TURP

Hello Everyone,

I went for a standard check with my urologist this afternoon, (Actually saw one of his Partners because my Urologist unexpectedly retired). I have an enlarged Prostate 67cc according to my 1st biopsy and 75cc according to the MRI. My original Dr. had advised against a TURP to treat the BPH due to the PCA stating that when it became more of an issue he would just take the whole prostate to take care of everything at once. The new Dr. said that since my original biopsy showed such a small amount of G6, (only 1 of 12 cores and a very small amount in that core, & the 2nd biopsy found no PCA) and my PSA has remained low, that I should consider a TURP to address the BPH now as I may never need to address the PCA. He also mentioned that if left untreated the BPH could lead to other serious issues such as damaged nerves in the bladder, damage to the bladder, and damage to the kidneys.

Has anyone had a TURP after learning that you had PCA?

Looking for wisdom from those with experience or knowledge.

Thanks,
gemson8

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Age at DX 52. (8/17) PSA 4.4 Under AS.
4/17 PSA: 4.1
7/17 Bx 1 of 12 positive (2 Suspicious) G6 2% arises in PIN, markers CK5/14p63 T1c, ICD-10: R97.20
prostate Volume 67cc PSAD 0.07
11/17 ER trip for Urinary Retention, Now taking Dutasteride and Rapaflo
1/18 3T mpMRI with contrast Nothing Specific found.
3/18 PSA 2.01
6/18 PSA 1.40

Hi Gemson

I had a turp while I was going through chemo. My medical oncologist agreed that I needed it, so my Urologist did it the next day after a chemo treatment infusion. I was in and out in under 22 hrs I stayed overnight and was out the next morning. I pee like a teenage boy now. No problems after. I would not hesitate to do it again if it was every needed.

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Age 59 when DX
DX Nov 2016
PSA 350
Bone & Lung Mets
Lupron @ 90 days
Gleason 9 ( 5 + 4 )
Jan 2017 Chemo
Sept 2018 Zytiga + Predisone

I don't know the answer to this question.

But if a patient had PCa would there be a risk of spreading it systemically by having a TURP concurrently?

A prostate biopsy only reveals the cancer that the needle hit. In my case it took 4 biopsies to find the Grade 4.

My dad had a TURP and he was bleeding for a week afterwards.

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Age: 65
Dx: 2011 3+3; Age 57; AS: 2011-2015; PSA 10
Da Vinci 01/2016; 3+4; pT3a; Close Margins; No SV; pN0: One reactive node examined. No cancer.
PSA 03/16: .04; 06/16: <.01; 09/16: .02; 12/16: .01; 03/17: .01; 07/17:.02 10/17: .01; 01/18: .03; 02/18: <.006 (Labcorp); 6/18: .02; 6/18: <.006 (Labcorp); 10/18: .01; 3/19: <.1 (Labcorp); 04/19: .01; 06/19: <.006 (Labcorp); 09/19: .01

TJ123 said...

But if a patient had PCa would there be a risk of spreading it systemically by having a TURP concurrently?

I was told very conclusively, by several physicians, that a TURP can not spread PCa., which was backed up by research I did before my TURP. I didn't save the studies, however. The TURP discovered my PCa.

Note that a TURP is a serious procedure, you want an experienced surgeon doing it, and unlike Green Light laser, only a TURP will yield pathology results, usually much more complete than a biopsy.

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72years old @ Dx
Ulcerative Colitis since 1973
TURP 2/16
4 cores; G 3+3, one G3+4
RALP 7/17 G3+4 Organ confined
pT2c pNO pMn/a
PSA .54 4 months post RR
ercMRI & DCFPyL PET Scan @ NIH/NCI
1" tumor in cavity at apex,
IMGT 70.2 GY, 2ADT, over 5/18
Radiation proctitis & Ulcerative Colitis flared
PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19, .078 5/19, .074 7/19, .081 9/19, .116 11/19

I had Green Light Laser ablation while on AS. Details below. I would suggest that you explore alternatives to TURP. There are a number of less invasive procedures. My GL Laser treatment took place at 6pm and I headed for home the following morning after the catheter was removed. It was a breeze with minimal recovery time.

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Age 67. Under AS.
2000 PSA: 1.8
2006 PSA 2.3, Retention issues, Flomax
2008 PSA: 3.0
2009 Biopsy: 12-core, negative
2012 PSA: 3.8
2013 PSA: 5.2, PCA3: 35
2013 Biopsy: 12-core, 1 core <5% G6, T1c
2014 Sat. Biopsy: 70-core, 1 core <5% G6, 1 core HGPIN
2015 MRI: Neg
2015 PSA: 1.9
2016 Green Light Laser Ablation for retention
2017 PSA: 3.0, MRI: Neg, PI-RADS 2
2017 Biopsy: 12-core, 1 core HGPIN