Prostate

[riclag]

5 hours ago, Farmerslife said:

Where's your usual optimism? 

 

" ....... extensive cutting ......"  

Jeez, I want them to reduce the size of my prostate, not disembowel me.???? Being eviscerated ain't on my list of things to do on turning 70.

If both the doctors that I have seen suggest a 3 day stay for after the operation should be adequate then I'll bow to their superior knowledge and anyway the more days in hospital the more expensive it becomes. 

 

  As for India? I know it works for you and that's great but it's a non-starter for me. I know next to nothing about the country and even less about its healthcare.

A 2 hour flight maybe, but by the time I had added on journeys at either end, booking in, clearing immigration etc I am looking at a good 6 hours or more. The prospect of doing this after an operation when I might need the toilet every 20 minutes, or perhaps with a catheter in place, fills me with dread. It just isn't practical for me.  

Please Please don’t encourage this kind of conversation! I come to this thread to see respectful advice !

 
I m struggling to use the ignore button 

[GarryP]

5 hours ago, Farmerslife said:

Where's your usual optimism? 

 

" ....... extensive cutting ......"  

Jeez, I want them to reduce the size of my prostate, not disembowel me.???? Being eviscerated ain't on my list of things to do on turning 70.

If both the doctors that I have seen suggest a 3 day stay for after the operation should be adequate then I'll bow to their superior knowledge and anyway the more days in hospital the more expensive it becomes. 

 

  As for India? I know it works for you and that's great but it's a non-starter for me. I know next to nothing about the country and even less about its healthcare.

A 2 hour flight maybe, but by the time I had added on journeys at either end, booking in, clearing immigration etc I am looking at a good 6 hours or more. The prospect of doing this after an operation when I might need the toilet every 20 minutes, or perhaps with a catheter in place, fills me with dread. It just isn't practical for me.  

Originally I was planning to get my treatment in the UK or Australia (covid permitting) but then I was lucky to get a discount package here in Thailand. In hindsight, I think I was very lucky for some of the very reasons you raise. I had a catheter fitted for 7 days and suffered urinary urgency for a while too post catheter. If I'd had to travel in that condition it would have been very uncomfortable/difficult. I think you are doing the right thing in getting the treatment here, unless you can stay overseas for a few months i.e. your home country, before returning to Thailand. Perhaps, you could find a Thai government hospital that provides the treatment that you need. I assume you are considering TURP. Just do your research on which gov't hospital the recommended surgeon works at. You'll find that a lot of very highly respected doctors work both at private and government hospitals here.   

[riclag]

@Farmerslife have you mentioned a cystoscopy to your dr or have they suggested this procedure prior to your surgery? Just asking.

Edited March 29, 2022 by riclag

[fredscats]

7 hours ago, Farmerslife said:

Where's your usual optimism? 

 

" ....... extensive cutting ......"  

Jeez, I want them to reduce the size of my prostate, not disembowel me.???? Being eviscerated ain't on my list of things to do on turning 70.

If both the doctors that I have seen suggest a 3 day stay for after the operation should be adequate then I'll bow to their superior knowledge and anyway the more days in hospital the more expensive it becomes. 

 

  As for India? I know it works for you and that's great but it's a non-starter for me. I know next to nothing about the country and even less about its healthcare.

A 2 hour flight maybe, but by the time I had added on journeys at either end, booking in, clearing immigration etc I am looking at a good 6 hours or more. The prospect of doing this after an operation when I might need the toilet every 20 minutes, or perhaps with a catheter in place, fills me with dread. It just isn't practical for me.  

Once the 3 day stay,or even 5 day stay is up catheter removed no more problems,you could I guess discharge yourself after 3 days,its only for observation,as long as someone to empty bag.

  Probably get a heavy bleed for a few mins after discharge,no panic,just drink lots of water.  You wont need any luck..smooth as silk...just get on with it      All the Best

[fredscats]

Was a good idea from Mr Rezum himself,approach your local govt hospital,or even Chula in BKK,as a private patient, would they do this procedure?   might get them to drop their phones anyway

 

I had to as I did not follow instructions to catheterise myself for 10 days after discharge,probably have told me to get back there Do not get blockage,it hurts like hell

[Farmerslife]

16 hours ago, riclag said:

@Farmerslife have you mentioned a cystoscopy to your dr or have they suggested this procedure prior to your surgery? Just asking.

I had both a flexible and a rigid cystoscopy when I had bladder cancer. The flexible one was a breeze but the rigid one went horribly wrong and I bled like a stuck pig for 8 days after.

 I'm in no hurry to repeat the experience.

 

[Farmerslife]

17 hours ago, GarryP said:

Originally I was planning to get my treatment in the UK or Australia (covid permitting) but then I was lucky to get a discount package here in Thailand. In hindsight, I think I was very lucky for some of the very reasons you raise. I had a catheter fitted for 7 days and suffered urinary urgency for a while too post catheter. If I'd had to travel in that condition it would have been very uncomfortable/difficult. I think you are doing the right thing in getting the treatment here, unless you can stay overseas for a few months i.e. your home country, before returning to Thailand. Perhaps, you could find a Thai government hospital that provides the treatment that you need. I assume you are considering TURP. Just do your research on which gov't hospital the recommended surgeon works at. You'll find that a lot of very highly respected doctors work both at private and government hospitals here.   

The urologist that I have seen in Bangkok privately does work at Chulalongkorn Hospital and I did attempt to see her there but despite arriving at 6:45am the place was utterly besieged. I waited for over 4 hours just to make an appointment to see her but eventually gave up. 

 With the benefit of hindsight, I probably should have stuck it out until I could make an appointment but it was the morning following my visit overnight to the ER to deal with my water retention and I wasn't at my best.

Edited March 30, 2022 by Farmerslife
Missing word

[fredscats]

11 minutes ago, Farmerslife said:

The urologist that I have seen in Bangkok privately does work at Chulalongkorn Hospital and I did attempt to see her there but despite arriving at 6:45am the place was utterly besieged. I waited for over 4 hours just to make an appointment to see her but eventually gave up. 

 With the benefit of hindsight, I probably should have stuck it out until I could make an appointment but it was the morning following my visit overnight to the ER to deal with my water retention and I wasn't at my best.

Should have sought out a private appointment,money does talk

[fredscats]

1 hour ago, Farmerslife said:

The urologist that I have seen in Bangkok privately does work at Chulalongkorn Hospital and I did attempt to see her there but despite arriving at 6:45am the place was utterly besieged. I waited for over 4 hours just to make an appointment to see her but eventually gave up. 

 With the benefit of hindsight, I probably should have stuck it out until I could make an appointment but it was the morning following my visit overnight to the ER to deal with my water retention and I wasn't at my best.

All these procedures just makes me want to spit, I know you do not want to go,but early morning arrival flight,diagnose,testing/operation all same day probably,at a quarter of the price given here.

Put a diaper on to hide symptoms,once operation done,catheter removed there are no more urgency/leakages,its all finished

[Dart12]

On 3/17/2022 at 11:58 AM, BritManToo said:

I take tablets once a day, 1 tablet (2mg) is enough at the moment.

The 5mg Finesteride (every other day) after 2 years seems to have rolled me back to nearly normal.

I'm too cheap to pay more than 1bht/tablet, Tamsulosin is too expensive for me.

Curious...how long after you first started this regiment did it take to see/feel results?   a week?  a month?

[BritManToo]

17 minutes ago, Dart12 said:

Curious...how long after you first started this regiment did it take to see/feel results?   a week?  a month?

Nearly 2 years ......... down to 1mg of Doxazosin + 5mg Finasteride every other night now.

[Dart12]

3 minutes ago, BritManToo said:

Nearly 2 years ......... down to 1mg of Doxazosin + 5mg Finasteride every other night now.

It took 2 years of med taking before you finally felt better?    I got that right?

**what dosage did they start you off at initially ( If it's ok to ask)?

[BritManToo]

Just now, Dart12 said:

It took 2 years of med taking before you finally felt better?    I got that right?

**what dosage did they start you off at initially ( If it's ok to ask)?

6mg Doxazosin every night (after 6 weeks acclimatisation with catheter).

But I could wee directly the catheter was removed, and after 2 years I could start reducing the dosage without losing the ability to wee. Finasteride takes time to reduce the prostate size (if it works for you).

[Dart12]

17 minutes ago, BritManToo said:

6mg Doxazosin every night (after 6 weeks acclimatisation with catheter).

But I could wee directly the catheter was removed, and after 2 years I could start reducing the dosage without losing the ability to wee. Finasteride takes time to reduce the prostate size (if it works for you).

Oh, you got almost completely stopped up and had to be hospitalized before you got on meds?

or are the meds useless before a treatment with the catheter (god that word scares me haha).

 

[BritManToo]

1 minute ago, Dart12 said:

Oh, you got almost completely stopped up and had to be hospitalized before you got on meds?
or are the meds useless before a treatment with the catheter (god that word scares me haha).

You can't take 6mg of Doxazosin from the get go ....... your body needs to get used to it until the dosage is enough to work. So they start you off on 2mg, then 2 weeks later 4mg, etc.

[Dart12]

13 minutes ago, BritManToo said:

You can't take 6mg of Doxazosin from the get go ....... your body needs to get used to it until the dosage is enough to work. So they start you off on 2mg, then 2 weeks later 4mg, etc.

I did read that online.  started at 1 mg week w1. 

 

thank you for taking the time to share this helpful Info BritManToo

[hgma]

On 3/28/2022 at 9:16 AM, Farmerslife said:

Believe you me, you will know when your turn comes. 

There is nothing imaginary about acute water retention.

I had mild intrusion (cancer)in 2018  Gleason 6 + 6   radiology in Khon Kaen * 40 treats @ 5.600 bath    ..... PSA now ,0.03.....normal pee

Edited March 30, 2022 by hgma

[simple1]

4 hours ago, hgma said:

I had mild intrusion (cancer)in 2018  Gleason 6 + 6   radiology in Khon Kaen * 40 treats @ 5.600 bath    ..... PSA now ,0.03.....normal pee

Given you're still having PSA count I assume you're being monitored on a regular basis. Have you been prescribed medication to slow the cancer reoccuring e.g. Lucrin. I was on on Lucrin for six years, but now have come out of remission, will be having PET scan next month and likely require radiation.

[hgma]

8 hours ago, simple1 said:

Given you're still having PSA count I assume you're being monitored on a regular basis. Have you been prescribed medication to slow the cancer reoccuring e.g. Lucrin. I was on on Lucrin for six years, but now have come out of remission, will be having PET scan next month and likely require radiation.

No No meds, no hormones nothing, and yes,  monitored every 6 month's

[Farmerslife]

This is a serious thread as we all know but I stumbled across this today and it had me in tears

 

Laughter is the best medicine.

[Boomer6969]

On 3/31/2022 at 1:14 AM, hgma said:

I had mild intrusion (cancer)in 2018  Gleason 6 + 6   radiology in Khon Kaen * 40 treats @ 5.600 bath    ..... PSA now ,0.03.....normal pee

Was Gleason 6 (3+3). Otherwise you would have been given hormone therapy. But on the other hand with Gleason 6 Active Surveillance could have been an option. What was your PSA, and how many cores of your biopsy showed cancer?

[Sparktrader]

On 4/8/2022 at 11:11 PM, Farmerslife said:

This is a serious thread as we all know but I stumbled across this today and it had me in tears

 

Laughter is the best medicine.

Genius

[ThaiPauly]

On 3/19/2022 at 4:04 PM, xylophone said:

You could always contact the manufacturer and see if/when it could be available here in Thailand, however as I said previously I had no other choice than to have a TURP, even though I wasn't keen on major surgery and all of the potential side effects.

 

I travelled from Phuket to Melbourne to have the operation done in the highly rated Epworth Hospital, but as you have probably gathered, it wasn't smooth sailing then, and hasn't been for more than a decade afterwards.

Not only did I have to wear an indwelling catheter and bag for more than a week after the operation, I then had to use a catheter for another week or more before I could do without it.

 

Fast forward eight years or so, and because I was getting regular UTIs I went to see the urologist here (Phuket) who did yet another cystoscopy and said that there was scar tissue round my bladder neck, as a result of the original TURP, and that was causing a problem and needed to be removed.

 

I asked if there were any side effects and he said no, so we went ahead and did it, and retrograde ejaculation was the outcome and the urine stream was still very average.

 

Go forward another two years and urine retention was causing me some more UTIs, so another cystoscopy and the problem couldn't be found. However, a top urologist in Bumrungrad has determined that my bladder has stopped working, and an implant may be necessary to get it working again.

 

What I'm getting at here is that all of what I have described above is as a result of a TURP, and although some of the damage was done due to stretching my bladder in the past because I put off emptying it, a great deal of it was also done from the TURP onwards because of urine retention and the bladder stretching.

 

Anyone who has had urine retention/bladder problems for more than a few years will have almost certainly stretched their bladder, which can make it "lazy" (underactive bladder syndrome) so although a TURP may seem to be the ultimate solution, it may not be.

 

Hence the reason I have recommended on this thread that folks try other, less invasive and reversible procedures, because once a TURP has been carried out, there is no turning back. It is determined as being "major surgery".

 

And one thing that really did surprise me was that "between half and three-quarters of men have permanent problems with ejaculation after a TURP. Although it is not life threatening, it can cause infertility in couples and can change was the sexual experience for men. Furthermore urinary or bowel incontinence can also result".

I'm not trying to be a pessimist, but I have experienced most of the above, and although another poster "fredscats" has had good results from a TURP, my experience is at the other end of the spectrum, so IMO I would try anything before settling on the TURP, even if it meant travelling overseas.
 

Same here  as you are of course aware of X.

Nothing but trouble since my TURP

Urethral Stricture from the damage done during the operation will probably mean that I will have to have repeat operations as the scar hardens four the rest of my life unless I go for a urethaplasty where they replace damaged tissue with tissue from inside your mouth. The cost is astronomical as is the pain and discomfort I would imagine.

I still suffer incontinence  since my last operation in December and have ED, when it's possible I have a retrograde ejaculation that is often painful.

I had my initial TURP in 2019 and wish I had gone in another direction 

[xylophone]

11 hours ago, ThaiPauly said:

Same here  as you are of course aware of X.

Nothing but trouble since my TURP

Urethral Stricture from the damage done during the operation will probably mean that I will have to have repeat operations as the scar hardens four the rest of my life unless I go for a urethaplasty where they replace damaged tissue with tissue from inside your mouth. The cost is astronomical as is the pain and discomfort I would imagine.

I still suffer incontinence  since my last operation in December and have ED, when it's possible I have a retrograde ejaculation that is often painful.

I had my initial TURP in 2019 and wish I had gone in another direction 

Hi TP,

Yes I am very aware of the problems you have had after your TURP and feel very sorry for you for what you have gone through as a result of the operation.

 

You mentioned the scar tissue, and I believe that's what caused my problem with urine retention a few years after the original TURP, and why I had to have a bladder neck incision operation, which also caused problems because of water retention, which I'm pretty sure has led to the current situation whereby I cannot empty my bladder – – so a catalogue of medical problems ever since the original TURP.

 

As I have said on this thread on a number of occasions, surgery like the TURP should be a last resort, especially with all of the other procedures/options available now, and I would move heaven and earth to be able to have access to those procedures if I were in a position of needing them now.

 

Sure, there would be many people out there who have had a successful TURP, but why have what is considered "major" surgery, with all its risks, when other non-invasive/less invasive procedures are now in play.

 

I do hope you are finding some relief TP, and I send you my best wishes.
 

[hgma]

On 4/17/2022 at 3:03 PM, Boomer6969 said:

Was Gleason 6 (3+3). Otherwise you would have been given hormone therapy. But on the other hand with Gleason 6 Active Surveillance could have been an option. What was your PSA, and how many cores of your biopsy showed cancer?

*naturally ) Gleason 3 + 3  not 6 + 6 (sorry)  PSA 9. 7 and 4 cores infected, on surveillance 6 years with 1 TURP yet negative all the time  then game the fourth biopsy with this result 

[Farmerslife]

I saw my urologist in Bangkok the other week.  She spoke very frankly.

 She thinks I may have some nerve damage that could be exacerbated further by surgery to reduce the prostate and might lead to me seeing out the rest of my days needing fairly regular medical intervention. 

 Given that bleak assessment, I am set on continuing my pill-popping habit until such time as it no longer works for me, whether that be a few months or a few years, I have no idea. 

 

 On her advice I have given up with the Prostagutt as it didn't seem to do anything for me anyway, other than make urinating somewhat of an uncomfortable experience. I am now just taking Duodart which is a combined pill of Dutasteride and Tamsulosin.  

 

 It has taken nearly 3 months since my acute water retention episode but matters have improved very gradually until now. I am getting a quite reasonable stream, probably the best for several years. I still need more trips to toilet than I would like and I don't think I will ever empty my bladder fully but, in comparison with the start of this year, I am relatively happy.

 

This is, probably, not the end of the story but it is where I am at currently.  

 

 

[simple1]

13 minutes ago, Farmerslife said:

I saw my urologist in Bangkok the other week.  She spoke very frankly.

 She thinks I may have some nerve damage that could be exacerbated further by surgery to reduce the prostate and might lead to me seeing out the rest of my days needing fairly regular medical intervention. 

 Given that bleak assessment, I am set on continuing my pill-popping habit until such time as it no longer works for me, whether that be a few months or a few years, I have no idea. 

 

 On her advice I have given up with the Prostagutt as it didn't seem to do anything for me anyway, other than make urinating somewhat of an uncomfortable experience. I am now just taking Duodart which is a combined pill of Dutasteride and Tamsulosin.  

 

 It has taken nearly 3 months since my acute water retention episode but matters have improved very gradually until now. I am getting a quite reasonable stream, probably the best for several years. I still need more trips to toilet than I would like and I don't think I will ever empty my bladder fully but, in comparison with the start of this year, I am relatively happy.

 

This is, probably, not the end of the story but it is where I am at currently.  

 

 

Something to be aware of...

 

Men taking DUODART should be regularly evaluated for prostate cancer risk including PSA testing.

 

https://gskpro.com/content/dam/global/hcpportal/en_NG/PDF/Home/therapies/Urology/Duodart_IPI.pdf

[Farmerslife]

15 minutes ago, simple1 said:

Something to be aware of...

 

Men taking DUODART should be regularly evaluated for prostate cancer risk including PSA testing.

 

https://gskpro.com/content/dam/global/hcpportal/en_NG/PDF/Home/therapies/Urology/Duodart_IPI.pdf

Yes, Dr. Umaphorn recommends I get myself tested every 6 months.

[xylophone]

38 minutes ago, Farmerslife said:

It has taken nearly 3 months since my acute water retention episode but matters have improved very gradually until now. I am getting a quite reasonable stream, probably the best for several years.

So pleased to hear that "matters have improved very gradually" for you, and who knows, that they may continue to do so, slowly but surely.

 

From not being able to empty my bladder at all, to using a catheter three times a day, then gradually lowering that until I only had to use it twice a day, and now I can get by with once-a-day – – in the main.

 

Occasionally I can manage to squeeze out some urine, which alleviates me having to use the catheter all of the time, so I'm hoping that any slight improvement continues, so keep your fingers crossed FL, and good luck to you.

[Farmerslife]

6 minutes ago, xylophone said:

So pleased to hear that "matters have improved very gradually" for you, and who knows, that they may continue to do so, slowly but surely.

 

From not being able to empty my bladder at all, to using a catheter three times a day, then gradually lowering that until I only had to use it twice a day, and now I can get by with once-a-day – – in the main.

 

Occasionally I can manage to squeeze out some urine, which alleviates me having to use the catheter all of the time, so I'm hoping that any slight improvement continues, so keep your fingers crossed FL, and good luck to you.

Thank you. I too hope you are able to continue to make some progress. 

 

You have suffered a great deal worse than I have. I know ultimately that you have no choice in these matters but I am not sure that I would have your strength. To have to constantly use a catheter is a burden I would struggle to manage.