Experience of prostate reduction surgery

[Wildpig]

Does anyone have experience of prostate surgery for benign enlargement? The option I am looking at is laser.  

What were your recovery times? When were you able to have anal sex again? Were there any difficulties to overcome for ff? Was there sensation change?

I would be so grateful for advice.  Many of us over 55 will face potential surgery or drugs which impact erectile function and libido. I know I won’t be alone in this room.

Thank you in anticipation   

 

[foryouruse]

I had a Uro-Lift done a few years ago and it was transformative. I have to take decongestants for my sinuses everyday, and I’ve had trouble peeing for 40 years. It wasn’t actually what the urologist recommended, but the downside of all the other surgery treatments scared the hell out of me. The downside is that it isn’t permanent and may need to be redone in 5 or 10 years. So far, no problem, but also, none of the side effects like incontinence or nerve damage.

[PhoenixTriad]

2 hours ago, foryouruse said:

I had a Uro-Lift done a few years ago and it was transformative. I have to take decongestants for my sinuses everyday, and I’ve had trouble peeing for 40 years. It wasn’t actually what the urologist recommended, but the downside of all the other surgery treatments scared the hell out of me. The downside is that it isn’t permanent and may need to be redone in 5 or 10 years. So far, no problem, but also, none of the side effects like incontinence or nerve damage.

I just had the Urolift too.  My urologist told me, aside from removing the prostate entirely, all the other procedures also need to be redone in 5 to 10 years.

[foryouruse]

1 hour ago, PhoenixTriad said:

I just had the Urolift too.  My urologist told me, aside from removing the prostate entirely, all the other procedures also need to be redone in 5 to 10 years.

Thank you for letting me know. I was completely freaked out when I was reading about the side effects from the other surgeries. I don’t have a clue why the others are recommended instead. I had no side effects and it fixed 40 years of problems.

[AlwaysOpen]

On 5/26/2025 at 10:51 PM, foryouruse said:

Thank you for letting me know. I was completely freaked out when I was reading about the side effects from the other surgeries. I don’t have a clue why the others are recommended instead. I had no side effects and it fixed 40 years of problems.

As someone who just spent a year on the prostate cancer journey ( from the failed PSA test to the last radiation treatment )  I think I can answer your question.  You are being diagnosed by a Urologic Surgeon. His entire educational focus was on surgery- and as it applies to penis and prostates. Down the street from his office ( or if he is  posh, down the hall)  there is a very nice, VERY expensive operating room, likely outfitted with a robotic surgery machine that cost a LOT ( a million perhaps) and has to be paid for, one man at a time. So his solution is cut the prostate out ( bigger billable) Up to 5% of the men he cuts up will have bladder leakage the rest of their lives, some will have one, or both, erectile nerves that run up opposite sides of the prostate severed or damaged, and will have to do " dick shots" to get some version of an erection. Oh- another issue with removing the prostate- the urethra runs up thru the damned thing- bladder to penis tip- if that gets sliced, they have to resection it. Now, there is no spare tubing between the bladder and the prostate, so they "pull up" the needed undamaged urethra from the other end- which means you will have a loss of length. 

Surgery is 1980 technology. The uro lift is much less invasive ( and less money for the practice)  but is better than losing a key part of your sexuality. 

[FF69]

5 hours ago, AlwaysOpen said:

As someone who just spent a year on the prostate cancer journey ( from the failed PSA test to the last radiation treatment )  I think I can answer your question.  You are being diagnosed by a Urologic Surgeon. His entire educational focus was on surgery- and as it applies to penis and prostates. Down the street from his office ( or if he is  posh, down the hall)  there is a very nice, VERY expensive operating room, likely outfitted with a robotic surgery machine that cost a LOT ( a million perhaps) and has to be paid for, one man at a time. So his solution is cut the prostate out ( bigger billable) Up to 5% of the men he cuts up will have bladder leakage the rest of their lives, some will have one, or both, erectile nerves that run up opposite sides of the prostate severed or damaged, and will have to do " dick shots" to get some version of an erection. Oh- another issue with removing the prostate- the urethra runs up thru the damned thing- bladder to penis tip- if that gets sliced, they have to resection it. Now, there is no spare tubing between the bladder and the prostate, so they "pull up" the needed undamaged urethra from the other end- which means you will have a loss of length. 

Surgery is 1980 technology. The uro lift is much less invasive ( and less money for the practice)  but is better than losing a key part of your sexuality. 

hope you have fully recovered from that journey

[foryouruse]

14 hours ago, AlwaysOpen said:

As someone who just spent a year on the prostate cancer journey ( from the failed PSA test to the last radiation treatment )  I think I can answer your question.  You are being diagnosed by a Urologic Surgeon. His entire educational focus was on surgery- and as it applies to penis and prostates. Down the street from his office ( or if he is  posh, down the hall)  there is a very nice, VERY expensive operating room, likely outfitted with a robotic surgery machine that cost a LOT ( a million perhaps) and has to be paid for, one man at a time. So his solution is cut the prostate out ( bigger billable) Up to 5% of the men he cuts up will have bladder leakage the rest of their lives, some will have one, or both, erectile nerves that run up opposite sides of the prostate severed or damaged, and will have to do " dick shots" to get some version of an erection. Oh- another issue with removing the prostate- the urethra runs up thru the damned thing- bladder to penis tip- if that gets sliced, they have to resection it. Now, there is no spare tubing between the bladder and the prostate, so they "pull up" the needed undamaged urethra from the other end- which means you will have a loss of length. 

Surgery is 1980 technology. The uro lift is much less invasive ( and less money for the practice)  but is better than losing a key part of your sexuality. 

I’m so sorry for you. I was negative for cancer, but even though it wasn’t the “recommended ideal”, I’m feeling lucky it was at least available for my problem. I was kind of shocked it fixed 40 years of problems peeing well (I swear my parents should not have had five kids with all their combined problems).

[Sfmike64]

I didn't have this exact problem, but like AlwaysOpen, I had prostate cancer in 2019 (I was 54 at the time). After hearing some horror stories about bladder leakage and incontinence, I decided to NOT have surgery.  I had proton beam radiation, which worked really well for me. I have now been taking FLOWMAX (the name cracks me up....I always say it like the voice of the guy advertising NITRO BURNING FUEL INJECTED FUNNY CARS!!!!! on local TV in 1977) daily and 20mg of Cialis twice a week. Those work well for me.....I.P. Freely (HA!) and my boners are consistent. I've been cancer free for 5 years.

I wish you good luck with whatever you choose to do. It was very strange to me to be offered a range of treatments when you're not an expert or a medical professional. I found it confounding. Two friends had PC the year after mine, and they chose completely different treatment options. There's no one right answer. It's not like an appendectomy where it's gotta come out, or else you die.

The other thing I would say is that if you're not confident in your urologist, FIND ANOTHER ONE. I can't emphasize this enough. I really liked the first one who explained my treatment options (but he was not a surgeon or an oncologist) but the second one (a surgeon, what a surprise) was a massive ASSHOLE (his name was Dr Raju Thomas, the prick).

He answered his fucking CELL PHONE during our consult! And not in a "I'm really sorry I must take this, I'll be right back, excuse me" kind of way. He just held up his finger to make me stop speaking and walked out of the room without a word. I was speechless (which is rare). He's also the head of Urology at Tulane Medical School so he's training doctors. Such a fucking jerk. I thought my husband was going to scream, he was so mad. We walked out of the consult after he answered his phone and left the room. It was one of the rudest things anyone has ever done to me. Hubz ended up calling the office of the President of the University to complain. but Dr. Asshole is still in his post. If you get treated like this GO ELSEWHERE.

[PozBearWI]

I've had prostate cancer for almost four years now.  Thankfully slow growing, so the my decision was monitoring.  I did have the Urolift procedure, damned glad I did.  It had to be repeated after 18 months as tissue sagged between the lifts.  But it has been successful.  

Tamulosin (FlowMax) is pretty brutal.  I switched to Alfuzosin with much better results.  

[SomewhereonNeptune]

13 hours ago, Sfmike64 said:

I have now been taking FLOWMAX (the name cracks me up....I always say it like the voice of the guy advertising NITRO BURNING FUEL INJECTED FUNNY CARS!!!!! on local TV in 1977) daily and 20mg of Cialis twice a week. 

2 hours ago, PozBearWI said:

 Tamulosin (FlowMax) is pretty brutal.  I switched to Alfuzosin with much better results.  

Well you both described my regimen pretty well. Enlarged BPH here, negative PSAs every year, started with Rapaflo (silodosin) and then somehow was changed over to Flowmax as it had fewer side effects. Doctor added tadalafil 5mg daily which has an off-label indication for prostate treatment, and it had some very beneficial side effects. 😀 Especially against other medications (SSRIs, SNRIs, etc.). But both are more treatments than 'cure' (welcome to Big Pharma and US medical practice, why cure something when you can make it an ongoing revenue stream). 

Speaking of stream, that's been fine but now you have me considering two things: One is the Alfuzosin, the other is the Urolift procedure. 

@PozBearWI, can you share the adverse effects of Tamsulosin that Alfuzosin doesn't have?

 

 

[PozBearWI]

When you get cataract surgery, they will have to do some workarounds as a result of having taken flowmax.  I found alfuzosin much more effective.  

[Sfmike64]

Interesting. I've not had any side effects from Tamsulosin, neither has my father (we take several medications in common, thanks genetics!)

[ellentonboy]

I have found that Tamsulosin also  known as  Flomaxx took forever to work and I eventually gave up.  Now I am told I have  a UTI and a bladder infection.  Thank God I have decent insurance with no copays but my quality of life is decreasing dramatically.

I often wonder if these so called "specialists" ( meaning my urologist) know what they are doing, or are they just ordering Cat Scans and different tests to line their pockets.   My PSA number is perfect, but these symptoms I have been experiencing have been horrific.  I am now taking Myrbetriq and the generic cypro  as written by a urologist.  To get "over rides" to obtain the brand name medication is like jumping through hoops.  Thank God I have a Ryan White coordinator who can get me overrides because most of what has been prescribed was denied by my WellCare, my medication provider.  THEY SUCK.....with the exception of HIV meds.

I have a CAT SCAN scheduled on my abdomen and pelvis, followed by a Cystoscopy a week later with the urologist.  Great, having some doctor shine a light  up my pee pee hole.  Glad I used to do "sounds" back in the early and mid 2000's I hope that tiny hole is stretched enough.

Glad I could vent here, I am mortified, but when I saw this thread I had to jump in.  Any suggestions?  There is a bridge I can see from the end of my complex, if things don't get better I may be tempted to jump (kidding, but maybe not).

Edited 16 hours ago by ellentonboy
spelling, leaving words out, etc.