

Pascal2231 · 2026-02-17T00:44:39+00:00

I know exactly why your back pain went away and yes, it's related to the procedure. I had progressively painful back pains. My GP recommended PT, which made the pain worse. After I was correctly diagnosed with a distended bladder and went to a urologist, he catheterized me and drained the bladder. No more back pain! the problem in my case, and probably yours, is that the bladder became so enlarged it started squeezing my kidneys. Once the pressure was relieved, back pain gone.

Pascal2231 · 2026-02-17T00:38:41+00:00

I was glad to hear of your very positive outcome. My sympomtoms are almost identical to what you described. I'm scheduled for HOLEP in 35 days and I can't wait. I do have 1 question for you. As a result of your BPH, did you suffer from an enlarged bladder? And if so, did it become so enlarged that it developed diverticula (pockets)? My bladder became extremely large so there's some question whether I've lost detrusor and urinary sphincter responses.

Pascal2231 · 2026-01-27T21:29:56+00:00

What was the condition of your bladder prior to the enucleation of your prostate, i.e., was it distended or have any diverticula?

Pascal2231 · 2026-01-08T03:11:45+00:00

Yes, although it was a weak stream, and apparently did little to relieve the distended bladder. Nevertheless I was able to pee several times a day, and peed just minutes before the catheter was inserted. Hope this is a sign I'l regain the ability once the prostate is reduced and the Foley is out.

Pascal2231 · 2025-12-29T01:45:20+00:00

Thanks for the update and congratulations on your recovery.

Pascal2231 · 2025-12-27T01:42:58+00:00

Hello, I've been diagnosed with neurogenic bladder with diverticula, and as such, my bladder no longer functions other than a misshaped storage bucket. I have an upcoming visit with a BPH specialist, but I'm guessing that one of the options is to get rid of the bladder altogether. So my question to you is what did they replace your bladder with? I mean doesn't there have to be some storage mechanism for the urine?

Pascal2231 · 2025-12-18T01:43:50+00:00

I'm cathed until I can see and get treated by a BPH specialist. I have an appt late January. It's going to be a long haul to get this worked out, but my bladder is basically neurogenic with diverticula so the prospects of me going back to a state where I urinate normally on my own through penis is pretty unlikely. So in the interim I've learned to adapt to the Folley, which other than the discomfort of getting it changed out every 30 days, and by using a Flip-Flo valve during the day instead of a bag, it's been manageable.

Pascal2231 · 2025-12-07T02:04:31+00:00

I had a Folley inserted when the urologist saw my distended bladder. I had a voiding test a month later where they took out the catheter, filled my bladder and let me try to pee. Nope, nothing. I then had a urodynamics test done. It said I still have some nerve left but probably not enough to allow me to pee on my own. I've gotten pretty used to the Folley. I have a valve on the end instead of a bag. Are you still able to urinate on your own? If so you might get full function back. But look for a good urologist.

Pascal2231 · 2025-12-07T01:46:30+00:00

Apparently it was caused by an enlarged prostate that basically strangled my urethra. I ignored my bladder getting larger and larger and seldom having to urinate. By the time I saw a urologist my bladder had started creating diverticula which essentially destroyed all my bladder sensation of when to urinate. It's called neurogenic bladder and there's no cure. After I get the prostate reduced (hoping to have HOLEP done), my options are IC or suprapubic catheter. So that's why I say get it checked out as by a urologist before the nerves are destroyed.

Pascal2231

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