Prostate

[Farmerslife]

49 minutes ago, Sheryl said:

It is not the hospital that matters, it is the doctor.

 

At Sukhumvit Hospital I have heard favorable reports of Dr. Umaporn Nuanthaisong

https://www.sukumvithospital.com/doctorprofile.php?id=188&language=en

 

 

 

 

 

Thank you. Yes, she was helpful and put me on Dutasteride after me being on Tamsulosin for more years than I can remember. She recommended the TURP if the Dutasteride doesn't improve matters for me.

 I would love to avoid surgery if I can and am trying a combination of Prostagutt and Tamsulosin/Dutasteride as prescribed by the Hospital in Saraburi. As I have only been trying this for a couple of weeks I will give it another month or two before making a decision on the TURP.  

 

 

[xylophone]

4 hours ago, Farmerslife said:

I have reluctantly accepted that I have to do something about my BPH. For a number of reasons and on advice from a couple of urologists I have settled on a TURP rather than some of the newer alternatives.

I have received quotes from Sukumvit Hospital in Bangkok and Mittraphap Hospital in Saraburi. Does anyone have any first-hand experiences of these two hospitals.

 

Thanks. 

 

With all due respect Farmerslife, I have had a TURP in one of the best hospitals in Australia and it wasn't all smooth sailing although it did come right after a few months.

 

If I was in the same position again I would certainly look at the iTind procedure, because it's quick and painless and if it doesn't work then nothing lost apart from a few thousand baht – – that's presuming that the size of your prostate does not rule it out.

 

Again if I had been in this position when the Urolift procedure was around, this would have been my second choice, and I think I would have met the criteria for this procedure with regards to prostate size.

 

The "gold standard" TURP should be the last resort, because it does involve an invasive procedure/surgery and is irreversible, and things can go wrong, whereas with the two options above, any problems and you can revert to the norm and then consider the TURP.

 

Just my opinion for what it's worth, and as Sheryl has said, it's the doctor and the number of the operations he has done, which should be a guide, and my doctor/surgeon in NZ has said exactly the same.

[BritManToo]

19 minutes ago, Farmerslife said:

I would love to avoid surgery if I can and am trying a combination of Prostagutt and Tamsulosin/Dutasteride as prescribed by the Hospital in Saraburi. As I have only been trying this for a couple of weeks I will give it another month or two before making a decision on the TURP.  

After 2 years on Finasteride (5mg every other day) along with Nettle root (1/day), I'm almost cured of prostate problems. Really, 1 month or even 2 isn't long enough time to tell if it's working for you. 

Edited March 14, 2022 by BritManToo

[Farmerslife]

2 minutes ago, xylophone said:

With all due respect Farmerslife, I have had a TURP in one of the best hospitals in Australia and it wasn't all smooth sailing although it did come right after a few months.

 

If I was in the same position again I would certainly look at the iTind procedure, because it's quick and painless and if it doesn't work then nothing lost apart from a few thousand baht – – that's presuming that the size of your prostate does not rule it out.

 

Again if I had been in this position when the Urolift procedure was around, this would have been my second choice, and I think I would have met the criteria for this procedure with regards to prostate size.

 

The "gold standard" TURP should be the last resort, because it does involve an invasive procedure/surgery and is irreversible, and things can go wrong, whereas with the two options above, any problems and you can revert to the norm and then consider the TURP.

 

Just my opinion for what it's worth, and as Sheryl has said, it's the doctor and the number of the operations he has done, which should be a guide, and my doctor/surgeon in NZ has said exactly the same.

Thanks.  I looked at iTind but the 3 year only efficacy put me off somewhat. It just seemed to me to be putting off the inevitable day when I would have to face up to a TURP. My prostate is also at the top end of the scale for suitability. 

 

[Farmerslife]

6 minutes ago, BritManToo said:

After 2 years on Finasteride (5mg every other day) along with Nettle root (1/day), I'm almost cured of prostate problems. Really, 1 month or even 2 isn't long enough time to tell if it's working for you. 

Thanks. "Cured of prostate problems" is a curious one. My experience to date is a gradual worsening over time. I only wish I could make the bl**dy thing shrink!

You may well be right about the amount of time I should give the new medication regime to prove itself but just having gone through a rather traumatic period of water retention and subsequent catheter usage, I am a bit despondent at present. 

[GarryP]

7 minutes ago, Farmerslife said:

Thanks.  I looked at iTind but the 3 year only efficacy put me off somewhat. It just seemed to me to be putting off the inevitable day when I would have to face up to a TURP. My prostate is also at the top end of the scale for suitability. 

 

Could it be possible that the 3 year limitation is because the device was not proved long ago so they do not yet have evidence of efficacy after 4 years? I remember with Rezum, they started with 3 years but are now saying it is still proving effective 5 years post treatment. Perhaps in a few more years, the iTind may prove to be effective for 5 or more years.

[BritManToo]

Just now, Farmerslife said:

Thanks. "Cured of prostate problems" is a curious one. My experience to date is a gradual worsening over time. I only wish I could make the bl**dy thing shrink!

You may well be right about the amount of time I should give the new medication regime to prove itself but just having gone through a rather traumatic period of water retention and subsequent catheter usage, I am a bit despondent at present. 

Yeah, me too, been there, thought it was the end of my life,

........ 6 weeks of catheter 2 years back, 6mg Doxazosin/day to wee at all, and even then it was difficult. Now I'm down to 2mg doxazosin some days, and am mostly weeing entirely normal ......... lots of exercise/hard work/sweating still makes things worse. But if I just sit around drinking beer all day, zero problems now.

[Farmerslife]

1 minute ago, GarryP said:

Could it be possible that the 3 year limitation is because the device was not proved long ago so they do not yet have evidence of efficacy after 4 years? I remember with Rezum, they started with 3 years but are now saying it is still proving effective 5 years post treatment. Perhaps in a few more years, the iTind may prove to be effective for 5 or more years.

On their website they talk about it lasting 3 years and then putting you through the same procedure again which they say might last you for 2 years.

[GarryP]

1 minute ago, Farmerslife said:

On their website they talk about it lasting 3 years and then putting you through the same procedure again which they say might last you for 2 years.

I see. In that case, I would tend to agree with you as you are already suffering quite severe symptoms of BPH. For Rezum, I am expecting to have to go through the procedure again in about 10 years, at which time I will probably reconsider what would be best taking into consideration surrounding factors. 

[Farmerslife]

Just now, BritManToo said:

Yeah, me too, been there, thought it was the end of my life,

........ 6 weeks of catheter 2 years back, 6mg Doxazosin/day to wee at all, and even then it was difficult. Now I'm down to 2mg doxazosin some days, and am mostly weeing entirely normal ......... lots of exercise/hard work/sweating still makes things worse. But if I just sit around drinking beer all day, zero problems now.

As my moniker on here suggests exercise, hard work and sweating are a given.

Also I thought alcohol was an irritant that made matters.

You seem to be flying in the face of convention. Good luck if it works for you.   

[xylophone]

4 minutes ago, Farmerslife said:

You may well be right about the amount of time I should give the new medication regime to prove itself but just having gone through a rather traumatic period of water retention and subsequent catheter usage, I am a bit despondent at present. 

I can sympathise with you FL as I have been battling with the water retention problem and the catheter use now for over a year and more, and it has gotten to the point where I am seeking the possibility of a spinal implant, not as bad as it sounds! (I hope).

 

I found that the water retention would often give me a UTI (infection) and at first I thought it was me and my hygiene/cleanliness not being up to scratch, however the good doctor Charuspong, said that provided I washed my hands vigourously with soap and water prior to handling the catheter and so on, and that I stored it correctly/hygienically, everything should be okay, whereas the urine remaining in the bladder was the real problem.

 

Luckily enough I happened upon an old antibiotic called fosfomycin (sold as Monural here) and it comes in a packet of 3 g which one dissolves in water and swallows it immediately, and that's it, and it works extremely well.

 

Just to back that up I have also started taking a tablet called Hiprex, which is a urinary antiseptic that fights bacteria in the urine and bladder and you can take it on a daily basis and from having a UTI every two or three weeks initially, I haven't had one for a few months now.
 

[xylophone]

9 minutes ago, Farmerslife said:

On their website they talk about it lasting 3 years and then putting you through the same procedure again which they say might last you for 2 years.

To be honest, I'd settle for having the same procedure every two or three years, which takes between 10 and 30 minutes at most and is painless, over anything else.

[fredscats]

Best thing ever did TURP,asked for laser,no idea what is thrown up the backside for the op,accepted 40 minute procedure,but one and half hours it went on for,came to fine and dandy,its a gift really is,no more pi.ssing when you do not want to,and  pis.sing when you want to,everything OK. Should have been done years before

 

TURP Surgery is recommended to older men suffering from BPH (Benign prostatic hyperplasia). BPH is a medical condition that leads to enlargement of prostate gland. In this condition, patients are unable to empty their bladder completely, leading to frequent urinary infection and bleeding. Severe cases include; extreme slow urination, formation of stones in the bladder and kidney damage.

This process takes about 1 hour. At first, some kind of spinal anesthesia is induced. In this condition, you do not feel any pain even when you are not forced to a subconscious state. Sometimes general anesthesia is also used by surgeons, depending on the mental state of their patients.

Edited March 14, 2022 by fredscats

[Farmerslife]

27 minutes ago, xylophone said:

I can sympathise with you FL as I have been battling with the water retention problem and the catheter use now for over a year and more, and it has gotten to the point where I am seeking the possibility of a spinal implant, not as bad as it sounds! (I hope).

 

I found that the water retention would often give me a UTI (infection) and at first I thought it was me and my hygiene/cleanliness not being up to scratch, however the good doctor Charuspong, said that provided I washed my hands vigourously with soap and water prior to handling the catheter and so on, and that I stored it correctly/hygienically, everything should be okay, whereas the urine remaining in the bladder was the real problem.

 

Luckily enough I happened upon an old antibiotic called fosfomycin (sold as Monural here) and it comes in a packet of 3 g which one dissolves in water and swallows it immediately, and that's it, and it works extremely well.

 

Just to back that up I have also started taking a tablet called Hiprex, which is a urinary antiseptic that fights bacteria in the urine and bladder and you can take it on a daily basis and from having a UTI every two or three weeks initially, I haven't had one for a few months now.
 

Once again thank you for all the information. 

I think a year of water retention and constant catheter usage would send me over the edge. I hugely sympathise with you. Fortitude! 

The information on the retained water causing urinary infections is interesting because this episode of mine started with urinary tract infection. I will see if I can get hold of the Monural you mention.

Without wishing to pry, how many years ago did you have the TURP done and how long did it benefit you before your current problems arose?   

[Farmerslife]

11 minutes ago, fredscats said:

Best thing ever did TURP,asked for laser,no idea what is thrown up the backside for the op,accepted 40 minute procedure,but one and half hours it went on for,came to fine and dandy,its a gift really is,no more pi.ssing when you do not want to,and  pis.sing when you want to,everything OK. Should have been done years before

I glad for you. It sounds very encouraging.  May I ask where you had the operation performed? Was it here in Thailand? Any surgeon you can recommend? 

 

[fredscats]

2 minutes ago, Farmerslife said:

I glad for you. It sounds very encouraging.  May I ask where you had the operation performed? Was it here in Thailand? Any surgeon you can recommend? 

 

Ill send PM

[KannikaP]

On 3/9/2022 at 2:33 PM, xylophone said:

I bought a bottle of Swanson Stinging Nettle Root capsules, and have hardly used any

So how do you know if they work or not?

[xylophone]

13 minutes ago, KannikaP said:

So how do you know if they work or not?

Because it's the fifth or sixth bottle I have tried, and whereas others have said that they get almost immediate relief, I had no relief over the many months I tried them.

[KannikaP]

12 minutes ago, xylophone said:

Because it's the fifth or sixth bottle I have tried, and whereas others have said that they get almost immediate relief, I had no relief over the many months I tried them.

Sorry, you said you bought 'A' bottle. Did you try Saw Palmetto?

Edited March 14, 2022 by KannikaP

[xylophone]

25 minutes ago, Farmerslife said:

Without wishing to pry, how many years ago did you have the TURP done and how long did it benefit you before your current problems arose?   

No problems, and I am only too willing to share my experience with others in the same boat: –

 

It was around 2008/9 when I had the TURP done at the Epworth Hospital in Melbourne and was kept in for three days with an indwelling catheter to drain the bladder and flush out any debris that was left, as can often be the case with this type of operation.

 

After that I was discharged and less than two days later was rushed back into hospital feeling very unwell and unable to pee, so the emergency nurse inserted a catheter and drained out 1.5 L of urine, which was exceptional because a "full" bladder is supposed to be around 400 to 500 ml, so you can imagine how uncomfortable I felt.

 

The nurse then trained me on how to use the catheter on myself because she said that it was necessary to do this in some instances after the operation. So I did this for about two or three weeks as I recall and then I could do without it as I was able to pee without catheter assistance.

 

However I will add that since that time I have never been able to have a really strong and full stream of urine.

 

About nine years later I had a few UTIs and realised that my bladder wasn't emptying, so went to see a urologist at the hospital who suggested that I might have had some scar tissue at the bladder neck, which he could remove to make my life easier and that there would be no side effects.

 

I had the operation called a bladder neck incision, and even after that there was not a good urine stream and I encountered retrograde ejaculation to boot.

 

That leads on to a period of time around 18 months ago when the current problems arose and I started using a catheter shortly after, and have been doing it ever since, despite a couple of cystoscopies and other tests.

 

As I mentioned in a previous post I would gladly settle for the iTind or Urolift procedures had they been available then, but they weren't.

 

If you do some research on the outcomes of the TURP, you will find that there are some dissatisfied customers and it isn't always as straightforward as others would have you believe, or the medical profession come to that.
 

[xylophone]

29 minutes ago, KannikaP said:

Sorry, you said you bought 'A' bottle. Did you try Saw Palmetto?

I probably should have said "another bottle" because I'd had many beside the last one, which I have now posted to someone on this thread, so I hope they work for him, because they didn't for me.

 

And yes I tried Saw Palmetto, Pygeum, Selenium, Lycopene and just about every other herbal remedy I could buy, all to no avail I'm afraid. However it's important to remember that it appears it's not my prostate that's causing me the problems, just that the nerves in the bladder which control emptying, have ceased to function.

 

PS. I should add a rider to this post because even prior to having the TURP I had tried just about every natural remedy known to man, as well as tamsulosin/Flomax and perhaps one other, the name of which I cannot currently recall.

 

And none of them worked although the Flomax did have some affect.

Edited March 14, 2022 by xylophone

[fredscats]

13 hours ago, xylophone said:

Obviously you're playing the fool, because no one can be this dim in real life, surely?

 

Just to help you out a little (as you obviously need it), the iTind device is put in place, painlessly, for up to 7 days and then removed, and thus far there have been favourable results for up to 3 years for this procedure. It takes less than half an hour and one is all set for up to three years of effortless peeing.

 

The part of my post which you have reproduced, has nothing whatsoever to do with meatal stenosis, and if you had understood my post you would have known this, but then again it is difficult for some people to understand the basics, as you have proven.

 

My bladder has stopped working and it has nothing to do with a blockage anywhere, so please refrain from your inane comments on something you obviously know absolutely nothing about – – shortly to go on the "ignore list" I think.

Problem here is you are looking for quack remedies that do not work,they cost more too than the procedure that is required, the only one, reduction of the lump  the prostate.  Likened to a screaming banshee,even first hand reports of your latest venture ,the Israeli one are not forthcoming,just snake oiled salesmanship

 

Best thing I ever did TURP  no more hot stinking urine,awake all night pis.sing,no pills,no after effects that's dreamed up by punters of life after it,all smooth sailing

[Farmerslife]

xylophone and fredscats, thank you both for responding to my posts. 

You both have had very different experiences following on from your TURP procedures. 

I am only too well aware of the risks and possible side effects and, if I am to be honest, they frighten the hell out of me. The internet is awash with all sorts of horror stories but the actual medical outcome statistics tell a different story. Overall success rates are pretty high.

Both the urologists I have seen have stated that, if medication is not able to help me, they recommend a TURP. They have a great deal of knowledge and experience between them to call on and I accept their advice. I have largely discounted alternative procedures for a variety of reasons, suitability, efficacy, availability, cost etc.  

Once again thank you both for your openness and honesty.

 

 

 

[xylophone]

15 hours ago, Farmerslife said:

Once again thank you for all the information. 

As I have stated previously, now that there are possible alternatives available, I would gladly settle for trying one of those, before TURP surgery, and below are a couple of paragraphs from various medical websites which you may wish to consider: –

 

1). TURP is a major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having TURP. 

2). Your doctor may only consider A TURP for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a TURP.

Common side effects of TURP surgeries include:

-difficulty completely emptying the bladder
-urinary incontinence or leakage
-urinary urgency or the sudden urge to urinate
-discomfort during urination
-small dribbles or clots of blood in the urine, for up to 6 weeks
-possible retrograde ejaculation

As I have also mentioned previously a TURP is also considered the "gold standard" in dealing with prostate problems, however as you can see above it does not come free of potential side effects.

Also have a look at this from the Mayo Clinic...
https://www.mayoclinic.org/tests-procedures/turp/about/pac-20384880

 

Of course, if all of the other procedures are not suitable/fail, then perhaps TURP is your only option until something else comes along.
 

[xylophone]

7 minutes ago, Farmerslife said:

Both the urologists I have seen have stated that, if medication is not able to help me, they recommend a TURP.

Seems like you posted a few minutes before I posted my views, and as you say in general a TURP is safe, however in another medical journal I noticed that 48% of men encountered retrograde ejaculation after a TURP, which is something that my urologist never told me about.

 

There is something which is worthwhile remembering, and that is that a urologist/doctor will recommend a procedure with which he/she is familiar and can carry out, whereas the new procedures are only carried out by a few urologists at the moment, so they are not that well-known and are unlikely to be recommended.

 

I used to have an old saying about prostate/urinary problems, inasmuch as if you walked into the wrong room when looking for a urologist, and came across an orthopaedic surgeon, then that surgeon would recommend an orthopaedic procedure, irrespective of the fact you had prostate problems – – they specialise in what they know, and I know that because two good friends of mine in NZ are doctors (one also a surgeon) and my son is a doctor working in a major London Hospital.
 

[Farmerslife]

24 minutes ago, xylophone said:

Seems like you posted a few minutes before I posted my views, and as you say in general a TURP is safe, however in another medical journal I noticed that 48% of men encountered retrograde ejaculation after a TURP, which is something that my urologist never told me about.

 

There is something which is worthwhile remembering, and that is that a urologist/doctor will recommend a procedure with which he/she is familiar and can carry out, whereas the new procedures are only carried out by a few urologists at the moment, so they are not that well-known and are unlikely to be recommended.

 

I used to have an old saying about prostate/urinary problems, inasmuch as if you walked into the wrong room when looking for a urologist, and came across an orthopaedic surgeon, then that surgeon would recommend an orthopaedic procedure, irrespective of the fact you had prostate problems – – they specialise in what they know, and I know that because two good friends of mine in NZ are doctors (one also a surgeon) and my son is a doctor working in a major London Hospital.
 

Sadly, retrograde ejaculation is not something I am unfamiliar with following on from my treatment for bladder cancer a few years back.
Prostate cancer is now a concern of mine, although a biopsy three weeks ago thankfully showed that the tumour on my prostate was benign.

As for alternatives, I accept your point about a surgeon recommending something they are familiar with but I'd rather go with a tried and tested method than be a part of someone's learning curve on a comparatively new procedure. 

Good luck to you, it sounds as if you have really gone through the mill on this.

Regards

[xylophone]

15 minutes ago, Farmerslife said:

Sadly, retrograde ejaculation is not something I am unfamiliar with following on from my treatment for bladder cancer a few years back.
Prostate cancer is now a concern of mine, although a biopsy three weeks ago thankfully showed that the tumour on my prostate was benign.

As for alternatives, I accept your point about a surgeon recommending something they are familiar with but I'd rather go with a tried and tested method than be a part of someone's learning curve on a comparatively new procedure. 

Good luck to you, it sounds as if you have really gone through the mill on this.

Regards

Good luck to you also Farmerslife.

 

All the best,

 

Xylo

[fredscats]

On 3/15/2022 at 9:43 AM, Farmerslife said:

Sadly, retrograde ejaculation is not something I am unfamiliar with following on from my treatment for bladder cancer a few years back.
Prostate cancer is now a concern of mine, although a biopsy three weeks ago thankfully showed that the tumour on my prostate was benign.
 

The torment of BNP without doubt takes over your life,best thing ever TURP.

However if and when Id plump for a ward,not that its cheaper,but life goes on around you,unlike a semi/private room where ceiling staring comes the norm,wear shorts,the  tube from catheter to bag takes shorter route than wearing long (supplied) pjs,keep yourself regular,no straining

If large prostate,that will be some cutting back,may keep you more than 3 days Rember couple of surgeons coming to me back in room straight after op stating how life must have been so uncomfortable,it was huge

[Farmerslife]

5 minutes ago, fredscats said:

The torment of BNP without doubt takes over your life,best thing ever TURP.

However if and when Id plump for a ward,not that its cheaper,but life goes on around you,unlike a semi/private room where ceiling staring comes the norm,wear shorts,the  tube from catheter to bag takes shorter route than wearing long (supplied) pjs,keep yourself regular,no straining

If large prostate,that will be some cutting back,may keep you more than 3 days Rember couple of surgeons coming to me back in room straight after op stating how life must have been so uncomfortable,it was huge

Interesting point about being on a ward. Shared discomfort, perhaps? ???? 

Wearing shorts is sound advice

Cheers

 

[xylophone]

9 minutes ago, fredscats said:

The torment of BNP without doubt takes over your life

What is BNP, pray tell??