Saying no to surgery

I have a question for those of you dealing with incontinence. I'm wondering if it's just plain wrong to say no thanks to having surgery. As I posted earlier, I believe I'd be a perfect candidate for the TURP surgery.
My problem is that at the moment I don't feel the problem is bad enough to submit to surgery. I can control my urge incontinence probably 90 percent of the time. I make it to the restroom and all's well. It does require a huge amount of effort tough. That doesn't bother me. My symptoms do not present any health threats. I had that checked out. I take Flomax and that has allowed me to completely empty my bladder easily. I still have the strong urge issues and somewhat reduced OAB though.
I now wear diapers nearly 24/7 and that allows me to live life without any drawbacks or issues. Yeah, there's more hygiene and I do more laundry, but I'm not laying in a hospital peeing blood clots or screaming in pain as they pull out a catheter. Or making monthly payments for the next 5 years.
If the time comes that I develop more serious health problems, I'll have to have it done and accept that.
I feel guilty that I'm chickening out by taking this path and acting childish. Everything I read tells me to GO GET CUT!! My doctor has told me that if I wish to pursue further treatment then let them know. I haven't been forced. But I feel like I'm being pushed subtly in the surgical direction. So I pee my pants once in a while. it doesn't bother me. Why get cut then? What do you think?

The longer you wait, the worse your prostate will get. That means they will have to cut out more later, you'll bleed more late, and you'll have more pain during the recovery later on.

It's not like you'll be saving any money either. You either pay for it now, or you'll pay for it later (and medical costs are on the rise).

Waiting could also have the effect of making you more incontinent after the surgery too. If your prostate swells enough, your sphincter muscles will subconsciously stop holding your pee as much since they won't be needing to. After they open your urethra back up, the weaker sphincter muscles will have a more difficult time taking back over again.

It truly is best to not wait. That said, it's your right to never have the surgery if your really don't want to. Just be preparred for any slight problems now to become irreversible later on.

Your profile does not give your age, but it states that you’re retired. I assume that that means your probably at least in your sixties. At that age, an enlarged prostate is quite common; and TURP surgery is said to be the “gold standard” for treating an non-cancerous enlargement of the prostate. However, the most important consideration is to rule out prostate cancer. Have you had a prostate biopsy? If I were in your situation, I would probably go through with the TURP surgery; and I would definitely make sure that there is no reason to suspect prostate cancer.

I'd say go for the TURP. If your prostate gets large enough, you won't be able to urinate at all without using a catheter. The issue isn't if it's causing incontinence, it's just that it may cost you a few ER visits if it gets bad enough. Plus, Flomax is not the greatest drug to be on because it may worsen your incontinence. Have the surgery now, spare yourself the headaches later.

My doctor gives me regular DRE's and at the time doesn't feel I'm at threat of cancer. He hasn't recommended a biopsy. By the way, I'm 63 and I'll get that in my profile. My prostate is "very large" according to him and his partner. It also runs in my family though not cancerous. I read of complications that are pretty nasty and the need to have the procedure done multiple times as you age. (I'm living forever by the way ...lol...) I feel strongly on avoiding surgery where possible. I had a really bad experience once (failed anesthesia during bone surgery).
I'm also curious about thoughts on the PSA test. My doctor feels it's useless and only creates false positives. There's a battle raging right now over whether it is even useful. With an enlarged prostate the PSA test doesn't differentiate BPH from cancer. Meaning the only real test is biopsy for all men. Both doctors feel my prostate feels normal, but enlarged. They haven't urged me to see a urologist. Just told me I could pursue this issue further if I choose. Thanks for your input and I'm glad to fill in any questions you might have.

I was at urologist office recently and they had literature on 2 new procedures for BPH that seem less traumatic than TURP. One was "green light" where they use a laser treatment and the other was "rezum" (www.rezum.com) where they use water vapor therapy. Maybe these would be helpful.

chuck said:

I was at urologist office recently and they had literature on 2 new procedures for BPH that seem less traumatic than TURP. One was "green light" where they use a laser treatment and the other was "rezum" (www.rezum.com) where they use water vapor therapy. Maybe these would be helpful.

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My neighbor claims his “green light” surgery was painless with like a one day recovery and total cured his urinary problems. He highly recommends it. But, like all surgeries, he stresses the importance of finding a doctor that is highly skilled in the procedure.

WBxx said:

My neighbor claims his “green light” surgery was painless with like a one day recovery and total cured his urinary problems. He highly recommends it. But, like all surgeries, he stresses the importance of finding a doctor that is highly skilled in the procedure.

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Not just the green light, but how deep they cut. MOST turp surgeries only remove the first 1/4 to 1/2 inch of the prostate's interior lining. Just enough to open up the urethra again.

However, as with me, they can cut out several inches of the prostate if it's bad enough. Obviously, the deeper they cut the longer it will take to heal.

As for a better comparison, my sphincterotomy surgeries were done with the conventional hot knife, and green light. The laser allowed them to cut me about 50% deeper, but with producing the same amount of pain/recovery as compared to the hot knife. Green light laser does not mean less pain.