The decision to have surgery wasn’t easy

Photo of a couple taking a walk (PantherMedia / Robert Kneschke)

Douglas, 60 years old

“As time went by, my symptoms got worse. I had to go to the toilet a lot in the evening and at night. My stream of urine wasn't as strong anymore. It couldn't flow out properly and I always felt like something was left behind.”

About four or five years ago I started having to go to the toilet more than once a night every now and then. From that point on my doctor and I kept a close eye on my prostate, but didn't do anything else. As time went by, though, it got worse and I often had to get up more than once a night. That really bothered me.

At first, my urologist and I decided that I wouldn’t take any medicine for it. After some time he told me about the different medicines that are available. He explained things really well. I decided to try a kind of medicine which aims to improve the flow of urine. It helped for a while, but wasn't a long-term solution. I took that for about two years.

Medication wasn't a long-term solution

As time went by, my symptoms got worse. I had to go to the toilet a lot in the evening and at night. My stream of urine wasn't as strong anymore. It couldn't flow out properly and I always felt like something was left behind. As a result, I often had infections and inflammations, which I often had to take antibiotics for. This happened more and more, and the sudden urges to pee also became more frequent. I don't really like taking pills. It was clear to me that I didn't want to keep taking them forever.

Work is very important to me – I really enjoy working, and I work a lot. But because of my problems and medication I was sometimes unable to go to work for a day or half a day. The medication made it difficult for me to work, and not being able to work the way I wanted to was frustrating.

I thought long and hard about whether to have surgery

I talked to my urologist again, and he told me all about the various surgical options. I also had a look on the Internet, because I wanted to be as well informed as I could. I thought long and hard about what to do. I also knew another urologist who performed this kind of surgery himself, and I discussed my options in detail with him too. And I went to see the hospital where the operation was to be done and spoke to the head doctor there. My options were either a standard operation, or a surgical procedure using lasers or heat. After in-depth consultations and advice I decided to go for the more conventional kind of surgery (TURP: transurethral resection of the prostate – Editor).

One important factor affecting my decision was the risk of not being able to ejaculate properly following surgery. After thinking carefully about it, I decided to accept the risk. It wasn't an easy decision to make. I discussed the pros and cons with my wife, which really helped me. We decided that surgery was the best option for us. Looking back, I can say that we made the right decision.

It took about two to three months for everything to settle down

I had the surgery about one and a half years ago. Afterwards things healed quite normally at first, but I got an infection so then it took a little longer. That was quite painful at times. I recovered well overall, though.

Straight after the operation I still had to go to the toilet about two to three times a night, but after a while things improved and became more normal. My urine stream was stronger, there was less dripping and I didn't have to get up as often at night. It took about two to three months for everything to settle down.

The pain caused by the wound was one of the drawbacks of the operation, so were the ejaculation problems. Although not being able to ejaculate properly means it's not quite the same, I still enjoy sex as much as I used to. I feel okay about it. After all, I don't want any more children. But I can understand why people are afraid. I wasn’t happy about it at first either, but I didn't feel like I had any alternatives. The disadvantages of the operation are minor compared to the problems I had before, which just kept on getting worse.

After the operation, it took some time before I could leave the house and get on with normal everyday activities again. Shortly afterwards I often felt a sudden urgent need to pee. I couldn't go to town because I always had to be within 5 minutes' reach of a toilet, just in case. You can't control it.

But I wanted to get some exercise. There's a big forest near my house where you can walk for hours without bumping into anyone, which was great for me because I had to go behind a tree every ten minutes at first. That’s not a problem in the forest, though. The exercise and fresh air did me a lot of good.

It wasn’t easy to come to terms with

I returned to work after four weeks at home. It was difficult at first because I still had to go to the toilet a lot. But over time I learned to manage things in such a way that it wasn't a problem. For instance, I made sure I didn't have any meetings that lasted longer than an hour. I would always sit by the door so that I could leave quickly if I had to. Things worked well that way.

It wasn't that easy for me to come to terms with my medical problem. I'm a very rational person, so I thought about things a lot. On the one hand, I am getting older, which automatically means that more and more things will start going wrong with my body. That's just part of life. You can be lucky, and you can be unlucky. I still feel fortunate that my illness won't really cause me any problems in the long term.

It's important for me to know what's causing my symptoms. If I understand why I'm in pain, I can cope with it better. I've learned from bad experiences with doctors in the past, and am now more careful about which doctors I go to. They have to be easy to communicate with and get on with as people. And I always try to get a second opinion. I think that's really important when you have a decision to make. I have also learned to go to the doctor if I'm feeling unwell, rather than putting on a brave face.

I don't see it as a serious illness, but an unpleasant growth in the wrong place. I did wonder whether it may actually be cancer, and worried that the doctors may have got the diagnosis wrong. In situations like that it really helps to have a doctor who you trust and can talk to. But I still sometimes worry about it, especially when I go for check-ups.

Although my urine flow is normal nowadays, I still feel a certain amount of pressure... a need to empty my bladder. So I sometimes still have to get up at night to go to the toilet. But it's much better than it used to be before the operation. It really was worth it.


Acknowledgment

Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.