You did have your prostate vaporized, so there is a surface inside you cannot see that has been changed. It is not near as raw as with the conventional old fashioned TURP resection...but the normal surface has been temporarily changed and will not return to normal immediately. Laser surgery is amazingly bloodless, but seeing some blood on occasion would not be out of the ordinary. The prostate surface may take from two weeks to one month to seal completely. If you lift, strain or have sex in the first 3 weeks post-op, you will likely see blood in the urine. It may be that you see no blood, until the 30-th day…any variation is possible. If you do see blood, it is usually a sign you lifted, did too much, strained etc., so , if you "see it", get off your feet, rest, drink lots of water. The main thing is to try to get any bleeding to stop before returning to normal activities.. The other thing is, if you do bleed and you don’t heed these measures, you just make your condition worse and may get a clot that blocks your ability to pee, thus you'll have to go to the emergency room to get that out. But this could really only happen if you ignored all the signs. Hence this is info you want to know.
Colace is an over-the-counter stool softener that prevents constipation. Constipation can be a cause of straining that may cause blood in the urine. So, get take colace if needed. Take any laxative you need.
So when can you go back to work?
It varies, but as long as you don’t lift or strain at work, maybe in three days. You can walk/drive/ take stairs/lift a fork immediately post op , but don’t do anything more than that for three days. After 3 days you can return to your regular daily activities. No lifting, straining or sex for three weeks.
What if you do lift or strain normally at work? Either get light duty or stay off work for 7 days.
When can you resume aspirin or blood thinners after a PVP?
Right away.. but be aware they DO thin blood, so behave! Obviously think of holding them or cutting back on them temporarily if your urine is bloody.
Do patients get catheters after PVP?
Some don't, but most patients do get catheters they keep over night. They are simple to remove and most patients remove their own the next day. Even the biggest of prostates has had immediate great improvement in voiding symptoms when the catheter was removed early the next day.. Its just sometimes safer to put one than to not put one.
Do some men get temporary frequency after laser PVP?
Yes, some do. It seems more likely if your prostate is really big. It usually doesn't occur. If it does occur, it usually starts suddenly at about post-op day 5, lasts 5 days , and stops suddenly. Rarely it can last a month. To minimize/prevent inflammation, I give patients medrol dose packs post-op .The symptoms will resolve on their own. Medrol just makes it more tolerable and go away quicker.
Some men are on proscar or flomax or other prostate meds ( cardura, uroxatrol, hytrin) before a PVP. Should they continue them post op?
I like to continue prostate meds for one month after laser, then stop them completely. If you run out quicker than one month, don't worry, just stop them without getting a refill.
Laser is a significant improvement over TURP (the old fashioned trimming). Even though its clearly better, you still did have surgery and a little bit of common sense will keep you from having any problems. As technology makes invasive surgery less and less invasive, patients will feel less and less like they actually had anything done, thus creating a new source of problems: doing too much too soon because they actually couldn’t believe how "great" they felt. Some mistakenly feel that if they "feel great", the post op instructions don’t apply to them, and abandoning the suggestions opens them up to the possibility of creating problems for themselves they could have otherwise avoided. The price of progress!!! Don't let that happen!
Laser patients have been doing so well post-op, they generally have not needed to come in to the office for routine post-op checks. I have started to make their follow-up "phone follow-up". I'll normally call a patient in follow up at day 4 and then again around day 14...Of course, you are welcome to call me any time you have a concern. The secretaries have been instructed to bring the rare patient who does have a post-op problem in for a visit at the next available opening if needed. Though infrequent, these instances are followed closely until resolved. The majority of patients do not need post-op visits and go right back to their yearly check-ups. Eventually everyone gets back on schedule with their yearly PSA and office visit.
Feel free to call me (302-266-7577) anytime with questions or concerns. Thank you for allowing me to participate in your care.
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