Hollow forms and prostate surgery

[Alan Weinberg]

Intriguing subject title, isn’t it? I have to warn you that it might be a bit graphic for some, but bear with me and you will understand—or just stop reading.

I’m a retired urologist learning woodturning. There’s a strong parallel to a common prostate surgery called TURP or transurethral resection of the prostate, known colloquially as a roto-rooter.

In hollowing, one has boundaries: preserving the walls of the form, not creating a funnel by penetrating the base, and preserving the neck or opening. Prostate surgery, specifically a TURP, is exactly the same—with an enlarged prostate obstructing urine flow, tissue is resected in a similar fashion as wood is removed in a hollow form. The prostate wraps around the urethra below the bladder neck and is reached surgically via the urethra. Think of the prostate as an orange and all the pulp needs to be removed, leaving the peel or capsule—just like in a hollow form where the desired wall thickness is left after removing all of the interior.

In a TURP, a scope is passed via the urethra and the prostate tissue is removed circumferentially down to the capsule, using an electrically charged loop via a resectoscope. Some surgeons use a laser. It’s just like passing tools in a form to hollow it out. Boundaries are similar to a hollow form with the same caveats—avoiding perforation and damage to the neck—but we also have to deal with bleeding and potential patient movement. However, the patient is not spinning at 800 rpm!

We smooth out the interior and remove all the tissue, leaving just the shell.

We use a camera video system as with some hollow forms and at the end of the procedure, all the shavings—called chips—are removed.

In the photo below one sees the prostate (to the left of bladder) before removal of tissue, so the urethra is obstructed, akin to a hollow form before hollowing.


Here’s a brief video that shows some of the procedure.

View: https://youtu.be/YujsTfjxT0o?si=TLrTy5Oj2XQnwJS7


Start at about 30 seconds, then go to 7 minutes if bored. The surgeon starts resecting tissue until a large cavity is left from bladder neck (bottom of the hollow form) to the veru, a structure that marks the location of the sphincter that controls urination, the “opening” of the hollow form.

It interests me that the parallels are so strong between this surgery and turning a hollow form.

 

[Phil Hamel]

Interesting correlation!
Being 66 currently, I think I prefer being the turner not the vessel.

 

[Richard Coers]

Is the prostate surgery considered art?

 

[Rick Moreton]

Is the prostate surgery considered art?

Only if it was done without being needed, otherwise it is too functional.

 

[Don Wattenhofer]

So you are one of those guys that come at you with that scope which I didn't want to look at when it was inserted, but of course I wasn't awake for the root o rooter or TURP, but afterward they stuck that scope all the way into the Kidney to get the stone they had discovered.

 

[Alan Weinberg]

Is the prostate surgery considered art?

It’s the art of surgery! So, yes.

 

[Alan Weinberg]

Interesting correlation!
Being 66 currently, I think I prefer being the turner not the vessel.

I always preferred the end of the scope I was on!

 

[Darryl Fective]

I don't think it's possible to render an incontinent (or impotent) hollow form, so I'll stick with my wood.

 

[Don Wattenhofer]

I always preferred the end of the scope I was on!

Probably giggled each time a new "vessel" came in to be "scoped out".

 

[Dennis Weiner]

How apropos! I have an appointment with my Urologist tomorrow morning! I use a red laser with my hollow forms but I am sure that he'll wish to discuss the green laser procedure.

 

[Richard Coers]

So you are one of those guys that come at you with that scope which I didn't want to look at when it was inserted, but of course I wasn't awake for the root o rooter or TURP, but afterward they stuck that scope all the way into the Kidney to get the stone they had discovered.

Wear a stent for 6 weeks after a lypotripsy, and then have it pulled out like I start my lawn mower! I almost went into shock when he drug out stones with that pull. I never went back to that urologist. I've watched veterinarians be more gentle than him!

 

[John Ames]

And I thought I started some off-the-wall topics! 😆

 

[Dean Center]

One major difference is that with the wooden patient spinning on a lathe, the resection is always symmetrical. You can adjust the position at the beginning of the procedure, but only a little. With a TURP, you can shave a little more off here and a little less there, and you have the capsule to tell you when you're done in a particular spot. With a hollow form, you only have shavings flying out of a circumferential slit to warn you that you've gone too far. And then it's too late. On the plus side, Johnny Appleseed's attorney will never go after you.

 

[Alan Weinberg]

One major difference is that with the wooden patient spinning on a lathe, the resection is always symmetrical. You can adjust the position at the beginning of the procedure, but only a little. With a TURP, you can shave a little more off here and a little less there, and you have the capsule to tell you when you're done in a particular spot. With a hollow form, you only have shavings flying out of a circumferential slit to warn you that you've gone too far. And then it's too late. On the plus side, Johnny Appleseed's attorney will never go after you.

and a lot less bleeding with a hollow form. And no family to have to explain why this happened:

 

[Bryan Field]

Thanks for sharing (I think!)

 

[Lou Jacobs]

My prostate procedure was a green light laser. I’ll have to ask my urologist if I can borrow his “rig” to try hollowing with the laser. Who knew this site would take us into such interesting corners of the universe!

 

[Ed Davidson]

Another parallel (woodturning and TURP surgery) to consider...if you ignore an enlarged prostate (as I did), it grows, and may eventually cause a complete urinary blockage, urine retention, very high blood pressure, and ultimately, kidney damage and failure...just like a good piece of wood that's been left on the shelf without proper sealing to avoid cracks and splits. I was diagnosed August 2022 with all the things described earlier, and had a TURP February 2023, removing 65 grams of prostate material. All seemed well prostate-wise for about five months, until I ended up back in the ER with a 100% bladder neck blockage, caused by scar tissue development from the first surgery. That was fixed August 2023. So now, for the punch-line...one thing leads to another, and if it goes on long enough, without getting fixed, you can die...just like that neglected piece of wood. I’ll be dealing with stage 4 kidney disease for the rest of my life…a completely avoidable life threatening issue.

 

[Hugh]

The human body has an "end date".
There are things that we can do to extend that date. If we don't take care of ourselves, the end date comes much quicker.
The older we get the more things there are out there that will keep trying to get us.
I really dislike going to the doctor. But, I sure do like that they can keep patching me up.

 

[John Ames]

Do you mount the patient between centers? Or do you use a face plate? Glue block? Donut chuck?

So many questions…

 

[Alan Weinberg]

glad many of you found this humorous and, wow, lots of TURP patients out there!

 

[Curt Fuller]

I got a chuckle out of it but at the same time I hope I never have the opportunity to compare the two. Just curious, have you ever had a serious "catch" while performing the TURP?

 

[Alan Weinberg]

I got a chuckle out of it but at the same time I hope I never have the opportunity to compare the two. Just curious, have you ever had a serious "catch" while performing the TURP?

Actually—yes. These something called an obturator reflex. Obturator nerve is responsible for adduction of legs—bringing them together. If one gets too thin at the base of the prostate, but more commonly during resection (removal) of bladder tumors, the current used may stimulate that nerve and the leg may jump and the scope then perforates the capsule or bladder wall, not a good thing. To avoid this happening when the tumor is near the obturator nerve (but outside the bladder) we have anesthesia paralyze the patient so the muscle won’t contract when the nerve is stimulated by the electric current used to remove the tissue.

 

[Kent Reisdorph]

A surgeon told me once that the worst word he could utter is, "Oops." Anything else was just banter or minor issues that could be correct. An oops was a big one. Just one surgeon's opinion, I'm sure.

 

[Ric Williams]

I don't think it's possible to render an incontinent (or impotent) hollow form, so I'll stick with my wood.

That's because you haven't seen any of my work!

 

[Roy Martin]

Alan, thank you for your interesting topic. I recently endured a TURP and got more information from my fellow woodturners than from my urologist. Maybe I should have come here for a second opinion

 

[Ric Williams]

I owe my life to a dedicated urologist who started tracking my PSA level once I turned 45, and insisted on biopsies when it kept climbing. It revealed that, at age 49, I was in the early stages of an aggressive form of prostate cancer. Because of his care, it was caught early enough that the prognosis was good and after much discussion I opted for a radical prostatectomy, knowing that it was likely to leave me with ED and incontinence. Given the choice, I decided that life with some inconvenience was preferable to an early, and likely gruesome, death. That was 22+ years ago and I've never regretted that decision. I'll be forever grateful to Dr. McDevitt. Incidentally, he was the doctor who performed my vascectomy a few years prior, when at one point a nurse had to come in the room to quiet us down cuz we were laughing so hard at the bad jokes we were making.

Guys, do yourself and your family a favor and get your PSA checked every year, and don't procrastinate if it starts rising. It's literally a matter of life and death, and the surgical techniques are much more advanced now with less risk of ED, incontinence or other after effects. It's not something to f#*k around with.

And thank you Dr. Weinburg!!!

 

[Alan Weinberg]

get your PSA checked every year

due to PSA screening the incidence of advanced prostate cancer has fallen over 40% in the US over the last few decades.

It’s a bit of a thread drift but worth mentioning to a bunch of mostly men, so thanks.

 

[Mark Jundanian]

And as long as they're drawing blood for th PSA, get a lipid screen (cholesterol).

 

[Dean Center]

For you fellows over 65, there's a whole lot more to the decision about whether to get a PSA test or not. It's not all good news. Talk with your family doctor about reasons both for and against testing.

 

[bob elliott]

Intriguing subject title, isn’t it? I have to warn you that it might be a bit graphic for some, but bear with me and you will understand—or just stop reading.

I’m a retired urologist learning woodturning. There’s a strong parallel to a common prostate surgery called TURP or transurethral resection of the prostate, known colloquially as a roto-rooter.

In hollowing, one has boundaries: preserving the walls of the form, not creating a funnel by penetrating the base, and preserving the neck or opening. Prostate surgery, specifically a TURP, is exactly the same—with an enlarged prostate obstructing urine flow, tissue is resected in a similar fashion as wood is removed in a hollow form. The prostate wraps around the urethra below the bladder neck and is reached surgically via the urethra. Think of the prostate as an orange and all the pulp needs to be removed, leaving the peel or capsule—just like in a hollow form where the desired wall thickness is left after removing all of the interior.

In a TURP, a scope is passed via the urethra and the prostate tissue is removed circumferentially down to the capsule, using an electrically charged loop via a resectoscope. Some surgeons use a laser. It’s just like passing tools in a form to hollow it out. Boundaries are similar to a hollow form with the same caveats—avoiding perforation and damage to the neck—but we also have to deal with bleeding and potential patient movement. However, the patient is not spinning at 800 rpm!

We smooth out the interior and remove all the tissue, leaving just the shell.

We use a camera video system as with some hollow forms and at the end of the procedure, all the shavings—called chips—are removed.

In the photo below one sees the prostate (to the left of bladder) before removal of tissue, so the urethra is obstructed, akin to a hollow form before hollowing.


Here’s a brief video that shows some of the procedure.

View: https://youtu.be/YujsTfjxT0o?si=TLrTy5Oj2XQnwJS7


Start at about 30 seconds, then go to 7 minutes if bored. The surgeon starts resecting tissue until a large cavity is left from bladder neck (bottom of the hollow form) to the veru, a structure that marks the location of the sphincter that controls urination, the “opening” of the hollow form.

It interests me that the parallels are so strong between this surgery and turning a hollow form.

Think of the worst smelling wood you've ever turned. Compare that to the smell 😫 of a TURP being performed. I prefer the smell of that wood any day!