Prostate

[Doctor Tom]

Just a few points that sometimes gets missed in all these discussions. It is far from inevitable that an enlarged prostate will cause bad things to happen later on.  It is far from inevitable that frequent peeing is anything more than a natural process of aging and is not indicative of serious issues now or later.  It is not inevitable that an enlarged prostate at some point will lead to cancer.  It is very far from the truth that modern, lab originating medicines are always a good thing to throw into your body. We older folk can sometimes get a bit paranoid about what is going to get us at some point and terminate our life.  Sure, something will at some point, but I sometimes think that worrying about all the myriad of things that people die of can contribute to accelerating the process. Just a view. 

[riclag]

40 minutes ago, BritManToo said:

What medication are you taking?

Doxazocin has sorted me right out, although I do need to vary the dosage a little.

2 pills, 2.5 pills, 3 pills (2mg/pill) depending on how it worked the previous day.

finasteride 1 pill  5mg

doxazosin 2 pills   2mg ,

Been doing this ,every day for 8 years

I haven't been to the urologist , since one year ago. At that time ,according to him, it was large .My Psa was 1.75

Edited August 21, 2021 by riclag

[xylophone]

2 minutes ago, riclag said:

finasteride 1 pill  5mg

doxazosin 2 pills   2mg ,

Been doing this ,every day for 8 years

I noticed that BritManToo has mentioned doxazosin as a treatment, and it can work, mainly because it relaxes the muscles in the prostate and bladder, thereby allowing urine to flow more easily, but for many people it is only a temporary measure.

 

If the prostate has become so large that it blocks the prostatic urethra, thereby restricting urine flow, then surgery is perhaps the only remedy, and because we live in Thailand, the TURP (or the equivalent by greenlight laser) is the only option we have, although as I said previously I would opt for the Urolift if it was here – – – but having said that, I have found out that it is available in Dubai and Singapore, if one could get there.

 

I was thinking of going, but the problem I seem to have now is that I cannot pass any water whatsoever so I'm having to self catheter three times a day, and have been doing this for about a month, despite having ultrasound and a cystoscopy, and nothing showed up, although I was rather hoping it was the prostate growing again so that I could get it fixed, but apparently it's not.

 

The urologist called it neurogenic bladder, which for some reason means that the nerves in the bladder wall and signals from the brain are not coordinating to allow the bladder to empty, so I have got more research to do, because the urologist here doesn't know what has caused it! Doesn't give me much hope.

 

If you can see a good urologist, he will be able to recommend a course of action and will know whether more/other meds will do the trick, or if an operation is necessary (only just seen your post re the meds).
 

[BritManToo]

5 minutes ago, riclag said:

finasteride 1 pill  5mg

doxazosin 2 pills   2mg ,

Been doing this ,every day for 8 years

I haven't been to the urologist , since one year ago. At that time ,according to him, it was large .My Psa was 1.75

Nothing to stop you upping the Doxazocin by 1/2 to 1 pill, see if it eases things.

I only take Finasteride 5mg every other day, as a study showed daily and alternate days didn't produce a significant difference in results.

[riclag]

5 minutes ago, xylophone said:

I noticed that BritManToo has mentioned doxazosin as a treatment, and it can work, mainly because it relaxes the muscles in the prostate and bladder, thereby allowing urine to flow more easily, but for many people it is only a temporary measure.

 

If the prostate has become so large that it blocks the prostatic urethra, thereby restricting urine flow, then surgery is perhaps the only remedy, and because we live in Thailand, the TURP (or the equivalent by greenlight laser) is the only option we have, although as I said previously I would opt for the Urolift if it was here – – – but having said that, I have found out that it is available in Dubai and Singapore, if one could get there.

 

I was thinking of going, but the problem I seem to have now is that I cannot pass any water whatsoever so I'm having to self catheter three times a day, and have been doing this for about a month, despite having ultrasound and a cystoscopy, and nothing showed up, although I was rather hoping it was the prostate growing again so that I could get it fixed, but apparently it's not.

 

The urologist called it neurogenic bladder, which for some reason means that the nerves in the bladder wall and signals from the brain are not coordinating to allow the bladder to empty, so I have got more research to do, because the urologist here doesn't know what has caused it! Doesn't give me much hope.

 

If you can see a good urologist, he will be able to recommend a course of action and will know whether more/other meds will do the trick, or if an operation is necessary (only just seen your post re the meds).
 

Sorry to hear that about you not passing water ! Do you think it might have something to do with your turp procedure years ago?

For me I have tried other medicines over the years ,these 2 that I mention have been the best out of all of them and they are very affordable here

[riclag]

4 minutes ago, BritManToo said:

Nothing to stop you upping the Doxazocin by 1/2 to 1 pill, see if it eases things.

I only take Finasteride 5mg every other day, as a study showed daily and alternate days didn't produce a significant difference in results.

555 I was just going to ask you about that !

The Urologist I see up here in Sakon Nakhon says I shouldn't up  it and that 4 mg per day was the max! I tried the skipping method and I noticed the flow and pressure was more discomforting 

Edited August 21, 2021 by riclag

[greeneking]

1 hour ago, riclag said:

Hi ,What ever became of your search for a prostate procedure in Thailand  ?

Thanks

If anybody has some recent experiences with procedures since this thread started, I would be very interested! 

 

I'm also getting at the point like someone is stepping on a  garden hose  because of the  enlargement ! 

 

 

Of interest to me too and I wondered about the cost if I went back to the UK for a while. A quick Google search gave me this:

Having Rezum treatment privately.

For self funding patients, the procedure costs in the region of £4100- £5700, depending on where you have the procedure.

[BritManToo]

Just now, riclag said:

555 I was just going to ask you about that !

The Urologist I see up here in Sakon Nakhon says I shouldn't up  it and that 4 mg per day was the max

8mg is the maximum dose according to Dr. Google.

I often take 3 pills/day but after a while they seem to accumulate, my BP gets a bit low and I feel a little faint in the morning. So I back off to 2.5 (or 2) pills/day for a while. Then it gets harder to wee, so back to 3 pills/day.

[riclag]

13 minutes ago, xylophone said:

I noticed that BritManToo has mentioned doxazosin as a treatment, and it can work, mainly because it relaxes the muscles in the prostate and bladder, thereby allowing urine to flow more easily, but for many people it is only a temporary measure.

 

If the prostate has become so large that it blocks the prostatic urethra, thereby restricting urine flow, then surgery is perhaps the only remedy, and because we live in Thailand, the TURP (or the equivalent by greenlight laser) is the only option we have, although as I said previously I would opt for the Urolift if it was here – – – but having said that, I have found out that it is available in Dubai and Singapore, if one could get there.

 

I was thinking of going, but the problem I seem to have now is that I cannot pass any water whatsoever so I'm having to self catheter three times a day, and have been doing this for about a month, despite having ultrasound and a cystoscopy, and nothing showed up, although I was rather hoping it was the prostate growing again so that I could get it fixed, but apparently it's not.

 

The urologist called it neurogenic bladder, which for some reason means that the nerves in the bladder wall and signals from the brain are not coordinating to allow the bladder to empty, so I have got more research to do, because the urologist here doesn't know what has caused it! Doesn't give me much hope.

 

If you can see a good urologist, he will be able to recommend a course of action and will know whether more/other meds will do the trick, or if an operation is necessary (only just seen your post re the meds).
 

The Uro up here has done a turp for a friend of mine and he swears by him !

His English is so so,which is a plus and he has done many procedures !

I have been visiting him for  six years now

I wanted to avoid the turp and go with a newer method but from what I'm reading nothing has changed here! The only other alternative is another country for a less invasive style. 

[riclag]

9 minutes ago, greeneking said:

Of interest to me too and I wondered about the cost if I went back to the UK for a while. A quick Google search gave me this:

Having Rezum treatment privately.

For self funding patients, the procedure costs in the region of £4100- £5700, depending on where you have the procedure.

Wow that comes to roughly 5 to 7 k in dollars ! Thats a lot !

I could swing it and I like the idea of the Rezum! But I don't know if they consider the size of the pesky walnut. I know from reading a large walnut restricts some procedures !

 

[riclag]

15 minutes ago, BritManToo said:

8mg is the maximum dose according to Dr. Google.

I often take 3 pills/day but after a while they seem to accumulate, my BP gets a bit low and I feel a little faint in the morning. So I back off to 2.5 (or 2) pills/day for a while. Then it gets harder to wee, so back to 3 pills/day.

I might try 3 doxazosin at 2 mg  and see if that helps the garden hose effect.

[riclag]

I have put off this procedure cause I'm not comfortable with the Turps procedure and didn't want to go any where near a hospital until I get 2 shots of the vacc!

I'm going Monday for my first shot of Pfizer and probably the second in September! So it looks like my options are starting in October!

Oh well just thought I'd ask about others experiences  and updates with a enlarged Prostate

Thanks

Edited August 21, 2021 by riclag

[kimamey]

1 hour ago, BritManToo said:

What medication are you taking?

Doxazocin has sorted me right out, although I do need to vary the dosage a little.

2 pills, 2.5 pills, 3 pills (2mg/pill) depending on how it worked the previous day.

I've recently been having these problems and Doxazosin wasn't mentioned as a solution but the fact I was already taking it for hypertension meant the consultant urologist advised against Tamsulosin. I'm on 5mg a day The other option of Finasteride apparently comes with the side affect of erectile dysfunction so they wouldn't use it at my age (67).

[BritManToo]

Just now, kimamey said:

I've recently been having these problems and Doxazosin wasn't mentioned as a solution but the fact I was already taking it for hypertension meant the consultant urologist advised against Tamsulosin. I'm on 5mg a day The other option of Finasteride apparently comes with the side affect of erectile dysfunction so they wouldn't use it at my age (67).

Finasteride MAY cause erectile dysfunction ........ doesn't seem to have any negative effect on me.

It doesn't do anything to help you wee, but it MAY prevent (or retard) further prostate growth.

[xylophone]

1 hour ago, riclag said:

Sorry to hear that about you not passing water ! Do you think it might have something to do with your turp procedure years ago?

For me I have tried other medicines over the years ,these 2 that I mention have been the best out of all of them and they are very affordable here

Thanks for your good wishes, however I don't think it has anything to do with my TURP procedure of many years ago, because it was over 10 years ago and I was peeing fine until about a month or so ago, and I don't know what has caused this, and nor does the urologist, however I think it's a different situation with regards to what you are experiencing now.

 

The meds like doxazosin and others will relax the prostate and bladder muscles, however the overriding situation is that your prostate is enlarging, and the meds probably won't stop that, just ease the situation with it, until it becomes basically unmanageable.

 

As I said earlier, if my situation was purely about the prostate enlarging, and thereby restricting the urine flow, then my first option would be the Urolift, even if it meant going to the likes of Dubai (or Australia, or the USA) to have it done, and the universally tried and trusted procedure of the TURP would be the next option (again).

 

In the main the TURP operation works for the vast majority of men, with just a few experiencing some side-effects, and retrograde ejaculation is probably the main one (in a small percentage of men I may add), however it doesn't stop the "enjoyment" of sex, it just means that the semen flows back into the bladder rather than out of the end of the penis, which doesn't feel any different, but is less messy!!

 

As for me, well I'm searching for ways and means to get the bladder working again, but it's a long hard road at the moment. I would be happy if it was just a prostate problem, but it doesn't seem to be.
 

[xylophone]

On 11/7/2020 at 6:55 PM, jonwilly said:

I mentioned 2 Brits have spoken well of the Steam treatment.

That's good to know, but from all of the research I've done I would go with the Urolift procedure, IF it was my prostate playing up!

[thaibeachlovers]

On 11/8/2020 at 3:47 PM, MrBrad said:

Death being the worst result, what can go wrong with this kind of surgery?  Please give some possible negative results.  Thanks.

Assuming you mean full prostate removal

incontinence

impotence

anal to urethral fissure ( unlikely with straightforward surgery )

elephantiasis caused by follow up radiation ( I refused radiation because of that possibility )

ongoing weakness ( I had several months off work after )

possible retention caused by the scar tissue occluding the urethra ( I had to go back for a second go because of that ).

 

If I had the opportunity to go back in time I'd have the green lazer and hormones. If that didn't work and I died, I might have been been better off.

 

[thaibeachlovers]

19 hours ago, Doctor Tom said:

Just a few points that sometimes gets missed in all these discussions. It is far from inevitable that an enlarged prostate will cause bad things to happen later on.  It is far from inevitable that frequent peeing is anything more than a natural process of aging and is not indicative of serious issues now or later.  It is not inevitable that an enlarged prostate at some point will lead to cancer.  It is very far from the truth that modern, lab originating medicines are always a good thing to throw into your body. We older folk can sometimes get a bit paranoid about what is going to get us at some point and terminate our life.  Sure, something will at some point, but I sometimes think that worrying about all the myriad of things that people die of can contribute to accelerating the process. Just a view. 

Obviously, one should have cancer confirmed by biopsy BEFORE considering surgery. Never go just by the test.

[xylophone]

On 11/8/2020 at 9:47 AM, MrBrad said:

Death being the worst result, what can go wrong with this kind of surgery?  Please give some possible negative results.  Thanks.

Despite an increasing age (55% of patients are older than 70), the associated morbidity of TURP maintained at a low level (<1%) with a mortality rate of 0-0.25%. The major late complications are urethral strictures (2.2-9.8%) and bladder neck contractures (0.3-9.2%). The retreatment rate range is 3-14.5% after five years.

 

Conclusions: TURP still represents the gold standard for managing benign prostatic hyperplasia with decreasing complication rates. Technological alternatives such as bipolar and laser treatments may further minimize the risks of this technically difficult procedure.

Edited August 22, 2021 by xylophone

[thaibeachlovers]

On 11/8/2020 at 4:05 PM, BritManToo said:

The usual side effects are impotence, and incontinence.

Both appear to be very common, from speaking with people who have had a TURP.

But I know one guy living near me, who claims no side effects after having it done at McCormick hospital in Chiang Mai.

 

Post op impotence depends on the skill of the surgeon. If they manage to spare the nerves one may be able to have an orgasm, even if never get hard again.

 

If not able to spare the nerves, game over.

[xylophone]

I did post this before but here it is again for those who may not have seen it..........it is a really good video on prostate surgery and options.

 

 

 

[thaibeachlovers]

On 11/19/2020 at 9:19 PM, Boomer6969 said:

Incontinence and/or impotence. Is that enough?

No, there are worse possible side effects that MIGHT happen. Fancy elephantiasis in your leg?

Google side effects of radiation post prostate surgery.

[xylophone]

There are very different potential outcomes between a TURP and having a prostate removed.

 

The extract below shows that there is a very small percentage of men who suffer from the side-effects of TURP surgery, whereas prostate removal surgery is a whole different ballgame, and therein lies the problem because impotence and incontinence can result, but with "nerve sparing" surgery done by an experienced surgeon the chances of these side-effects are lessened somewhat.

 

Unfortunately before the da Vinci machine came to be, prostate removal was a bit of a lottery and many men suffered because of it. Nowadays it's a better option using that machine, but I think we are confusing two separate subjects, one being the treatment for BPH with a TURP or similar, and one for prostate removal. 

 

Conclusions: TURP had no negative impact on erectile function in contrast to ejaculatory function. Of the 109 patients with good erectile function in pre-TURP, 5.8% reported a worsening of erectile function after TURP. Among the 136 patients with ED moderate/mild pre-TURP 3.7% reported a worsening in the post-TURP, 16.2% reported an improvement, while 9.5% stopped any sexual activity. In 3.7% of the cases a complete ED was reported after TURP, while a decline of libido and sexual satisfaction was detected in all patients with worsening of sexual function. Retrograde ejaculation was observed in 48% of those sexually active after TURP. Particular attention has to be paid to the psychological aspects, both before surgery and in the postoperative period, which may become an important factor in the decline of sexual activity.

 

https://pubmed.ncbi.nlm.nih.gov/25847889/

[BritManToo]

10 minutes ago, xylophone said:

The extract below shows that there is a very small percentage of men who suffer from the side-effects of TURP surgery,

About 40% ...... small, as in less than 50%.

But I wonder how many of the old guys actually reported impotence, as most of them wouldn't have anyone to do it with.

[elektrified]

By about the middle of next year, the Rezum steam treatment will be available at BNH Hospital. Supposedly another treatment is already available at BNH, the name of which escapes me. They install a device into the urethra and then remove it several days later. I believe the cost is 130,000 Baht.

[jonwilly]

BNH which hospital is this ?

 

john

[jonwilly]

Too answer my own question,

https://www.bnhhospital.com/contact-us/

 

BKK hospital. Saving up my Baht.

 

john

[riclag]

10 hours ago, thaibeachlovers said:

Post op impotence depends on the skill of the surgeon. If they manage to spare the nerves one may be able to have an orgasm, even if never get hard again.

 

If not able to spare the nerves, game over.

Good luck to get a commitment that they won't cause nerve damage !

 

 

[thaibeachlovers]

18 hours ago, BritManToo said:

About 40% ...... small, as in less than 50%.

But I wonder how many of the old guys actually reported impotence, as most of them wouldn't have anyone to do it with.

LOL. Part of post op recovery from prostate surgery is masturbation ( obviously not straight away ), at least that's what the female surgeon that did my op told me to do. In any event, Cialis came to the rescue for me when I returned to LOS.

[thaibeachlovers]

8 hours ago, riclag said:

Good luck to get a commitment that they won't cause nerve damage !

 

 

NO competent surgeon would ever commit to anything like that. No one can guarantee a perfect operation, which is why we have to sign the consent form pre op.