jonnyramone

It is not a question of how bad the symptoms are it is whether or not those symptoms respond to other less invasive treatments than surgery.

Surgery should be a last resort.

I thought was clear that if the symptoms are real bad , it does mean that all the drug therapies have failed.

I was on Alphalytic drugs for almost 2 years, until I got to the point to urinate only a few drops at a time. My post voiding residual was almost 100 ml... My creatinine level was so high because the urine stucked in the bladder was backing on my kidney

What I'm trying to say is that sometime waiting too long could be a wrong choice.

I guess the point is that there are risks in any sort of operation and for enlarged prostate there are many other options that can help without having to take unnecessary risks with surgery.

I guess the point is how bad your symptoms are....If the obstruction , caused by prostatic hypertrophy , does not allow you to empty the bladder to 50%, it's more risky than surgery. Would you like to live with a catheter or going to the bathroom every 30 minutes , damaging your bladder walls, compromising your kidney ?

It's a question of point of view...

Just about every man over 50 is going to have an enlarged prostate.

There are many many options that can help with an enlarged prostate without going down the very dangerous route of surgery.

Best friend of mine had surgery on his enlarged prostate in Oz last year and is still in agony when he urinates.

A supposed quick overnight operation ended up with him hospitalised for 10 days and he nearly died of kidney failure because of wrong medication and he has more prostate problems that before he went in for the operation..

Your friend was very unlucky...No doubt on it. TURP or new Laser procedures for enlargement prostate are very safe.

In most of the case, the erection improves. The only side effect could be retrograde ejaculation, but in some case, as for Mr. Aforek , the normal ejaculation can remain.

I did operation when I was 45, now I'm 50, never have problem on sexual issue except for ejaculation. My erection is 100 % the same as before, and so it is for my friend, 70 years old from USA who did TURP on B.P.Hospital. He still banging girls on Soi 6.

I think some people in this forum don't have a clear idea about Prostate Operations. If someone got prostate cancer,TURP in not effective because the entire gland must be removed...In this case , with a complete prostate removal ( radical prostatectomy), more side effect could be involved (Incontinence,impotence,etc.etc.). However, also in this case, new robotic and laparoscopic procedures with the nerve-sparing technique, give a lot of hope in terms of keeping a decent sexual life.

Cheers.

Not completely and always true : sometimes, but not often ( may be one time out of twenty ), I have a little bit sperm out, by the normal way

BTW, what is proscar and when and why to use it ?

Proscar is finasteride, a drug able to decrease the DHT level in the body. DHT is the hormone responsible for Prostate enlargement .

Thanks very much for the info. Is the procedure done under a local or general anaesthetic? I must admit "going under the knife" so to speak terrifies me. Never had anything done more serious than an ingrown toenail.

There are 2 kind of anesthesia for this procedure. Epidural and total. I've done epidural, while my friend did total . It's depend of the anesthesiologist. With epidural anest. you remain conscious , just your lower body sleep.

No way you can do TURP with local anesthesia...

Do you know whow much your friend paid at BKK Pattaya Hospital?

So I asked him, he said it was 70,000 baht, including after surgery recovery, medication and consulting after the operation.

I suggest you to take a look at Sirikith Hospital in Satahip. Most of the doctors working there are the ones that you find at International or Bangkok Pattaya Hospital. Anything is extremely cheap there and the service is more than acceptable. I went there with a friend of mine who had a cystoscopy from the Urologist working at International Hospital too. Price on International Hosp. was 20,000 baht while he paid just 2,300 baht at Sirikith in Satahip...Procedure and Doctor exactly the same, so I guess TURP operation will be much cheaper in Satahip as well.

From my experience and other people, the medicine will at some point not work with a trip or two to the emergency. The thinking today is to prolong surgery as long as possible with medication. In my case the medicine worked around 70 to 80% with a trip to emergency but had the TURP surgery because I had no choice.( a longer story)

As with most guys, surgery was the last option on my mind, but it may be the best thing you can do for yourself for the long term. It's like getting your normal life back. A good doctor will try to convince you to wait until your symptoms get worse as all surgery comes with risks, but a for profit doctor would be happy to do the surgery anytime.

The surgery is basically painless but it is not a cure and the prostrate will grow back from 5 to 10 years so continuing to take medicine after the surgery means you will be symptom free for a long time. My suggestion is if your medication is working then continue with it but if it is borderline then talk with your urologist.

I totally agree with you about the fact that alpa-lytic drugs (Xatral,omnic,etc.) will not work forever, and prolonging surgery as long as possible is not a good option....It will only damage kindney and bladder.

However it's not sure that prostate will grow back in 5 , 10 years after the surgery. My father is now 84, he had TURP when he was 62 and since then he never gone back to the operating room.

TURP remains the gold standard for treating BPH, other procedure instead, like TULIP,HOLEP,Green Light Laser,PVP,etc.. are safe as TURP (sometime even better) in terms of excessive bleeding and fast recovery BUT they have high re-treatment's rate.

My suggestion is to forget about new procedures...Go for the gold standard TURP.

With all respect to those suggesting herbs treatment or magic pills, my humble advice is to contact a qualified urologist and follow his therapy to the letter...Don't underestimate your Benign prostatic hyperplasia (BPH).

Do you know whow much your friend paid at BKK Pattaya Hospital?

I'll try to contact him and I will let you know precisely....I just remember he was happy about the operation....

I had TURP two years ago and I haven't lost sexual life... TURP is a very safe procedure, the nerves responsible for erection are not affected. The only thing I have lost is the ejaculation , infact the sperm goes to the bladder instead of going out (retrograde ejaculation)...Not a big thing....The orgasm is still the same, nothing's changed .

I suggest anyone with enlargement prostate to consider in having The post-void residual (PVR) urine test wich measures the amount of urine left in the bladder after urination. It is very dangerous if your residual is more than 30 ml. because you can compromise your kidney function .

I had the operation in Switzerland but a friend of mine had it here at Bangkok Pattaya Hospital. Very simple operation , you'll be home the next day and you will be fine in two weeks.

Good side of retrograde ejaculation is : no more worries about girls pretending you're the father, and discount on happy ending massage....because "she didn't let you come"....

Cheers.

Funny that most of the people claiming to live in thay style choose some of the most western cities (Pattaya,Phuket,Chang Mai). I don't think there are so many gentlemen here that want to live like thais...

I started with gel... the drug companies pass it out free to endos in the states. My endo said "Take this, I have plenty more if you like it". Some subsidize the part of the bill we copay with coupons right on the samples. It's big money.

With gel you have to be very controlled and not let kids or women contact any.

May give it a second try if the joints pain and cholesterol would improve with no AI. Better libido with gel.

I think I'm gonna start taking some anastrazole 'cause my estrogen levels are raising. I've found it in the nana pharmacy from an underground brand called Meditech , do you ever used it ? The cost is 2000 baht x 30 capsules, problem is that each capsule is 1,00 mg. and it cannot be split . 1,00 mg. is definitely too much, I was thinking about 0.25 mg. every 3 days or 0.5 EOD . Do you know any other brands producing anastrozole in tablets form instead of capsule ?

Cheers.

I agree that gel is not cost effective for a TRT , that's the reason why most of the therapies legally prescribed by endocrinologist are made with vials .

That's true everywhere but the US. In the US Androgel rules TRT.

To be honest, Gel therapy is spreading around the world , more and more doctors are prescribing gel instead of vials but I think it's a marketing problem. Pharmaceutical companies have invested a lot of money on this new testosterone form and I would not be surprised to know that they are pushing on doctors to prescribe gel instead of vials. The gel seems to be "more friendly" than injections anyway. It doesn't even make the patient feel he's doing a medication...It's a gel, just like any cosmetic preparation....You can bring it anywhere, and used it everywhere....

Thanks for sharing your knowledge jonnyramone.

I had never heard of andriol testocaps, at least not in my experience in the USA.

"ANDRIOL TESTOCAPS, an important part of the active substance

testosterone undecanoate is co-absorbed with the lipophilic solvent from the intestine into the

lymphatic system, thus partially circumventing the first-pass inactivation by the liver."

Your subsequent post mentioned zinc. I take that - it's nickname is "Trainers' best secret". (whole food sources; brewers yeasr, wheat germ/bran)

Some typos in that link, not sure what to make of that if from manufacturer -thoughts???; http://personalsteroid.com/product_view.php?ref_id_type=6&id_prd=13

Gel and cream is not cost-effective for me. Weekly Cyionate IM injections are cheap and easy with 1/2mg Anastrozole 24 hours after.

Is pharma grade Anastrozole available in Bangkok pharmacies?

Anybody know if Anastrozole raises cholesterol (LDL-C)?

You welcome ..

I know that Andriol and Proviron are not so popular in US , while they both are in Europe instead.

Anastrozole raises Cholesterol and decreases tryglicerides (sugar fat)...see link below :

http://www.ncbi.nlm.nih.gov/pubmed/22093630

I agree that gel is not cost effective for a TRT , that's the reason why most of the therapies legally prescribed by endochrinologist are made with vials .

The only advantage using Gel is that it doesn't raise estrogen levels as bad as vials.

I don't know if pharma grade Anastrozole is available in Bangkok pharmacies . I remember there was an indian underground brand called Alpha Pharma wich was manufacturing anastrozole,I think it's still available in Bangkok pharmacies...but, as I said before, it's an underground grade so I would be carefull before use it.

cheers.

Testosterone gel seems far the best delivery method.

No needles and big boost on one day, it is steady through the month and it follows the body's natural daily cycle of TLevels.

It used not to be available in Thailand and expensive abroad.

Is anyone accessing the gel here or abroad and what are you paying?

Testosterone gel is available in Thailand, you can get the original one (Testo-gel) , in any big Hospital like Bumrungrand or Samitivey (Bangkok) and Bangkok Pattaya Hospital (Pattaya) as well . I have a friend from Sweden who recently got his Testogel from B.Pattaya Hospital after a regular doctor's visit. Problem is that is very expensive. Some underground pharmacy in Bangkok and Pattaya are also selling some Testosterone gel from an underground brand called : Meditech. Price is cheaper than the original (see link below)

http://personalsteroid.com/product_view.php?ref_id_type=6&id_prd=13

Anyway I'm not sure about this one...As I said, Meditech is an underground brand made for bodybuilders, I would go for pharma grade stuff...always, without a doubt.

i am not sure why you would chose a synthetic product to enhance testosterone when a 100% natural product is available ?.... Cordyceps ...www.thaiherbsonline.com ..... yes natural products may take a little longer but they have none of the risky side effects .....

All these stuff like Tribulus Terrestris, gynco, serenoa repens, etc.etc. will not increas testosterone. There are some other hormones able to do that , like HCG or Nolvadex,Clomid, etc.etc.with other side effects.

Feeling better taking herbs has nothing to do with testosterone .

Zinc is good for prostate , it can help an healthy man to keep stable his testosterone level too

but it won't increase more testosterone in the body. So if your testosterone is naturally high, you could keep your own level stable taking zinc , eating well, sleeping good,etc.etc.

Unfortunately most of the men, me included, see their testosterone levels decline badly after 40, that's the reason why I'm on TRT. Testosterone Replacement Therapy is perfectly legal and it can be prescribed by any certified endochrinologist around the world.

Low testosterone levels is not only related on low sex drive, muscles,etc.etc. , it's related on many other serious symptoms .

Updates?

Tim is still waiting for his gold + money back....In the meantime Police seem don't give a damn about what he said ...Honestly , why should they ? They got what they wanted , no cop has been charged with extorsion,robbery or anything else...So everyone's happy. Sharky has increased its reputation as bad ass tough guy and Police "get off scot-free"....Just another typical pattaya's story.

I'm also on TRT (testosterone replacemant therapy) since 2 years. No sides if you get the right dosage from a certified endoc.(wich is most of the time 200/250 mg. every 10 days). I suggest testoviron 250 from Bayer-Shering wich is definetely REAL. Other brands might be fake . You can buy it to any serious pharmacy (Fascino or Boots as well). I tried Andriol tablets as well, but it's weaker and more expensive that the injectable one.(you have to take 6 tablets a day to feel something.) The gel seems to be the best form,and you can find it only in big Hospital around Thailand under prescription (Bumrungr., Samjtivey, Bangkok Pattaya, etc.) it is very expensive too. Vial is the cheapest solution.

Orals toxify the liver which has many essential functions beyond filtering. I would never do pills. In fact, the reason for transdermal gels is to avoid loading the liver IIRC. Correct me if I'm wrong please.

That 10 day interval is long. Cypionate has a longer carbon chain and its 1/2 life is longer. With 10 days and 200-250mg you may see aromatization and your estradiol will rise. Gynocomastia (sp?) is tough to get rid of and unless you have tamoxifen (Soltamox) and raloxifene (Evista) on hand when nips get puffy & sensitive you may not head it off. Then it's surgery.

I use 80mg every 7 days IM cypionate with 1/2mg Anastrozole 24 hrs later - and respond very well to that.

I do worry about Anastrozole raising my cholesterol (LDL-C) however.

I have never cycled steroids and only on doctor prescribed TRT - my info is from personal interest research only and I'm no expert. Just want to help if I can.

EDIT TO ADD; This time I'm bringing my own syringes and needles from the US with me... very cheap and no hassle from pharmacies or hospitals in LOS.

Dear friend, good thing about andriol is that's absorbed through the lymphatic system so not big issue for liver , bad thing about it is that its bioavailability is very weak, it does mean you should take at least 6 to 8 tablets a day every 6 hours....I don't know where you can get cypionate in Thailand, the reason why I mentioned Testoviron before is because it's 100 % real from Bayer-Shering Thailand . Unless you're Cypionate is from Pharmacia/Pfizer or Schein (both certified american brands) I would be very carefull before use it. So many fakes in Thailand....

80 mg. every 7 days is a good dosage anyway, it will keep your testosterone stable, I don't know why you need Arimidex (anastrozole) instead.... you should take it only in case of severe gyno, otherwise I would go for 50 mg. of proviron (mesterolone) every day during TRT.

Tamoxifene (Nolvadex) is good for PCT, Post cycle therapy, I used it after the cycle to boost my gonads and testosterone, it worked always very good, better than clomid.

Be carefull with Anastrozole, suppressing estrogen levels it may affect your sex drive badly...Estrogens are very important for libido too .

I had my first extension (3-month mark) on Thursday and he told me to come back for next extension(month 6-9 period of 1 year) in March. I received my visa prior to the changes in Early September, so confused as to what will happen in March.

This entire visa system is a fiasco. i think not one country in the world is amending their visa rules as fast as the current power base here.

Total lack of consistency of regulation enforcement and information at borders/immigration offices/information from schools.

You pay on the basis of 1 year's study and then they just rip everything up. No integrity whatsoever.

They change laws/rules "in the twinkling of an eye" , this is the most frustrating thing... the fact of knowing that everything here is never 100 % sure . Be prepared about anything in March.

Being a "sportman" since I was a kid , I suggest to avoid any sport activity before 8.00 pm due to adrenaline production...Unless you go to sleep at 4.00 am. All the time we exercise , our body produces adrenaline, an hormone produced by the adrenal glands during high stress or exciting situations. So, it's good to exercise in the morning or in the early afternoon.

Sorry, it was " avoid any sport activity after 8.00 PM .

Sadly the ED visa has been widely abused for many years, now it's getting harder and harder for genuine students who want to study in Thailand.

To be honest , 80 % of foreigners getting the ED visa don't really care about learning thai...They don't even attend the courses . They just need a way to stay in the Kingdom one year in a row. We all know that , and authorities know it too...That's the reason for the new restrictions.

In my opinion, tourist visa is much safer than ED, now more than before. At least police won't stop you at the airport checking your language skills.

Being a "sportman" since I was a kid , I suggest to avoid any sport activity before 8.00 pm due to adrenaline production...Unless you go to sleep at 4.00 am. All the time we exercise , our body produces adrenaline, an hormone produced by the adrenal glands during high stress or exciting situations. So, it's good to exercise in the morning or in the early afternoon.

Here in Pattaya I've found the opposite to be true. I drive past many police checkpoints and they are only stopping Thais for paper checks. Some foreigners got stopped for not wearing helmets.

In Pattaya there's Tim Sharky , they better don't <deleted> with farangs ...

Wow...If what the user nasa123 is true , it seems that ED visa is not convenient anymore.....You pay a lot of money for let them kick you out of the country every 6 months ....Very good. Who said that Tourist visa was a trap ?