Problems post TURP operation

[Lorn Macintyre]

I am 68 years old and had a TURP operation three months ago. I have normal ejaculation, not retrograde. Is this unusual after a TURP? Though two of the benefits of the operation are a stronger urine stream, and fewer noctural visits to the toilet, I still have the prostatic infections I had before the operation. Does this mean that too little tissue was shaved away in the operation, and is there anything I can do about my infections, which seem to relate - as before - to the ejaculatory mechanism?
 

[Arnon Krongrad, MD]

Retrograde ejaculation is not uncommon after TURP but, depending upon which tissue was resected, it is not a given. We tell patients about it before surgery so as they are not surprised if it happens.

 

To answer your question about sufficiency of resection really requires a step back. You say you have a history of urinary retention, bladder stone, and prostate infection. What was the treatment objective?

 

As a related matter, what do you mean specifically by "prostate infections?" What are the signs and symptoms you've had? How was this diagnosis established? How do you see that these are related to ejaculatory mechanism?

 

Admin note: If when you reply the network re-pastes italicized text, please delete it before typing. It's just redundant filler. Thx.

[Lorn Macintyre]

Dear Dr Krongrad, Thank you for your helpful reply. Before my TURP I had, from time to time,  infections  of both the prostate and the bladder, with blood in the urine and the sperm, the urinary infections established by culture; and one instance of urine retention which had to be relieved with a catherer. My urine flow was poor, with frequent nocturia, and I had a golf ball-sized stone removed from my bladder in December 2009, when the urologist, having seen the prostate while operating on the stone, recommended a TURP, which was carried out in late October 2010. The TURP was primarily to increase the urine flow and prevent the formation of another bladder stone through unvoided urine lying stagnant in the bladder.  Since the prostate was pressing on the bladder, and probably transferring infection there, the urologist thought that this would relieve my prostatitis. It has not. Activating the prostate to eject fluid (recommended by some urolgists to prevent a stagnant build-up of infection) I continue to get pain round the penis, nausea and dizziness.

 

 

[Arnon Krongrad, MD]

Lorn,

 

Your case shares elements with this one: A 70-year old man with 45 years of prostatitis. He also had a TURP but did not solve his problem. Have a look for interest.

 

Many patients who come to me for laparoscopic prostatectomy for prostatitis have had a TURP before, which did not relieve their symptoms. One patient had not only a TURP  but also an open (retropubic) partial prostatectomy, and these did not relieve his symptoms but his LRP did. These cases also have some theoretical bearing on your situation.

 

Not sure if this answers your question or not.

 

Arnon

[Lorn Macintyre]

Dear Dr Krongrad, Thank you for your prompt reply. I will certainly look at the case of the 70 year old with 45 years of prostatitis. Probably I expected too much from my TURP operation, particularly with regard to erasing or easing  infection/discomfort. I do try to maintain a well-balanced body and to avoid alcohol, coffee and foods such as curries which can irritate the prostate. I would like to understand the mechanism which leads to discomfort and pain when my prostate is activated sexually. Am I spreading a latent infection through my reproductive system, or is there an inflammatory element?  Even in my pre-TURP days when I decided on celibacy as a strategy to avoid infection/discomfort, I still ended up with distressing symptoms which required penetrative antibiotics. The paradox in my case seems to be that whereas urologists advise emptying the gland of its secretions to avoid infections and perhaps also, even cancer, I still get infections and pain with no activity. I presume that a second TURP, with more grammes of prostate tissue shaved away, would not ease my situation.