Post-Operative Issues After Thulium Laser Prostate Surgery: A Patient's Concerns - Urology

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Post-operative complications following Thulium laser prostate surgery can be quite concerning, especially when symptoms persist long after the procedure. Based on your description, it seems you are experiencing several issues, including ongoing bleeding, difficulty sitting, and problems with bowel movements. Let's address your concerns one by one.

1. Ongoing Bleeding: It is not uncommon for patients to experience some degree of bleeding after prostate surgery, particularly in the initial weeks. However, if you are still experiencing significant bleeding six months post-operation, this is not typical and warrants further investigation. The bleeding could be due to several factors, including residual tissue that has not healed properly, the presence of blood vessels that have not clotted, or even an infection. It is crucial to consult your urologist for a thorough evaluation, which may include imaging studies or a cystoscopy to visualize the bladder and urethra directly. Treatment may involve cauterization of bleeding vessels or other interventions depending on the underlying cause.

2. Inability to Sit Comfortably: Difficulty sitting on soft or hard surfaces could indicate nerve or vascular injury during surgery. The prostate is located near several critical structures, and while laser surgery is generally less invasive, complications can still occur. Rehabilitation may involve physical therapy focused on pelvic floor exercises to strengthen the surrounding muscles and improve blood flow to the area. Additionally, your healthcare provider may recommend pain management strategies, including medications or topical treatments, to alleviate discomfort.

3. Bowel Movement Issues: If you are experiencing hard, difficult bowel movements, this could be related to several factors, including changes in diet, medication side effects, or potential nerve damage affecting bowel function. It is essential to maintain a high-fiber diet, stay hydrated, and consider the use of stool softeners or laxatives as recommended by your physician. If bowel issues persist, a gastroenterologist may need to evaluate your condition further to rule out any complications related to the surgery.

4. Residual Prostate Tissue: The presence of residual or enlarged prostate tissue, as noted in your ultrasound, can lead to ongoing urinary symptoms. If the prostate remains enlarged, it may compress the urethra and cause difficulties with urination. Treatment options may include medication to help shrink the prostate or, in some cases, a repeat procedure may be necessary. Discuss these findings with your urologist, as they can provide guidance on the best course of action based on your specific situation.

5. Cystoscopy Consideration: If your symptoms persist and your concerns remain unaddressed by your current physician, it may be prudent to seek a second opinion. A cystoscopy can provide valuable information about the condition of your bladder and urethra, helping to identify any obstructions or abnormalities that may be contributing to your symptoms.

In summary, while some post-operative symptoms can be expected, ongoing issues such as significant bleeding, pain, and bowel difficulties should be thoroughly evaluated by your healthcare provider. Open communication with your medical team is essential, and if you feel your concerns are not being adequately addressed, seeking a second opinion may provide you with the clarity and treatment options you need. Remember, your health and comfort are paramount, and you deserve comprehensive care.