Almost 10 Years Since My GreenLight Procedure for Prostate Enlargement, All Is Still OK

NOTE: If you want to learn my experiences with the GreenLight treatment for BPH (benign prostate hyperplasia), please go back to the first posts on this blog. I had the treatment in late 2006.

Fortunately, there is not much news to report. I can still pee "like a firehose".

It sometimes takes up to 20 seconds to initiate urination if I didn't really need to go, such as preparing to leave on a car trip). But if I need to pee, everything works right away and like a charm.

I'm 68 years old now, retired from a desk job, staying active and feeling fine.

I travel quite a bit, sometimes with my wife and sometimes solo. If you want to see a list of the latest hot travel deals (mainly deeply-discounted airfares) that I am personally interested in, check out HowYouCanFlyFree.com

I'm still a fan of GreenLight procedure for prostate issues. I hope it works for you as well as it has for me.

6+ Years, Still OK. Medicare Coverage for Green Light?

Today someone posted a comment to this 'Me and My BPH' blog, which reminded me that I haven't posted any updates in awhile. While trying to remember how to create new postings, I noticed that people actually read this...ten to 30 people per day...who knew?!

It's been six years and a few months since the GreenLight procedure, and everything is still OK.

As in past years, there is still a tendency toward hesitation in starting to pee, if I didn't really need to go. For example, I'm getting ready to go shopping so I decide (just on general principles) to pee before I leave. Getting started may take 5, 10, 20 seconds.

But if I do need to pee, it starts right away.

Flowrate is still great. I never need to get up in the middle of the night to pee, and I haven't had any urinary tract infections since the procedure.

I'm still surprised that one of the doctors that I consulted with recommended TURP over Green Light. From what I've read, TURP is bloody (maybe even a blood transfusion), painful and requires a hospital stay. I'm glad I didn't follow his advice!

I'm now on Medicare. Had I delayed getting the Green Light treatment, I do not know if Medicare would have covered the procedure or not...does anyone reading this know?

5 Years Since Greenlight, Still Happy

I see that another year has passed since I had the Green Light prostate surgery. Actually, surgery doesn't seem like the right term, since I was in and out the same day and no scalpel was used. The Greenlight laser gizmo treats non-cancerous enlarged prostate, or benign prostate hyperplasia (BPH). It's the modern-day version of what we guys used to call the roto-rooter procedure.

Anyway, it's been another year and everything is still fine. I notice some hesitancy in starting urination, but only if I don't need to pee...like, going to the bathroom before starting a car trip or before bed. In those situations, it can take up to 20 seconds or so to start the flow.

But, if I need to urinate, it starts right away and flows like a fire hose. Compared to when I had BPH, it's just wonderful! I'm so glad I had the procedure!

Another Year, Still Happy

Another year has passed since I had the GreenLight procedure for benign prostate hyperplasia (BPH, enlarged prostate). I am still very happy that I had it done.

Any changes in the last year? Well, it does take 10 to 30 seconds to start urinating IF I don't really need to. For example, if I plan to drive across town and decide to pee before I g0, but don't really need to pee, then it takes awhile for flow to begin.

But, if I need to pee there is no delay.

3 Years Since GreenLight for BPH, No Regrets

It's been 3 years since I had the GreenLight treatment for BPH (benign prostate hypertrophy). Everything is fine.

There are two minor issues, which are closer to non-issues:
1. Sometimes I can't tell if I really need to urinate or not.
2. If I don't need to urinate, but choose to (say, before a car trip), it may take up to 20 seconds for the flow to begin.

I don't know if either of these is related to the GreenLight BPH therapy. When the flow does start, it's firehose-esque, not a tiny stream.

My PSA before the treatment was 2.4 to 2.6. Sixteen months after Greenlight (April 2007) the PSA had dropped to 0.90, in April 2008 it was 0.90, in April 2009 it was 1.10.

HoLAP Prostate Treatment Experience

My treatment for BPH was done using the GreenLight laser, but a newer technology is HoLAP (Holmium Laser Ablation of the Prostate). I see that a blogger has related his recent HoLAP experience today. The URL is http://www.restoringtally.com/blog/2009/11/results-my-prostate-surgery

You can see a little more information about HoLAP treatment for benign prostate hypertrophy (BPH)at http://HoLAPprostate.com

Two Good Years!

Well, it's been 2 years and ~3 days since I had the GreenLight procedure for BPH (benign prostate hyperplasia). Everything is boringly good...urine stream strong.

The only odd thing is that, if I don't really need to pee but decide to go (say, before a car trip), it may take a long time for the stream to start.

I'm still very pleased that I had the Green Light procedure.

Wonderful Boring Reality

In about 3 weeks it will have been a year since I had the GreenLight prostate procedure. I have good news, and that is that there is nothing bad to report :-)

I recommend the procedure, it has certainly worked for me!

7 Months Since Green Light Procedure

It's been 7 months now since the PVP GreenLight procedure on my prostate gland, and everything is still OK.

EPCA-2 Test May Dramatically Improve Prostate Cancer Detection

All men are, or should be, hoping that the EPCA-2 blood test becomes available soon. It is specific for prostate cancer, in comparison to the PSA test which isn't specific for much of anything. In a test of 330 men, the test was positive in 94% of the men with prostate cancer and negative in 97% of those who did not. In those men whose standard PSAs were lower than 2.5 (and therefore would be assumed to be cancer-free), the EPCA-2 test successfully detected 78% of those who had prostate cancer.

Men with benign prostate hyperplasia (BPH) often have elevated PSA numbers, even if they are cancer-free. The ECPA-2 test successfully identified 3/4 of the cancer-free men with BPH and high PSA numbers.

Dr. Robert H. Getzenberg, the developer of the test, hopes it will approved by the FDA by the end of 2008. However, that agency has a habit of confounding the prognosticators so this date could slip into 2009 or later, or never.

Six Months Since Green Light Procedure

Tomorrow it will be 6 months since I had the GreenLight PVP prostate procedure. It's still good! If you are thinking about it, I say go for it!

In the last couple (?) of months my firehose urination has slowed to a more moderate pace, probably as the bladder muscle has returned to normal size. It's now about 30-35 seconds to empty a full bladder and zip up...such an improvement from before the procedure!

If I don't really need to go, there can be an abnormally long hesitation before urination starts. I don't know why. If I do really need to go, there is no hesitatino at all.

Siz months, 180 days, maybe 1000 urinations that have not been an exercise in patience. All right!

GreenLight Procedure, 6 Months Ago

Wow, 6 months since I had the procedure. No problems to report, everything is "going with the flow."

The Return of Morse Code?

An interesting thing happened about a month ago, and has been repeated a few times since. If I get up in the middle of the night to pee, sometimes the stream is weak and comes in Morse code segments...just like the bad old days!

A separate, but perhaps related, phenomenon that started about a month ago is occasional hesitancy in starting the stream. If I really need to go, no problem...it starts quick and flows fast. But if I don't need to go too bad, sometimes the flow is slow to start.

The worst example was at a local restaurant, when I went to the bathroom to take a whiz before starting on a drive. There were two urinals, extremely close together and with no modesty partition between them. A fellow was using one, and I could not get my stream to start for a good (bad) 20 seconds or so. Embarrasing!

GreenLight Prostate Procedure Patient Report - 4 Months Since Surgery

Time flies, especially when you aren't standing in front of a urinal!

Everything is fine, I'm glad I had the procedure, and glad the surgeon had the opportunity to learn from his mistakes on the patients before me.

GreenLight Prostate Procedure Patient Report - First PSA Test Since Procedure

As a part of my annual physical exam I had a PSA test today...the first since November of last year (before the Greenlight procedure). At that time the PSA was 2.40 (doubled to an effective 4.80 because I was / am taking Avodart).

Today's number is a remarkable 0.9 (doubled to 1.8). Hooray!

My urologist said that they don't do any PSA tests until 7 months after the PVP, because until then the results don't mean anything.

GreenLight Prostate Procedure Patient Report - 3 Months Since Surgery

It's been 3 months today since I had the Green Light procedure for benign prostate hyperplasia (BPH). Nothing new to report, everything is still good.

GreenLight Prostate Procedure Patient Report - 2 Months Since Surgery

The surgeon told my wife, while I was still unconscious in the recovery room, to tell me to wait a full 2 months before giving the GreenLight procedure an evaluation. Well, that milestone has arrived (and slightly passed), and here is my report to all readers:

-- Urethral irritation is gone.
-- I'm continent.
-- I'm potent, but not likely to have any more children.
-- I can pee real fast!
-- The health insurance disagreement is down to $100.

If you are peeing in Morse code like I was, and if you can find a surgeon who has already done at least 50 or 100 GreenLight (PVP, photo vaporization of the prostate) procedures, I recommend it.

If you are curious, go to YouTube and look for the videos of Greenlight procedures by the Spanish surgeon. They are very educational.

thgilneerg

GreenLight Prostate Procedure Patient Report - Almost 2 Months Since Surgery

My pee time is now down to about 20 seconds to pass 98% of the urine...outstanding! I step up to the urinal at the same time as a young person and finish as quickly as he does.

This morning, completely unexpectedly, a blood clot and a chunk of necrotized tissue popped out while I was peeing. And this evening another chunk came through. I thought that stage of recovery had long passed.

GreenLight Prostate Procedure Patient Report - Almost 7 Weeks Since Surgery

Things continue well, with only one minor problem. I can pee like a fire hose...empty 98% of a full bladder in 20 seconds. That is absolutely WONDERFUL!

The minor problem is that sometimes, when I realize that I need to pee...I REALLY need to pee RIGHT THEN. No accidents have happened yet, but I can envision a problem on, say, a road trip out in the middle of the boondocks.

They say that the bladder-emptying muscle gets very strong when you have BPH, in order to push the urine out. Since that power is no longer needed and the muscle probably will weaken, perhaps the flowrate will slowly diminish and the urgency problem will subside.

GreenLight Prostate Procedure Patient Report - 1 Month + 5 Days Since Surgery

Today I noticed the urine flow diminishing to less and less. Then, this afternoon while peeing, a large chunk of necrotized tissue came out. It was quite a surprise, because it was larger than any of the blood clots that were popping out a couple of weeks ago. It felt like a jellybean on the way out, and I'm fortunate that it came out and didn't get stuck like a cork.

Ever since, the urinary flow has been fire-hose strong. Nice!

GreenLight Prostate Procedure Patient Report - 1 Month + 4 Days Since Surgery

Yesterday the burning on urination returned, much to my surprise. Today I passed, machine-gun style, 3 somethings. Coincidentally, today I had my follow-up visit to the surgeon.

GreenLight Prostate Procedure Patient Report - 1 Month Since Surgery

This morning, exactly a month and a day after the surgery, the burning sensation on urination disappeared. I hope it stays away! I've resumed taking an aspirin a day for protection against heart disease and colon cancer, and to mute the flushing side effect of my niacin supplement.

GreenLight Prostate Procedure Patient Report - 4 Weeks Since Surgery

Things are slowly getting better. No bleeding for about 5 days, I'm completely off Flomax, urinary flow is good (not great) and the burning sensation during urination is only about half as bad as it was. And...I haven't ever peed when I didn't intend to! :)

GreenLight Prostate Procedure Patient Report - 3 Weeks Since Surgery

It's hard to believe that the surgery was 3 weeks ago.

Bleeding comes and goes. Irritation stays and stays, but it's usually only painful when I pee. Urinary flow diminished over the last couple of days, so I took a Flomax last night and urinary flow is much improved today.

Perhaps I have prostatitis or a urinary tract infection, or maybe this is normal.

It is a relief to not be concerned that I might wake up some night and just flat-out not be able to pee :)

GreenLight Prostate Procedure Patient Report - 19 Days Since Surgery

Frequent urinary-tract irritation and occasional small discharges of blood persist. The irritation makes you think you need to pee, even if you don't really, so it's "irritating" in more ways than one.

Before the procedure, the urologist said that I would need to go to the bathroom a lot, "and sometimes you may not make it." A couple of days ago I was walking outside and I thought that might come true...the sensation of needing to go was very strong.

The disappointing thing is that there is no sense that this is getting better; in fact, it's getting worse.

GreenLight Prostate Procedure Patient Report - 13 Days Since Surgery

Dang blood clots! For the last couple of days I've had an annoying irritation of the urethra, but no blood. Then this evening there was some blood (probably a teaspoon) followed by the largest clot I've seen. That explains the irritation. Good thing I haven't resumed taking aspirin, which would make the bleeding much worse.

I'm ready for the healing to be complete!

GreenLight Prostate Procedure Patient Report - 12 Days Since Surgery

Blood clots and minor bleeding continued until yesterday, but now they have completely stopped. There is no telling if they will return (they stopped before and then returned) or if that part of the healing process is finally over. The urinary tract is still somewhat irritated, causing me to feel as if I need to pee when I don't.

Blood clots are soft and red, and settle to the bottom of the toilet when you are peeing. You can feel the larger ones come out, but they are soft and not painful at all.

The urinary stream is much improved. Emptying a full bladder takes about 30 seconds, compared with up to 2 minutes before the procedure.

I'm still on one Flomax per day, but I might as well stop it tonight because the flow is so good.

GreenLight Prostate Procedure Patient Report - 9 Days Since Surgery

Today is another blood clot day. I cut down to one Flomax yesterday, but things slowed down so I am back up to 2/day today. I probably get about a teaspoon of blood with every urination...too little to have any health effect, but it has caused me to take an iron pill just to make sure I don't run low.

And, I've resumed the UTA (urinary tract anaesthetic) medication because those dlslodged blood clots seem to cause irritation of the urinary tract.

GreenLight Prostate Procedure Patient Report - 8 Days Since Surgery

Today seems to be blood clot day! Almost every time I go, I pass a blood clot or two or three. Some are pretty big. And, with every clot you get some blood also.

But it's all normal, and the flowrate is increasing nicely :-)

A funny thing happened this morning: I went out to breakfast to a place that has electric-eye urinals. After I peed a few clots and some bloody urine, the urinal would not flush! So, I just skulked out, leaving the mess behind. I'm sure the next guy wondered what the heck had happened!

GreenLight Prostate Procedure Patient Report - 1 Week Since Surgery

It's hard to believe that a week and 12 hours have passed since the Green Light PVP tretment for benign prostate hyperplasia (BPH). My condition is improving.

On December 24 I called the on-call doctor due to my greatly diminished urinary flow. I wanted to know what to do if the flow stopped completely ("retention"). He said to continue taking 2 Flomax per day and to go to the ER if I went into retention. That would have been a bummer on Christmas Eve.

It didn't happen, and yesterday and today the flow has definitely improved. Perhaps the reason is related to the blood clots I'm starting to see...maybe they were clogging up things? After almost no visible blood for about 4 days, I'm now seeing a little almost every time I go to the bathroom. The doctor told me to expect that, but I thought he meant right after the Green Light procedure. Oh well, whatever.

I ran up the 3 flights of stairs at work today...a little less vigorously than normal, to avoid any un-necessary jostling.

GreenLight Prostate Procedure Patient Report - 6 Days after Surgery

Virtually all my discomfort is gone, but my urine flow continues to diminish. In fact, it's down to about where it was when I finally decided I had to have the Green Light procedure. Today is Sunday and also Christmas Eve, and tomorrow will be Christmas Day...not great times to seek medical assistance. I don't know whether or not to call the doctor today (via Medical Exchange) and seek assistance, because I figure he'll just insert a catheter and tell me to come see him Tuesday.

GreenLight Prostate Procedure Patient Report - 5 Days after Surgery

My recovery continues. A couple of days after surgery my urine flow began to decrease to pre-surgical levels. It has gotten a little better since, but is nothing like the flowrate I expected. Maybe the prostate is still swollen from its laser-induced trauma. I have returned to taking 2 Flomax per day.

Urinary-tract burning has gotten much better, but it is still there. I wonder if they used a harsh antibacterial soap in the urethra before surgery.

The good news is:
-- No incontinence
-- No impotence
-- No blood in urine
-- No pain (except burning on urination)

A word about coffee:
A week before the procedure I began to cut back on caffeine, and I was way, way down when I went in for the GreenLight procedure. I think that was wise, because otherwise I would have been in caffeine withdrawal during recovery.

GreenLight Prostate Procedure Patient Report - Day after Surgery

Well, it's noon the day after surgery and I continue to feel good. There is no discomfort from the prostate area. The severe burning sensation while urinating has considerably diminished, although it's still not a lot of fun to pee. My stream has not improved tremendously, but the doctor said it requires about a week. I took a Flomax this morning and probably will do so for a few more days. (Down from 2/day previously.)

The amount of blood in the urine is tiny, probably just a few drops. No blood clots have been seen.

I'm continuing to avoid lifting heavy objects, but I probably will go shopping later today.

Oh, and I'm not impotent :-)

GreenLight Prostate Procedure Patient Report - Day of Surgery

Over the last year my BPH continued slowly getting worse, so this morning I had the GreenLight PVP procedure. That procedure vaporizes parts of the prostate gland by use of a powerful green laser.

After 12 hours, it's so far so good...generally.

At 5:30 AM my loving wife and I showed up at the designated medical clinic. I was suitably starved and dehydrated (NPO since midnight, and not really a problem). The staff was very friendly and nice, and soon enough had me interviewed and hooked up to an IV (took 2 sticks). The anesthesia nurse came by to ask her questions and look at my throat. The urologist came by to say hi and make certain I didn't want to back out (kind of late for that!). Then they wheeled me into the OR. I think they put a mask over my face.

A moment later I was awake in the recovery room, alone except for a few staff members. I don't know how long it took to wake up, but from the moment I remember I was fully conscious and alert, no nausea, no pain. I had to lie there for about half an hour, chatting sometimes with the fellow assigned to me. During that time no other patients entered the room...very odd, given that many people choose elective surgery at the end of the year because they have already met their insurance deductible. I looked down to verify that I had a catheter inserted, which they had done after the anesthesia took effect.

After the allotted time in the recovery room they wheeled me back to the private room where my wife was waiting. I felt fine, ready to hop up and run around, except the IV and catheter were still hooked up. We waited for maybe an hour, then came the moment of truth...I had to see if I could pee. The nurse injected 200 ml of water into my bladder through the catheter, then pulled it out and handed me a urinal. I went into the restroom and peed about 300 ml of rose-wine looking liquid into the urinal. Success! I could go home without a catheter!

The urologist gave me scripts for 3 medicines, 2 of which were not sold by CVS, Walgreen's or the local grocery store pharmacies. After much calling around we found a small independently-owned pharmacy that sold them. At least one, "UTA" (which probably stands for Urinary Tract Analgesic) was probably made on the spot by the druggist. It is supposed to turn the urine blue, but after 5 hours that has not happened and precious little analgesia has happened.

In about half an hour I was riding home with my wife at the wheel. Since there was no drowsiness or pain I could have driven without difficulty, but I'm sure the hospital would not have allowed it.

The only discomfort I have had in the 12 hours since the procedure is intense burning when I pee. Did I mention it was painful? It feels like somebody stuck a hot rod about one-fourth inch into the end of my urethra. I would love for that UTA to go to work!! The location suggests that they didn't lubricate the catheter too well before they inserted it...or maybe they did and then stuck some sand onto it .

For the first few hours after the procedure there was essentially no blood visible in the urine, but now it has a color like pinkish champagne. No blue is visible in the urine, and no blood clots are either.

Peeing in Morse Code...Not My Cup of Tee

About 10 years ago, when I was in my late 40s, I gradually realized that urination was taking longer than usual. I didn't think much about it until one late-night trip to the bathroom when almost nothing would come out. At that moment it dawned on me that something was happening to my body, something that I didn't like.

My family physician informed me that I had BPH, or benign prostatis hyperplasia. At least he assumed it was benign. He explained that a doctor's rectal exam could check only two of the three lobes of the prostate for irregularities that would indicate cancer. He guessed that I could continue about 7 years before needing something done. Something that I really didn't want to have done!

Well, it's been about 10 years, and I haven't yet had a TURP or other prostate-reduction procedure. But the disease is progressing, so I know it will have to happen one of these days...or nights.

One of the odd symptoms of BPH is that your urination pattern becomes changed. The normal pattern is:

• approach the toilet
• big blast of urine
• couple of quick squirts
• zip up and you're done.

For guys with BPH, the pattern becomes:

• approach the toilet
• wait
• small flow of urine for a long time
• think your're finished, so a quick squirt
• realize you're not finished, pee some more
• think you're finished, so a quick squirt,
• repeat a few times
• realize that somebody is waiting, so zip up,
• repeat in 30 minutes to an hour.

This sounds a bit like Morse Code, which is why this blog is named "Pee in Morse Code."

Any other guys out there who care to chime in?