AboutRonald Levy, M.D. Expertise Associate Professor of Anesthesiology, University of Texas Medical Branch at Galveston. I am a board certified anesthesiologist who can answer all questions related to any type of Anesthesia with the exception of Pain Management.
Expert: Ronald Levy, M.D. Date: 7/3/2008 Subject: anesthesia options for BPH surgery
Question QUESTION: For years I have had BPH; the drugs no longer help and it's now time for surgery. I'm 54 and in good health except fo the BPH which means trips to the bathroom ever 2 hours or so at night...I saw 2 urologists, one recommended the old TURP procedure and the other doc recommended the newer laser PVP procerure (I guess since she's a younger urologist)..The 2 urologists even talked to each othr and the consensus was that I needed the procedure and that they used general or spinal anesthesia (which is a bad idea for me since I have had extensive back surgery)..My question is: lacking the spinal/epidural option, is there anyway that I can avoid a general anesthetic? The urologists didn't know and the hospital anesthesia epartment won't answer questions until the morning of the procedure (seems like a really bad idea). They both said that the procedure would likely take 30-45 minutes; I'm willing to take the pain, but if it's anything like the cystoscopy that I had 10 years ago, I'll probably pass out anyway..It hurt a lot, but if thats what I have to do, I will. Thanks for reading this long message.
ANSWER: There is no way to do this procedure without anesthesia. If spinal is not an option, then general is the way to go. There is nothing wrong with general and for this short procedure, it seems reasonable. Many people are scared of general anesthesia but it is EXTREMELY safe. If you have no other medical problems, go for the general and enjoy the nap.
Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston
---------- FOLLOW-UP ----------
QUESTION: Thanks for the reply; one more question, if I may. My problem with general anesthesia was from the sevoflurane (hours of PONV as well as the nasty smell and feeling of suffocating)...I have had propofol and fentanyl befoer without problems; would it be reasonable to request a general with just these 2 agents? Thanks again, I feel comfortable with the general anesthetic after reading your comment.
Answer While it is possible to do the entire anesthetic with injected agent (called a TIVA or Total IntraVenous Anesthetic) I would not recommend it because it will likely delay your discharge. Again, if Sevoflurane was the problem, there are other inhaled anesthetics (besides, it was probably not the Sevo but rather Nitrous Oxide or the narcotics that gave your the PONV).
Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston
