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jonwilly

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On 11/20/2021 at 12:18 AM, elektrified said:

John, the Finasteride takes 5-6 months or more to work so doubtful you will feel any relief in a month. And I would recommend Alfuzosin over Doxazosin. Alfuzosin is 3rd generation and time-released over 24 hours. It does not lower your blood pressure like Doxazosin does.

That's true but the drugs you mentioned are expensive ....... and not available at the government hospital.

I can live with a BP of 100/70, it doesn't seem to harm me.

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  • 3 months later...

Anybody got any recent prostate experiences to share ? Its been almost 4 months!

My urologist up here in Sakon Nakhon suggested to come back next year for a follow up! 69 yrs old,Psa ,0.93 ,large prostate  about the size of 50 grams im told by the ultrasound doctor.

Unfortunately he only does TURP the gold standard.

Im very much open for a less invasive procedure . PAE sounds promising but I have to look if hospitals here offer it!

 

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4 hours ago, xylophone said:

My experiences are related to prostate, and associated problems, so I will post here, although I think I've also posted on another prostate/rezum thread, but anyway here goes.

 

I have just come back from Bumrungrad Hospital after going there for some treatment and I was very impressed with it, because it is a very well run hospital with excellent staff, and whilst I was waiting for my procedure, I noticed a very large cardboard cutout "advertisement" for Rezum treatment of the prostate, so they are now using that procedure at Bumrungrad.

 

I have to thank @Sheryl for her recommendation of Dr Charuspong Dissaraan, because he is excellent and as she stated in another post, has an excellent "bedside manner", explains things in great detail/fully and seems a very caring doctor. So I also highly recommend him.

 

As for me, well I eventually bit the bullet and went to this hospital to try and sort out my problems of not being able to pee, because it was wearing me down having to use a catheter and get up around five times a night to try to empty the bladder, but to no avail on many occasions, although I didn't use the catheter every time, just stood there pointing Percy at the porcelain, all to no avail.

 

After a first consultation with Dr Charuspong, he determined that he would book me in for an appointment in two days for a urodynamic flow test, followed by a cystoscopy, and then an overnight stay to possibly treat something like a bladder neck stenosis, all of which I thought was brilliant because one of them had to solve my problem I would have thought.

 

It got to a point where I wasn't really worried too much about the cost, because if I stayed in hospital my insurance would cover it, whereas if it was just an outpatient treatment I would have to pay for it myself.

 

Turned up at the hospital at 9 AM two days later and proceeded to have the urodynamic flow test, which I can only describe as "different". It involves sitting in a specially adapted chair contraption which has a container to collect urine, footrests which are adaptable and it's a bit like the "chair" one sees in a maternity ward!

 

At this particular time one has to let ones inhibitions/modesty go out of the window, because they insert a very thin catheter in the end of the penis, and a very thin catheter into the rectum, which is available to them because of the angle in which one sits in the chair. Not painful, nor really uncomfortable once it's done, although getting the sticky tape off the old fella after the two hour procedure was another matter altogether – – tears to the eyes and biting hard to alleviate the pain!

 

The object of the exercise is to connect the catheters via special connectors to a machine which monitors the bladder and its contractions, all the while feeding a small amount of water/saline into the bladder in order to effect this.

 

I was hoping for some good news, however to all intents and purposes I had no bladder action whatsoever, so he did the procedure a second time just to check (a very thorough Dr I will add) and the same result.

 

So it was removal of the catheters (ouch) and a quick consultation in his office whereby he/we decided that as he had found the cause of not being able to empty my bladder, a cystoscopy was not necessary, nor was a bladder neck incision operation, which relieved me somewhat, but saddened me in another way, this because I was going to have to use a catheter to empty my bladder 2 to 3 times a day for the rest of my life probably.

 

However rather than rush through it like my urologist did in Phuket, he took time to explain things, how I should go about catheterisation, how I should store the catheter and other things relating to the hygiene around it to stop any infections.

 

So upon leaving his office I was resigned to my catheter use forever, although he did say that sometimes if the damage to the nerves in the bladder wasn't too serious, that some urine evacuation could take place given time.

 

In a way I was glad to leave Bangkok because staying overnight in hotels is not ideal where one doesn't have the access to the usual things pertaining to catheterisation and it's a clumsy exercise when those things aren't available, and more to the point I wasn't getting any sleep and probably haven't had a good night sleep in months – – literally.

 

Now onto the prostate part of the equation: – I had thought that it was the prostate which had grown back after my initial TURP which was causing the problem, but obviously not, nor was it a bladder neck problem, and since I had had a cystoscopy some six or eight months ago which didn't show anything up, he said it wasn't necessary to have another one, whereas I thought a second opinion might be good in that regard, however he thought it wasn't necessary.

 

So I changed my air ticket and flew home to Phuket yesterday and as I was able to empty my bladder using the catheter in familiar surroundings, I did have a few good hours of sleep last night.

 

Before I finish this saga, I will explain how this nonworking bladder event occurred, and I discussed this with the doctor, so it's from the best source possible: – over many years I have been employed in high level management and stressful positions in multinational companies, Rank Xerox, American Express and as Chief Manager Investments of a subsidiary of CBA bank, and I would be diligently working at all hours, especially in the last two jobs without paying attention to my bladder needs, and indeed if I felt the need to go to the toilet, because I was stretched for time, I would mentally override that sensation (yes you can do it) and carry on working and I did that for two or three decades if not more and once that is done, the bladder stops responding to the signals it has been receiving, which happened in my case.

 

The nerve endings in the bladder signal the bladder neck to loosen and allow urine to pass, and because the bladder had become overstretched consistently for decades, those nerves ceased to function in my case.

 

So there's a lesson to be learned for anyone who would listen, and that is always to respond to the needs/signals of your bladder, or suffer the consequences over time.

 

However there is a light on the horizon, because in discussing my situation with the good Dr Charuspong, I mentioned that I could pass urine if I took a laxative in the early hours of the morning and when it worked, I could pass some urine, which was a blessed relief, although the urine amount wasn't much, it was enough to stop feeling full. This especially as there is a laxative which can be taken on a daily basis which is safe for people with chronic constipation, and which doesn't affect the normal workings of the bowel.

 

The Dr explained that although the nerves in the bladder were not reacting to the urine content, the pressure put upon the bladder when using the laxative was enough to force some urine out, and this even more so if I took Cardura XL, which although is meant to relax the muscles in the prostate, also does so in the bladder neck, so this will help me, and just this morning it has – – thankfully.

 

Now onto something which is near and dear to many people's hearts, COST! I didn't find it that expensive considering the treatment which was the two hour session with the urodynamic flow test, with two nurses in full-time attendance, plus the technician who was in charge of the machine, and visits by Dr Charuspong to monitor progress, as well as two consultations with the good doctor, so a total cost of 39,000 baht seemed reasonable to me.

 

In addition I got an estimate for the cystoscopy, and that was 20,000 baht, which is exactly the same cost as here in Bangkok Phuket hospital, so not unreasonable in my estimation.

 

So in answer to the post by riclag, the rezum treatment is available at Bumrungrad, and it is a hospital which I would now fully recommend, and I did notice that they have the da Vinci robotic machine, which is used for prostate removal and other complicated surgeries.

 

Sorry it's been so long, but I thought I would put my experiences down on paper in case it helped another poster.

Here in Australia I had a history of urine retention after a radical prostatectomy, being woken many times at night with 'urgency', but no urine flow etc. I had the same urine flow test as uou a few times without a solution being identified. Eventually a urology specialist recommended a sacral neural modulator implant which has resolved my issues.

 

https://www.neuromodulation.com/fact_sheet_sacral_neuromodulation

 

Being Australia there was no cost involved, though I understand the cost in the privare sector would be around $20k, You may like to check out if the expertise / technology is available in Thailand or the thoughts of a NZ specialist as to suitability for your circumstances.

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On 11/22/2021 at 5:36 PM, xylophone said:

As you can see my faith in urologists here is just about zilch,

That pretty much matches my findings after spending lots of cash on four different urologists. One on Samui, two in Bangkok and one in Suratthani. (The one in Suratthani kicked me out of his office and refused to treat me.)

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I have been told by two urologists, one in Australia, one here, that I have an obstructive prostate. Thus far, it does not seem to have affected me. Sometimes there is a bit of hesitation before flow starts. I am taking 5 mg of finasteride daily. I've found consuming alcohol gets me up more often in the night, it's a diuretic.

I can recommend Dr. Wittawat Rawiyotai at Bangkok Hospital in Chiang Mai as a urologist. Speaks good English, professional, answers my questions about any procedures. He does my routine cystoscopies.

IIRC, it was Sheryl who initially recommended him. Thanks Sheryl.

 

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2 hours ago, simple1 said:

Here in Australia I had a history of urine retention after a radical prostatectomy, being woken many times at night with 'urgency', but no urine flow etc. I had the same urine flow test as uou a few times without a solution being identified. Eventually a urology specialist recommended a sacral neural modulator implant which has resolved my issues.

 

https://www.neuromodulation.com/fact_sheet_sacral_neuromodulation

 

Being Australia there was no cost involved, though I understand the cost in the privare sector would be around $20k, You may like to check out if the expertise / technology is available in Thailand or the thoughts of a NZ specialist as to suitability for your circumstances.

I had read about this procedure simple1, and I will investigate whether it is available here or not, however in the meantime I am persevering with intermittent catheter use, and using it three times a day to try and get the bladder back working again (fingers crossed).

 

As you may have read in my post, I do have a sort of "workaround" using a laxative, which does help because I am one of those people who is always chronically constipated!!! Even with spicy Thai food and raw chilis.

 

I have just read the link you provided (thank you) and would like to ask if the finished product inhibits you in any way at all, such as: – in sleeping, showering, having a massage etc??

 

Thanks for posting your info.
 

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2 hours ago, simple1 said:

Here in Australia I had a history of urine retention after a radical prostatectomy, being woken many times at night with 'urgency', but no urine flow etc. I had the same urine flow test as uou a few times without a solution being identified. Eventually a urology specialist recommended a sacral neural modulator implant which has resolved my issues.

 

https://www.neuromodulation.com/fact_sheet_sacral_neuromodulation

 

Being Australia there was no cost involved, though I understand the cost in the privare sector would be around $20k, You may like to check out if the expertise / technology is available in Thailand or the thoughts of a NZ specialist as to suitability for your circumstances.

I have just read that this procedure is available at Bangkok Phuket Hospital, and is under the auspices of one of my favourite doctors there, Prof. Dr Art, so that is very fortuitous, and I will persevere for a short while with my "workaround" and in the meantime I will make a note to go and see Dr Art after a couple of months.

 

Thanks again simple1.
 

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1 hour ago, xylophone said:

I had read about this procedure simple1, and I will investigate whether it is available here or not, however in the meantime I am persevering with intermittent catheter use, and using it three times a day to try and get the bladder back working again (fingers crossed).

 

As you may have read in my post, I do have a sort of "workaround" using a laxative, which does help because I am one of those people who is always chronically constipated!!! Even with spicy Thai food and raw chilis.

 

I have just read the link you provided (thank you) and would like to ask if the finished product inhibits you in any way at all, such as: – in sleeping, showering, having a massage etc??

 

Thanks for posting your info.
 

No issues with daily life, My device is implanted in my lower back with no discomfort, therefore no lower back massage. Be aware going through screening, such as airports requires you to notify security who need to to carry out physical ckeck, not electronic. Also need to ensure the lead attached to the modulator inside your body is MRI compatible. The specialist will assist with setting up the configuration which is managed by a bluetooth external device, The battery needs to be replaced approx every five years which requires a minor operation to replace.

 

Peter...

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Twice I have been told my prostate is not large by Ultrasound measurement. For almost 40 years Drs have told me Large Prostate following finger up back passage method.

I am now having a Cystoscopy in 2 weeks.

I will report.

john from Chiang Mai.

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2 hours ago, jonwilly said:

Twice I have been told my prostate is not large by Ultrasound measurement. For almost 40 years Drs have told me Large Prostate following finger up back passage method.

I am now having a Cystoscopy in 2 weeks.

I will report.

john from Chiang Mai.

Will be interested in your feedback JW.

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6 hours ago, jonwilly said:

Twice I have been told my prostate is not large by Ultrasound measurement. For almost 40 years Drs have told me Large Prostate following finger up back passage method.

I am now having a Cystoscopy in 2 weeks.

I will report.

john from Chiang Mai.

Good luck with that!

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First ultrasound was at RAM, second at McCain.

A further 2 finger insertions have taken place one at Suan Dork where their Urologist put me on a course of antibiotics, which are controlling the multiple  night time visits to toilet and he has me booked in for a look up my urine tube, small camera or tunnel boring machine if required, on 16th March.

        John

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1 minute ago, jonwilly said:

First ultrasound was at RAM, second at McCain.

A further 2 finger insertions have taken place one at Suan Dork where their Urologist put me on a course of antibiotics, which are controlling the multiple  night time visits to toilet and he has me booked in for a look up my urine tube, small camera or tunnel boring machine if required, on 16th March.

        John

I can't remember if you said that you had a cystoscopy previously, but if you haven't, it's very straightforward and takes about 10 to 15 minutes and is not painful, perhaps a little uncomfortable, but they do squirt some Xylocaine gel down the end of the old fella to numb it before the camera goes in – – lucky it's not an Instamatic!!!

 

Again, good luck.

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On 3/3/2022 at 10:23 AM, Sheryl said:

Read his more recent posts - he had a very good experience with a urologist here

 

With all types of doctyors, one has to select them carefully.

 

And I will add something to that, because after my very good experience with Dr Charuspong at Bumrungrad, I received a phone call from him this morning asking how things were and we had a little chat about one thing and another – – – now how many times in any country has anyone had that happen before, certainly not me, so once again thanks to @Sheryl for her recommendation.

 

And whilst I was speaking to the good doctor I enquired about the sacral neural modulator, as mentioned by @simple1 and he said that it was primarily for incontinence sufferers, and worked very well for them, whereas for bladder retention the success rate was around 50%.

 

The good thing about this is that they fit it and you get to trial it for about a week to see if it actually does work, and if it doesn't, then the operation doesn't go ahead, but if it does work and you want to proceed, then the procedure here will be around 1 million baht!!!

 

As its basically an OPD operation, my insurance won't cover it, so I'll give it a little while and do some more research with Prof Dr Art here to find out a little more about it and the actual cost here in Phuket.

 

I suppose it comes down to the quality of life I want heading into my 75th year, and whether I want to spend some of the money I have invested in NZ, and I'm just getting my head around that.

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1 hour ago, xylophone said:

And I will add something to that, because after my very good experience with Dr Charuspong at Bumrungrad, I received a phone call from him this morning asking how things were and we had a little chat about one thing and another – – – now how many times in any country has anyone had that happen before, certainly not me, so once again thanks to @Sheryl for her recommendation.

 

And whilst I was speaking to the good doctor I enquired about the sacral neural modulator, as mentioned by @simple1 and he said that it was primarily for incontinence sufferers, and worked very well for them, whereas for bladder retention the success rate was around 50%.

 

The good thing about this is that they fit it and you get to trial it for about a week to see if it actually does work, and if it doesn't, then the operation doesn't go ahead, but if it does work and you want to proceed, then the procedure here will be around 1 million baht!!!

 

As its basically an OPD operation, my insurance won't cover it, so I'll give it a little while and do some more research with Prof Dr Art here to find out a little more about it and the actual cost here in Phuket.

 

I suppose it comes down to the quality of life I want heading into my 75th year, and whether I want to spend some of the money I have invested in NZ, and I'm just getting my head around that.

The cost for the sacral modulator is more than double the cost for a private patient in Oz - so much for lower fees in Thailand!

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1 hour ago, xylophone said:

And I will add something to that, because after my very good experience with Dr Charuspong at Bumrungrad, I received a phone call from him this morning asking how things were and we had a little chat about one thing and another – – – now how many times in any country has anyone had that happen before, certainly not me, so once again thanks to @Sheryl for her recommendation.

 

And whilst I was speaking to the good doctor I enquired about the sacral neural modulator, as mentioned by @simple1 and he said that it was primarily for incontinence sufferers, and worked very well for them, whereas for bladder retention the success rate was around 50%.

 

The good thing about this is that they fit it and you get to trial it for about a week to see if it actually does work, and if it doesn't, then the operation doesn't go ahead, but if it does work and you want to proceed, then the procedure here will be around 1 million baht!!!

 

As its basically an OPD operation, my insurance won't cover it, so I'll give it a little while and do some more research with Prof Dr Art here to find out a little more about it and the actual cost here in Phuket.

 

I suppose it comes down to the quality of life I want heading into my 75th year, and whether I want to spend some of the money I have invested in NZ, and I'm just getting my head around that.

 

Most hospitalization only policies WILL cover day surgeries so look into that.

 

Even though you don't stay overnight the procedure will likely be done in an OR and most insurers would consider it day surgery.

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On 11/20/2021 at 2:06 AM, ozimoron said:

One day without it and I have difficulty urinating. Two a day and all is good.

i've just finished with beta sitosterol with no noticeable BPH benefit.

am now onto my next trial - swanson stinging nettle root one 500 mg capsule per day.

you mention two a day..........are they 500mg capsules?

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9 minutes ago, Bvor said:

i've just finished with beta sitosterol with no noticeable BPH benefit.

am now onto my next trial - swanson stinging nettle root one 500 mg capsule per day.

you mention two a day..........are they 500mg capsules?

As you may have read from a previous post, the prostate is not my problem, it's just that the bladder has ceased to function.

 

I bought a bottle of Swanson Stinging Nettle Root capsules, and have hardly used any, so you are more than welcome to have my bottle, and as you are a fellow sufferer, if you want to send me a postal address via PM, then I will post you it free of charge!

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4 minutes ago, xylophone said:

As you may have read from a previous post, the prostate is not my problem, it's just that the bladder has ceased to function.

 

I bought a bottle of Swanson Stinging Nettle Root capsules, and have hardly used any, so you are more than welcome to have my bottle, and as you are a fellow sufferer, if you want to send me a postal address via PM, then I will post you it free of charge!

yeah, thanks will not go to waste.

i'm back in pattaya 12/3 so will pm you my condo address.

if your still in bangkok come on down for a visit 

am interested in ozimoron's dosage as the swanson label recommends 500mg per day but if a larger dosage works better i will do same.      

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On 3/1/2022 at 7:37 PM, riclag said:

Im very much open for a less invasive procedure . PAE sounds promising but I have to look if hospitals here offer it!

PAE isn't available in Thailand, and IMHO it will be a while, as the procedure is performed by interventional radiologists and not by Urologists. You can imagine the difficulties, in terms of turf war and non-cooperation this could create here.

 

It is available in UK and France and covered by the Governments' health systems. From here it would require a two to three weeks trip, as I don't see myself on a long haul flight with the post PAE syndrome which occurs normally during the second week after the procedure. 

 

Also PAE doesn't produce the same result as TURPs, and other butcheries but I'd see it as means to get out of my medication (Finasteride + Doxazosin) for a few years, before a Radical Prostatectomy, or any other treatment, if my PCA decides to progress. (I have a tiny Gleason 6 tumour in a massive prostate of 105 grams).

Edited by Boomer6969
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20 hours ago, simple1 said:

The cost for the sacral modulator is more than double the cost for a private patient in Oz - so much for lower fees in Thailand!

When I was investigating costs for Rezum treatment, private treatment in Australia was cheaper than Thailand and the UK. Singapore was absolutely ridiculous though. Luckily, I got a special discount package at Bumrungrad Hospital, and surprisingly my office insurance covered some of the costs, so I had the treatment here. 

Edited by GarryP
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On 3/8/2022 at 6:34 PM, simple1 said:

The cost for the sacral modulator is more than double the cost for a private patient in Oz - so much for lower fees in Thailand!

Hey @simple1, a question for you because I have not had much luck trying to get hold of Prof Dr Art at Bangkok Phuket hospital here as I keep being fobbed off by someone in reception who doesn't understand what I want to talk to him about and simply says, "we don't do that here", so we have a receptionist who is determining my health, which I'm not happy about, and if I do go to the hospital I'm going to break his firking nose!

 

Apart from that, it was stated to me that the cost here for the sacral neural stimulation modulator here would be about 1 million baht, yet you managed to get yours done in Oz for just about half that; so my question is where did you have it done?

 

It may well be worth me travelling over to Oz to have it done there, so I will do some investigating if you would provide me with a few details please.

 

Thanks in anticipation.

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