Basic prostate surgery
I waited 2 weeks for my early morning appointment with the urologist. He had the report from the ER and advised me he was surprised I wasn’t in much more pain when I went to the ER. He said if he was retaining that much fluid he would rat out his three closest friends for the last couple of felonies they had committed just to get faster treatment. I decided I liked this guy and his sense of humor. We discussed the situation and he decided to remove the catheter, have me go home and drink lots of fluids and return later the same day for a bladder scan. His nurse removed the catheter (no big deal – it slipped right out) and I went home and returned at 3 PM. They had me visit the restroom and then they did a bladder scan. A bladder scan is very simple. You just lower the front of your slacks about 3 inches and they do an ultrasound scan, just like the ultrasound of a pregnant mom checking on the baby. I was still retaining too much fluid, so I had to be re-catheterized. It seems that a bladder that can’t empty properly is susceptible to bladder infections and I would have been very uncomfortable in a day or two. The next step was to have the nurse re-catheterize me and then have me wait 2 weeks for an appointment for a cystoscopy.
Years ago when I had to endure my first colonoscopy my comment after was that I didn’t realize that I was walking through life with a sign on my backside saying “insert TV camera here”. Well a cystoscopy is kinda similar but uses the front door, so to speak. A small shaft about the same size as the catheter is inserted in the urethra after a topical desensitizing cream is inserted. The nurse apologized that the desensitizing cream would feel a little cold and I assured her she could use as much as she wanted. Or even more. The cystoscopy includes a light and tiny camera with other tools that allows the doctor to see what the obstruction might be. There is no pain, only a little bit of pressure as the doctor inserts the cystoscope. With that in pace the doctor can see the inside of the urethra, prostate and bladder. The prostate is a small, walnut sized gland shaped a bit like an old fashioned Dunkin Donut at the bottom of the bladder where the urethra begins. In my case the center of the donut essentially closed. So, once the doctor surveyed the issue, out comes the cystoscope, I get re-catheterized, and I have a discussion with the urologist about the best treatment for my condition. There are several choices and my doc excused himself to consult with his senior partner. The recommendation is TURP surgery. That stands for transurethral resection of the prostate. Go ahead and search the web for ‘images of TURP surgery’. It is minimally invasive, requires no incision, follows the same route as a catheterization or cystoscopy and trims the prostate internally to enlarge the center of the donut to provide relief. So I wait 4 more weeks for the surgical appointment. Three days prior to surgery I was required to get a Covid test that came back negative. The TURP surgery was scheduled for early December 2020 and the in-hospital preparation is similar to the hip surgery discussed earlier; being swarmed by professional, compassionate, caring medical professionals at 6 in the morning. I was wheeled into a similarly cold operating theater, settled onto the operating table, legs in stirrups, arms out to the side, mask put in place, told to count backward from 100 and never got to 98. This procedure came with an inpatient stay for the day of the surgery and the following day, included no pain but came with another planned 7 day stay with my buddy, the catheter. Oh, and the doctor forgot to call my wife with an update after the procedure, so she had to call the hospital and snarl at someone to get a brief report about the surgery and how I was doing. I did fine and had an uneventful overnight stay. I also realized that with the number of people who had to work on my prostate or check the surgical results, if I ever had a modicum of modesty, it was gone now. I don’t believe it was the high point of their day, either.
The next post will address my infection with Covid-19.