www.incontinentsupport.org

Next week I see my urologist again. I emailed him some concerns, and he felt because of my complicated history I should visit with him earlier than my original appointment which is next June. I really don't know what he will suggest. I told him the pain and pressure when peeing seems to occur more often. Plus, there are days when I hardly feel the need to pee at all. At my last visit, he indicated that TURP surgery could make my incontinence worse. He does know that I also have several bladder diverticulum and lumbar stenosis. I'm afraid he will put the ball back in my court, and I will need to decide whether to have surgery or not. Not an easy decision to make. I'm comfortable managing my condition with diapers, but don't want anything more serious to happen...like kidney issues. How does anyone know what to do? Back surgery, prostate surgery, no surgery??? Of course, my anxiety is mounting because of some decision I will need to make. This may sound strange, but at times I almost wish my condition was worse. Should I be proactive and have TURP surgery, or continue to wait it out? I know I'm the only one that can make that decision, but any advice would be greatly appreciated.
Dennis

A TURP can cause a result that is similar to a sphincterotomy. If both you and your urologist agree that that is an acceptable outcome, go for it.

Well you did say you're already ok managing your incontinence with diapers. If the turp surgery will likely eliminate your problems while also making you pee much more easily to where you won't have to think about it, then it seems pretty straightforward to me.

Personally I look at every surgery like this. Does it have at least an expected 80% chance of improving or lessening your problem.

Is there more than a 20% chance for something to go wrong? If that does happen, is this something you could live with as a trade off for the intended improvement.

Thee or six months from now, where do you see yourself without having had the surgery? With? Which one is better in your mind?

Is this surgery a permanent improvement (or at least long term semi permanent)? If not, then what's the point in going through with it. If yes, what do stand to loose by not going through with it.

Just ask yourself these questions for any surgery. Your own answers will decide for you if you should get it done or not.

I have had TURP surgery in the past. Before the surgery I would leak after each time I voided and my stream was weak. Now I have urgency incontinence but my stream is OK with out any pain, I must wear a diaper, which I do not mind. I think of them as my underwear, If your doctor thinks you should have a TURP then I feel you should have it.

Back surgery is another matter. I would not, repeat not, have it. Too many things can get worse with back surgery. Back surgery should be a last resort.

Just my two cents worth of advice.

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RetiredRN

I agree fully with Brian's thoughtful post about the various things that you should think about and questions to ask yourself before deciding one way or the other about the surgery. If I were in your shoes, I would probably go ahead and have the surgery. If your current level of incontinence requires you to wear a diaper, what does worsening your incontinence mean from a practical standpoint? Maybe an additional diaper or two a day? If the surgery has a good chance at relieving your urological pain and difficulty urinating, that prospect would make the surgery worth doing from my perspective.

Inconmiss hit that one one the head. This was the exact same thing I had to get my urologist to understand before he would do my sphincterotomy surgeries.

I told him I was already needing to wear, and fully use, a diaper 24/7. By doing the surgery I would still be in that exact same position, but would hopefully not be living with my painful urges and constant need to strain and push to pee. (Which has been slowly coming about).

While the surgery its self has done nothing to get me out of diapers, they most certainly have done a lot to improve my quality of life.

(And ps, I feel the same with my spine, heart, brain, and lungs. The risk of complications is just way too high for me to get a surgery on any of them. I'd have to be in immediate danger of death to agree to any of those. My bladder or sphincters though, not quite as serious)

I agree that no surgery should be requested without an accurate understanding of everything, good and bad, involved; however, this is not always possible, especially for us laity. The genetic disease which has caused my incontinence is also attacking my heart, specifically the aortic valve. Although my cardiologist keeps it under surveillance, he has told me that I could need cardiac surgery, perhaps on very short notice.

Oh absolutely. Like I said though, once a problem becomes life threatening then even surgery on the heart, spine and brain are on the table.

Sorry to hear you're having heart problems. I take it you're doing all that can be done- non surgically- first.

Indeed I am, including cardiac medications and yearly ultra-sound exams. Thanks for asking.