TURP versus TUNA

[drz]

I need one more operation to try fix things and this one is to reduce my risk of recurrent bladder infections. I have had many UTIs ever since the CTX IV treatment and oral meds and needed a catheter for several weeks. I have had no infections now for over a year but still have increased risk of bladder infections due to trouble emptying bladder quickly and easily. I am now considered safe enough to purse some operation to try fix this problem. One urologist recommended a TUNA operation, less invasive and simple out patient procedure, but not as effective. It takes a longer time for any benefits, may need to be repeated, and often makes things worse for a few weeks before you see any benefits. Another urologist recommended a TURP since benefits are more immediate and likely to last longer. Downside is that it is more invasive and has somewhat more risk of complications. He is at the hospital I would prefer to use for family and personal reasons and where I got my care for Wegs so I feel they have better resources so I will most like do it there.

Just wondering if anyone else has needed this surgery and what experience or knowledge any readers have on this issue?

[pberggren1]

I have never heard of either one. Sorry I cannot help you.

[Sangye]

I haven't heard of either one, drz. Can you go to a major research institution for their opinion? If it were me, I'd want the input of people involved in research.

The TUNA name did make me giggle though.

[Al]

I haven't heard of either one, drz. Can you go to a major research institution for their opinion? If it were me, I'd want the input of people involved in research.

The TUNA name did make me giggle though.Yeah--I haven't heard of it either. But it sounds fishy....

[pberggren1]

This thread sounds like we are talking about food.....lol.

[Sangye]

I bet someone's gonna come along and ask if they use a real tuna.

[pberggren1]

Turnips and Tuna for supper......lol.

[Lightwarrior]

Another urologist recommended a TURP since benefits are more immediate and likely to last longer. Downside is that it is more invasive and has somewhat more risk of complications. He is at the hospital I would prefer to use for family and personal reasons and where I got my care for Wegs so I feel they have better resources so I will most like do it there.

Just wondering if anyone else has needed this surgery and what experience or knowledge any readers have on this issue?

I have no idea what tuna stands for but turp stands for transurethral resection of the prostrate (TURP) it is generally done to unblock the flow of urine for men who have benign prostatic hyperlasia. Go with the guy you trust since you are usually home in a couple of days after a turp.

[drz]

I asked my treating doctor for GPA and he leans toward the bipolar TURP where they use an electric arc to slowly slice out blockage areas. The cut parts are then flushed out so nothing is left behind to stimulate the immune system. The Green light Laser method leaves some sloughage behind which might not be a good thing when you have GPA. Most of the tissue is vaporized and there is less bleeding with this procedure. i will get Dr. Specks advice next month on the issue.

On the upside my last labs indicated that after being anemic for some years from the Wegs stuff I have finally recovered to the point where I am no longer in anemic range. All labs were pretty good. The lymphocytes were low from taking azathioprine but I think that is whole point of taking it to control the GPA stuff. Two years and three months after diagnosis things are looking relatively good but don't tell anyone and wake up the sleeping dog.:wink1:

[Sangye]

Yay, I'm glad to hear you're doing well from a Wegs point of view! It took me several years to get out of the anemic range, too. (In my case I feel certain that it was because I had smoldering Wegs all that time) Keep tiptoeing around the Wegs dog, drz. :thumbsup:

[Psyborg]

Great news on the sleeping pooch DRZ :)

[drz]

I also just got my last ANCA score and it also hit the normal range for first time since diagnosis. For me the ANCA seems to correlate fairly well with SED and CRP values so provides another measure of how well the GPA is being controlled.

[drz]

I had the TURP surgery today. The experts agreed on the electric loop procedure since it leaves the smallest amount of dead tissue behind so it should have lowest risk of Waking the Wegs dog. They had me stop azathioprine two days before the surgery to reduce risk of infection and to resume day after. Day of surgery to hold vitamins, fish oil, and lisinopril blood pressure meds. I can now get off the Flomax generic med I took to help me empty my bladder. If things go well for next few months they might want me to try tapering Azathioprine and see what happens. If that all goes well then I will taper the prednisone.

I had spinal block instead of general anesthesia this time and it seem much easier but it takes longer in recovery room to get your legs back so you can go home. The original plan was to keep me over night but surgeon said the surgery went so well and bleeding from electric loop procedure was much less than expected so he wanted me to go home to reduce risk on getting another infection. I have had MSRA and vancomycin resistant infections there previously so they take extra precautions in dealing with me. Everyone wears those disposable gowns, slippers, gloves etc anytime they enter area or contact me so I got to leave the hospital a few hours after surgery and am staying with sibling nearer the hospital. I get the catheter removed tomorrow and it is a real pain carrying the storage bag around so I will be glad to get rid of it. I had one in for several weeks after my first and only CTX IV treatment when first diagnosed but had forgotten what a hassle the bags are to empty and clean. The pain and recovery of several weeks to several months will begin after catheter is remove.

The good news is it is the last of four operations in past year since remission almost 14 months ago so I hope to take a long break from OR rooms. The hearing implant and cataract surgeries made this surgery much easier since I could hear with hearing aids and see without glasses. The hearing aids whistled and shrieked anytime it touched the bed or pillow but at least I could hear most of what staff said to me. No one wanted to touch the aids so they ignored the noise and left them in whole time. The noise didn't bother me till I woke up.

[mishb]

Wow that certainly is good news and how wonderful to think that very soon you might be able to taper down those horrible meds.

You are doing so well from when this all started to now.....excellent job :thumbsup:

[renidrag]

Great news drz.
Dale

[chrisTIn@]

...I hope to take a long break from OR rooms..

I hope so too, drz!
I wish you a soon recovery...:thumbsup:


... The hearing aids whistled and shrieked anytime it touched the bad or pillow but at least I could hear most of what staff said to me.
No one wanted to touch the aids so they ignored the noise and left them in whole time. The noise didn't bother me till I woke up.

Quite bizarre...:wink1:

Luckily it did'n't bother you till you woke up. Were you able to put the noise down immediately?
Seems an odd way to wake up from surgery.
But the important thing is, that everything else went well.
Sure hope the Wegsdog stays asleep, and you will be able to taper the meds eventually.
Wonderfull news!


Again, get well soon! :hug3:

[Sangye]

I'm SO happy to hear it's done and it went well, drz! Glad you can get off one of your meds and hopefully aza and pred in the coming months. Rest up, friend. :smile1:

[KathyB]

What a great story, drz! I'm just catching up on the TURP surgery thing. WOW!! Sounds like you are on the path to recovery. It's also great hearing about the special care and accommodations you have received. You must be pleased! Here's to your continued improvement!! :hug3:

KB

[Jennie]

That's wonderful neww drz, best wishes for a speedy recovery.:thumbsup:

[Lightwarrior]

Happy Happy Days, I am so happy that your surgery was successful DRZ.

[drz]

I had to stay near hospital for weekend in case some thing happened after surgery but had no problems. Didn't even need any pain meds so went back home today. Only significant issue is not to lift anything over 7 KG or 15 pounds for next month. Might be hard to remember that. Other wise surgery seemed successful and I am happy to have it done. Thanks for the wishes for quick recovery and happy thoughts.

[Psyborg]

I hope you have a quick recovery drz. :) I'm happy the surgery and recovery are going so well for you.

[KathyB]

Lots of great news, drz!! So happy to hear that "smile" in your "voice," too!! Woohoo! Keep up the good work!!

KB

[drz]

A month after last post I had a very anxious weekend. I had been warned a scab would form inside in the area that was removed to make it easier to empty my bladder and that this would probably come off in two or three weeks. I don't remember it being any problem or concern at that time. But five and half weeks after surgery I started passing big blood clots and bright red blood. I thought it might be the scab coming off late due to diabetes and Wegener's that might have delayed healing so wasn't too worried initially but the blood clots persisted during the day Saturday.

The urologist doctor returned my call that evening and said to keep drinking lots of water and emptying the bladder as often as possible. If I could not empty it due to clots blocking it I might have to have the bladder rinsed out and needed to see some one right away if that happened . Also if it kept bleeding I might need to have the scar area cauterized. He said to give it two days and see if the urine cleared up. That would happen if the scar area healed up again and all the clots in side the bladder passed out.

I passed several last night and several more clots this morning but the urine seemed to clear up this afternoon and no blood or blood clots have been seen since so I am hopeful it is all better now. It did make for a rather sleepless night and anxious couple of days. Hope the urine remains blood free and things heal up nicely. There are lots of bad scenarios that could happen but I don't want to go there unless symptoms return and require further evaluation and/or treatment. After a severe case of Wegs though it is very easy to rapidly envision all sorts of bad things that symptoms could be and hard to keep the anxiety under control at these times. It helps me to remember though I made it through some really bad times with the Wegs and that I am unlikely to get anything I can't handle. I also found the doctor's words very reassuring and greatly appreciated his counsel last night.

[mishb]

I am so glad that things have come good for you drz ........in more ways than you need to know (yes the bad scenario)
I am doing a happy dance for you and good job on your doctor's part.

Get some rest and take care

[KathyB]

Happy dance from me, too, drz! Sounds like you had quite a weekend! Let's keep the faith that all continues to improve!

KB

[Lightwarrior]

Happy dance from me, too, drz! Sounds like you had quite a weekend! Let's keep the faith that all continues to improve!

KB

Happy dance me three, can you visualize Michelle, Kathy and me dancing around singing happy songs for you???

[Sangye]

Yikes, drz! I'm so glad it resolved as the doctor thought it would. Add me into the happy dance :biggrin1:

[drz]

Happy dance me three, can you visualize Michelle, Kathy and me dancing around singing happy songs for you???

I would love to see you all doing a happy dance at any time for any reason. The bleeding in my bladder seemed to resolve itself so no extra medical procedure was needed. Will do regular routine lab tomorrow and see what my status is now on other issues.

[drz]

I had last follow up appointment with surgeon who did the TURP. He said everything seems fine so no need to come back again. I can now empty bladder completely and quickly which should help reduce risk of having frequent bladder infections.

My GPA doctor also said yesterday I still seem in a stable drug induced remission from the GPA despite my four minor surgeries in past year so I will continue on current maintenance meds indefinitely. He reassured me that many people who have had organ transplants have taken azathioprine for decades. Before its invention the only option for people with organ transplants was large doses of prednisone.

He also reviewed the research with me that pertained to whether I should get a flu shot and cited three studies that indicated positive findings for doing so and no studies have yet confirmed a risk from doing so. One study indicated people who didn't get the shot were more likely to flare than those who did get the flu shot. The three benefits for getting to flu shot are reduce risk of dying, reduced risk of getting flu, and reduced risk of having a GPA flare. Due to my age and broken immune system the benefits for me are less than others but the risks if I get the flu are also much higher so he highly recommends I get the flu shot as soon as possible. I had one a year ago and it seemed to go OK for me.

[Pete]

drz,

Great news on your checkup! Hope all continues to go well for you.

As for flu shots, both my rheumy and PCP strongly urged me to get one, so I did. I'm having no side effects from it.

[chrisTIn@]

Wonderfull to see all this good news drz!
Have you already decided about the flu shot?

Have a GOOD weekend! :thumbsup:

[drz]

Wonderfull to see all this good news drz!
Have you already decided about the flu shot?

Have a GOOD weekend! :thumbsup:

I will probably get one unless my consultant at Mayo says differently. They will be given at my living place in two weeks.