Visit to PVP Doctor in Rhode Island

Two days ago (June 30) I visited Dr. Barry Stein at Rhode Island
Hospital in Providence. He took a urine sample, poked my abdomen, and
did a rectal digital exam. I am supposed to go back for an ultrasound
to check the size of my prostate, and also have the urine flow rate
test. If all results indicate a prostate problem, I would have the PVP
on the third visit.

Dr. Stein does PVPs and TUNAs. He used to do TURPs but prefers PVP
now. Here's a summary of Dr. Stein's comments about PVP, as well as I
can remember.

Comparing PVP to TURP:
Incidence of retro ejaculation: TURP 90%, PVP 80%!!! I am sure he
said this. These may be his own results.

PVP advantages are little or no bleeding, short recovery time. He
said that many patients can urinate shortly afterwards and can go home
the same day with no catheter.

In some cases there may be no immediate improvement in urination
because of swelling. Improvement in flow may take several weeks.
Because the inside of the prostate forms a scab, there may be bits of
tissue passed as the scab breaks up.

He said that Laserscope's website and their printed brochure make
overly optimistic statements. A new brochure will be coming out soon
with more realistic statements.

His statement about retro shook me up. I guess at my age I shouldn't
be so concerned about retro.

My own history:
I have been lurking in this group for 6-7 years.
I am retired,70, living alone, and have had urgency problems since
1984. Have been treating the BPH with saw palmetto and other herbs in
various brands and doses since early 90s. Have tried Hytrin, Proscar,
Flomax, and Cardura, all with various unpleasant side effects. Since
1999 I have been taking Cardura 2 mg plus saw palmetto and beta
sitosterol.
The multiple bathroom trips at night and the nasal stuffiness from
Cardura are wearing me down.
I'm retired and living in northern Connecticut so Dr. Stein is the
closest PVP doctor, about 2 hours away.
I haven't made an appointment for my second visit yet. I don't think
Dr. Stein has come up before in any discussions here. If anyone has
any comments I would welcome them.

--
Uncle

Uncle,

You sound like a good candidate for a PVP procedure. I think that an
80% retro rate is high, but again it depends on the doctor and what
types of prostates they are operating on. The higher the medial lobe
is in the neck of the bladder, the greater the risk of retro, seems to
be the consensus of this group.

I had a PVP six weeks ago with a very large medial lobe in the bladder
and I have retro, yet the doc who did mine had only a 20 % rate of
retros. But he told me that because of the size and location of the
medial lobe there was a better than 50% chance of retro in my case,
that might or might not correct itself in 4 to 6 months.

Can't say how soon I saw improvement in my flow rate, because the
catheter had to be in five days, two of which were because it was
Memorial weekend. The doc wanted the catheter in for 3 days because
of the extensive work he had to do in the neck of the bladder. Anyway
as soon as the catheter was out I was peeing at four times the flow
rate compared to before the procedure.

I would ask Dr. Stein how many PVPs he has done. I wouldn't want to
be one of the first ten he had done. Nor would I want to be the first
or second one he did that had a large prostate size (>75gm) or a large
medial lobe in the neck of the bladder.

Everything he told you is correct, many do go home without a catheter
and many have very little bleeding. However, just remember that
doesn't say all. Today, I would guess that over 90% do not stay in
the hospital overnight. So you had better have someone go with you
when you have the procedure done to drive you home. The procedure
requires anesthesia.

Good luck and I can say that you probably will kick yourself for
waiting as long as you have. I know I did. I waited at least eight
months or so before I had the PVP, when I was sure that was the way to
go.

Jack


"Uncle" wrote in message
news:AcHMa.7458$VY2.2124190821@newssvr10.news.prodigy.com...

> Two days ago (June 30) I visited Dr. Barry Stein at Rhode Island
> Hospital in Providence. He took a urine sample, poked my abdomen,

and

> did a rectal digital exam. I am supposed to go back for an

ultrasound

> to check the size of my prostate, and also have the urine flow rate
> test. If all results indicate a prostate problem, I would have the

PVP

> on the third visit.
>
> Dr. Stein does PVPs and TUNAs. He used to do TURPs but prefers PVP
> now. Here's a summary of Dr. Stein's comments about PVP, as well as

I

> can remember.
>
> Comparing PVP to TURP:
> Incidence of retro ejaculation: TURP 90%, PVP 80%!!! I am sure he
> said this. These may be his own results.
>
> PVP advantages are little or no bleeding, short recovery time. He
> said that many patients can urinate shortly afterwards and can go

home

> the same day with no catheter.
>
> In some cases there may be no immediate improvement in urination
> because of swelling. Improvement in flow may take several weeks.
> Because the inside of the prostate forms a scab, there may be bits

of

> tissue passed as the scab breaks up.
>
> He said that Laserscope's website and their printed brochure make
> overly optimistic statements. A new brochure will be coming out soon
> with more realistic statements.
>
> His statement about retro shook me up. I guess at my age I shouldn't
> be so concerned about retro.
>
> My own history:
> I have been lurking in this group for 6-7 years.
> I am retired,70, living alone, and have had urgency problems since
> 1984. Have been treating the BPH with saw palmetto and other herbs

in

> various brands and doses since early 90s. Have tried Hytrin,

Proscar,

> Flomax, and Cardura, all with various unpleasant side effects. Since
> 1999 I have been taking Cardura 2 mg plus saw palmetto and beta
> sitosterol.
> The multiple bathroom trips at night and the nasal stuffiness from
> Cardura are wearing me down.
> I'm retired and living in northern Connecticut so Dr. Stein is the
> closest PVP doctor, about 2 hours away.
> I haven't made an appointment for my second visit yet. I don't

think

> Dr. Stein has come up before in any discussions here. If anyone has
> any comments I would welcome them.
>
> --
> Uncle

Lee,

That's right, but I'm 73, so where the semen ends up isn't that
important to me. All the sensations are the same except for the
ejaculate going out the penis. Besides the increased flow rate which
allows me to stand to urinate compared to having to sit before the
PVP, I now can hold the urine for 15 to 20 minutes, only one to two
minutes before the PVP.

During the day I was going about every hour to an hour and a half.
However, at night I only had to get up once. But I was sure not to
have any fluids after dinner. Now I can go up to two and a half hours
during the day, but go, on average, one and a half times at night! I
can't figure that one out. I still retain urine in the bladder but
only about 30% compared to the 66% before the PVP.

Jack

"Lee M." wrote in message
news:5K1Na.31131$fG.15571@sccrnsc01...

> Can I infer from your remarks that the improvement in your urination

more

> than offsets the negative side effect of retro? What was your

daytime and

> nighttime frequency prior to the PVP?
>
> Lee
>
> "Jack" wrote in message
> news:be1n2s$2t1$1@bob.news.rcn.net...
> > Uncle,
> >
> >
> > I had a PVP six weeks ago with a very large medial lobe in the

bladder

> > and I have retro,
>
> > Good luck and I can say that you probably will kick yourself for
> > waiting as long as you have. I know I did. I waited at least

eight

> > months or so before I had the PVP, when I was sure that was the

way to

> > go.
> >
> > Jack
> >
> >
> > "Uncle" wrote in message
> > news:AcHMa.7458$VY2.2124190821@newssvr10.news.prodigy.com...
> > > Two days ago (June 30) I visited Dr. Barry Stein at Rhode Island
> > > Hospital in Providence. He took a urine sample, poked my

abdomen,

> > and
> > > did a rectal digital exam. I am supposed to go back for an
> > ultrasound
> > > to check the size of my prostate, and also have the urine flow

rate

> > > test. If all results indicate a prostate problem, I would have

the

> > PVP
> > > on the third visit.
> > >
> > > Dr. Stein does PVPs and TUNAs. He used to do TURPs but prefers

PVP

> > > now. Here's a summary of Dr. Stein's comments about PVP, as well

as

> > I
> > > can remember.
> > >
> > > Comparing PVP to TURP:
> > > Incidence of retro ejaculation: TURP 90%, PVP 80%!!! I am sure

he

> > > said this. These may be his own results.
> > >
> > > PVP advantages are little or no bleeding, short recovery time.

He

> > > said that many patients can urinate shortly afterwards and can

go

> > home
> > > the same day with no catheter.
> > >
> > > In some cases there may be no immediate improvement in urination
> > > because of swelling. Improvement in flow may take several

weeks.

> > > Because the inside of the prostate forms a scab, there may be

bits

> > of
> > > tissue passed as the scab breaks up.
> > >
> > > He said that Laserscope's website and their printed brochure

make

> > > overly optimistic statements. A new brochure will be coming out

soon

> > > with more realistic statements.
> > >
> > > His statement about retro shook me up. I guess at my age I

shouldn't

> > > be so concerned about retro.
> > >
> > > My own history:
> > > I have been lurking in this group for 6-7 years.
> > > I am retired,70, living alone, and have had urgency problems

since

> > > 1984. Have been treating the BPH with saw palmetto and other

herbs

> > in
> > > various brands and doses since early 90s. Have tried Hytrin,
> > Proscar,
> > > Flomax, and Cardura, all with various unpleasant side effects.

Since

> > > 1999 I have been taking Cardura 2 mg plus saw palmetto and beta
> > > sitosterol.
> > > The multiple bathroom trips at night and the nasal stuffiness

from

> > > Cardura are wearing me down.
> > > I'm retired and living in northern Connecticut so Dr. Stein is

the

> > > closest PVP doctor, about 2 hours away.
> > > I haven't made an appointment for my second visit yet. I don't
> > think
> > > Dr. Stein has come up before in any discussions here. If anyone

has

> > > any comments I would welcome them.
> > >
> > > --
> > > Uncle
> >
> >
>
>

Jack,

One produces more urine in the prone position.
After PVP, the better flow also flushes out fluid which previously was
backing up in the body. Your weight should have gone done a bit.
A way to check production and capacity, is to pee in a calibrated beaker for
a while and measure the quantity. In my case, I can hold no more than
500-600 ml, but my nightly production is 100-150 ml per hour. Therefore,I
have to get up at least once at night now. Pre PVP I got up several times
because of urgency but the production was always less than 200 ml. My PVP
results are excellent and I'm a happy camper again. Getting up once per
night is no bother to me.
I Hope this helps a bit.

Fred Henzi


"Jack" wrote in message
news:be2gam$mqq$1@bob.news.rcn.net...

> Lee,
>
> That's right, but I'm 73, so where the semen ends up isn't that
> important to me. All the sensations are the same except for the
> ejaculate going out the penis. Besides the increased flow rate which
> allows me to stand to urinate compared to having to sit before the
> PVP, I now can hold the urine for 15 to 20 minutes, only one to two
> minutes before the PVP.
>
> During the day I was going about every hour to an hour and a half.
> However, at night I only had to get up once. But I was sure not to
> have any fluids after dinner. Now I can go up to two and a half hours
> during the day, but go, on average, one and a half times at night! I
> can't figure that one out. I still retain urine in the bladder but
> only about 30% compared to the 66% before the PVP.
>
> Jack