@cmulwee
I'm shocked that you had a TURP for BPH. Maybe I'm wrong, but I believe HoLEP was already in use in 2001. But that might have been only in Italy and China.
I don't understand how you had a TURP for BPH, and later developed prostate cancer, except that your prostate had regrown and was not sufficiently monitored and biopsied, or you wouldn't have progressed to the full cancer stage, and could have had a full cure. (Not meaning to rub salt in your wounds).
I had to jump thru hoops to find ONE doctor who did the TuLEP (he was doing the HoLEP when I first contacted the State hospital clinic he worked at), but during the 6-9 months of hoops, he had progressed to the TuLEP, being Italian & going to Italy for training & seminars regularly.
My BPH was discovered by biopsy, and followed for 15 years, using high-dose Tamulosin to exist w/ the urges to urinate small amounts of urine, which got worse as prostate grew and grew. This should have been addressed with Green Light when it was much smaller, but, no, because of the incompetence and ignorance of the hugest group of urologists in the Chicago area.
Due to such mediocre & eventually neglectful care of my urologist, who, 15+ years ago, named Top Urologist by Chicago Magazine. to join the rest of their political & BS titles. He seemed sufficiently competent when I first saw him, but after 5 years, I noticed a decline in his energy & mental acuity.
He REFUSED to do more than one biopsy when I told him my problem was getting worse, answering "Your BPH hasn't changed enough to warrant it, so forget it, or find another doctor." Imagine the pomposity of this doctor in decline, though maybe 50 years old.
I did tons of research, and found papers on the HoLEP laser for large prostates. My Medicare Advantage plan required me to go see another in-network urologist who just happened to have gone through partial training in TuLEP (under the Dr. who did my surgery!), but said it was a difficult procedure that he would not ever do after his assisted procedures under my eventual surgeon. He explained he had no intentions of going through the training with my Dr. because of the time & number of surgeries he'd have to do to become competent.
I needed him to evaluate my prostate, & most importantly, write a letter stating why I needed that procedure specifically, and provide a recent 12 pt. prostate biopsy, which had not been done for 5 years prior, when it was 90 gm. He discovers it grew to 160 gm...!!!!! HUGE!
My surgeon might be very competent, but he doesn't conduct visits acceptably. They consist of him talking with you; no examination whatsoever, and then keep doing your Kegels. That was what I was told two weeks after surgery when the Kegels were not improving my leakage. Then, after he offers he his email, encouraging me to write at any time, & he would answer. But, other than ONE time, he never answered any other of perhaps 8 emails. When I confronted him, "Why have you not answered all but one email from me 7 months ago?", he answers, "Because I wanted to see you in person." A pathetic excuse, that left me suffering for 7 months before I saw him only the 2nd time since surgery, and the rest is detailed at the beginning of this (my) topic. He insists that his technique never touches the bladder neck - that is where he leaves some tissue. And that in doing thousands of these, he has had no incontinence result (sound like a crock).
All I can do at this point, is try to do these seemingly worthless Pelvic Floor exercises, which give no sensation of even working the pelvic floor. If no improvements, then I'll have to carefully pick a physical therapist who specifically works on men's incontinence after, as the Dr. described it to me, where the bladder was used to having a huge ball just about filling it totally, there is now a large void, and my bladder doesn't know how to handle it. But, the Kegels should have taken care of this. Others here with far worse problems, having radical prostectomies, there are a number that have little or no incontinence, though I know there are many who suffer from much incontinence.
We are all a bunch of poor souls, who resulted in our conditions because of the pagthetic state of urology that existed for decades in this country, and still doesn't bother to up their training, abilities, and knowledge to treat this disease. Which, if they did, men who faithfully go to urologists would have enlarged prostates handled and followed for possible further disease.
Here is a link to a clinical study, entitled "Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate
clickable text
