Prostate issues

[xylophone]

5 minutes ago, Yellowtail said:

 

Any real downside to the TURP?

 

Meds work okay for me, but I've been thinking about getting "broached"....

 

Baht 170K at Bumrungrad, which is 20-40% less than I would likely have to pay in the US. 

 

 

 

Well if you don't have to have the TURP, then IMO it is last resort surgery, so to speak and if you can manage it with meds, then carry on I would say.

 

Many people don't have any side effects with the TURP, however I did, having to use a catheter for a few weeks to get the bladder to empty properly, and there is always the possibility of retrograde ejaculation, which didn't happen to me in the first instance, but a few years later I had to have a bladder neck incision, probably as a result of the TURP, which did result in retrograde ejaculation.

 

A bit of a balancing act I would say, but if your urine stream is okay and you are not getting any urinary tract infections from retained urine, then carry on with what you're doing.

 

Feel free to PM me if you wish.

[Yellowtail]

6 minutes ago, xylophone said:

Well if you don't have to have the TURP, then IMO it is last resort surgery, so to speak and if you can manage it with meds, then carry on I would say.

 

Many people don't have any side effects with the TURP, however I did, having to use a catheter for a few weeks to get the bladder to empty properly, and there is always the possibility of retrograde ejaculation, which didn't happen to me in the first instance, but a few years later I had to have a bladder neck incision, probably as a result of the TURP, which did result in retrograde ejaculation.

 

A bit of a balancing act I would say, but if your urine stream is okay and you are not getting any urinary tract infections from retained urine, then carry on with what you're doing.

 

Feel free to PM me if you wish.

 

I get on okay with meds, usually sleep all night, have goo flow and no urgency, but I do experience retrograde ejaculation as a result of the meds. It is a little annoying, but I can live with it. 

 

I just started thinking about it after watching the video above...

[xylophone]

My ongoing battle with poor urine stream and potentially BPH has taken a turn for the worst, because four days ago I found out that I could not pass water at all, read that again AT ALL, so I desperately ferreted around in my medical drawer to find my old catheter, rubber gloves and so on so that I could self catheterise, which I did, and it resulted in just under a litre of urine!

 

I put up with that for about two days to see if it would get any better, and it didn't so I made an appointment at the local hospital to see the urologist I had seen previously.

 

I thought that my prostate would be the culprit and told him so, but the answer he gave me put me in doubt as to his "capabilities", because he said that on the ultrasound my prostate wasn't enlarged, and that had me worried because the prostate doesn't necessarily have to be enlarged to cause a restriction, as the outside of the prostate can stay intact whereas the growth and restriction can come from inside it. Not only that, prostate regrowth (inside it) after a TURP is quite common in about 20% of the cases.

 

Anyway he has booked me in for a cystoscopy next Monday and that will hopefully show up more as to what is going on, and I sincerely hope it is the prostate, because if it's the bladder which has stopped functioning, then that is a different matter altogether and if tablets don't help, then it's pretty much a catheter for life, so to speak, and that is not appealing.

 

Whereas if it is prostate regrowth, then I will have another TURP but ONLY as a last resort, however I have been investigating the cost of the Urolift procedure in other countries, because they don't do it in Thailand, and I've come up with some costs which don't include flights unfortunately, and for an "operation" which is seemingly a 30 minutes procedure on a walk-in/walkout basis, then it's bloody expensive!

 

Urolift in New Zealand is nearly 300,000 baht; in Singapore 460,000 baht; in Dubai 350,000 baht, and this is considerably more expensive then a TURP here, but as I don't have a lot of confidence in urologists here, then I would take a chance in Dubai if it turns out that the prostate is the culprit.

 

So Monday is "D-Day" so to speak and what I find out will determine the next course of action and whether I have to travel overseas, quarantine et al.

 

Not a happy man at the moment and the thought of having to self catheterise three times a day for the rest of my life is not something which appeals to me.

[BritManToo]

32 minutes ago, xylophone said:

Not only that, prostate regrowth (inside it) after a TURP is quite common in about 20% of the cases.

My pal down the road had a TURP and takes Finasteride to stop regrowth.

One option you could try is a course of Antibiotics, frees me up every time, MOXICLAV 1g (875mg Amoxicillin +125gm clavulanic acid), 2 tabs a day for 7 days around 250bht.

Edited July 7, 2021 by BritManToo

[xylophone]

22 minutes ago, BritManToo said:

My pal down the road had a TURP and takes Finasteride to stop regrowth.

One option you could try is a course of Antibiotics, frees me up every time, MOXICLAV 1g (875mg Amoxicillin +125gm clavulanic acid), 2 tabs a day for 7 days around 250bht.

I'm sure you mean well, however my prostate has already grown to a point where it can't be "ungrown", so to speak.

 

And it isn't an infection, so Augmentin (same antibiotic as Moxiclav) won't be of any help I'm afraid, and I would be tempted to try Fosfomycin IF it was an infection, so I'm left with very few options, sad to say.
 

[BritManToo]

15 minutes ago, xylophone said:

And it isn't an infection, so Augmentin (same antibiotic as Moxiclav) won't be of any help I'm afraid, and I would be tempted to try Fosfomycin IF it was an infection, so I'm left with very few options, sad to say.

Inflammation is a common cause of 'failure to wee' in prostate victims (like me).

One of the side effects of Amoxicillin is reducing inflammation of the prostate.

 

I've found the treatment I suggested very effective.

It may not help you, but you have nothing to lose by trying it (beyond the 250bht).

 

PS. The urologist at my local government hospital recommends a catheter kept in place for 1 month when urinary retention exceeds 450ml, just to stretch things out a bit. Don't know how good that advice is, as I bailed after 3 weeks.

 

Edited July 7, 2021 by BritManToo

[xylophone]

An update on the most recent procedures for BPH (benign prostate hyperplasia) which do not include surgery as in the TURP operation.. It seems like the Urolift

 

Is One BPH Procedure a Cut Above the Rest?

— Study assesses real-world complication, retreatment rates for four separate procedures

A large-scale analysis of treatments for benign prostatic hyperplasia (BPH) showed that complications are lowest after the UroLift Prostatic Urethral Lift (PUL) procedure, and real-world retreatment rates are highest for the Rezum steam injection therapy.

 

While retreatment rates for PUL, transurethral resection of the prostate (TURP), and GreenLight Laser Prostatectomy were comparable over the course of 365 days, the 1-year retreatment hazard was 36%, 40%, and 43% higher for Rezum versus PUL, TURP, and GreenLight, respectively, reported Steven Kaplan, MD, of the Icahn School of Medicine at Mount Sinai in New York City.

[Nojohndoe]

Excuse  me if I chip in to the topic. I too have a very enlarged prostate which at times severely impedes urine flow. I have found that anti inflammatories help a lot on such occasions.

My main reason to comment is that I note  many comments associating  an enlarged prostate as evidence of prostate cancer. The reality is that the two are not necessarily connected although the symptoms can present as similar. Another reality is that the younger guys who take testosterone supplements are inviting  prostate cancer .

 

 

[ourdon]

On 5/13/2021 at 1:03 AM, Sheryl said:

Prostate problems do not "work themselves out" on their own.

 

The correct spelling is ProstaGenix. And the main ingrediant is beta-sitosterol. There are many brands of that around; this particular high priced product just adds a bunch of minerals and vitamins to it to justify a separate patent.

 

It will definitely not effect a cure and is not a "wonder drug". but it gives some symptomatic relief to some people.  See https://pubmed.ncbi.nlm.nih.gov/10796740/

 

If you want to try beta-sitosterol, you can get it in Thailand from Shoppee or order from iHerb

https://shopee.co.th/Source-Naturals-Mega-Strength-Beta-Sitosterol-375-mg-120-Tablets-i.36735443.1705782635

https://th.iherb.com/search?kw=Beta+Sitosterol&gclid=CjwKCAjw-e2EBhAhEiwAJI5jg9NPMB_gJNH2Wj9RQ3jq9SA9sIyet5GrjehZOL5ptEPBGqh1Gqau6xoCimcQAvD_BwE&gclsrc=aw.ds

 

This aside, it does not sound like your condition is being managed very well and I suggest you change urologists or at least get another opinion. there are many different drug combinations that can be tried.

 

Who are you seeing at BPH? And how long have you been on your current medications? Is the urologist aware that your symptoms have not improved?

 

 

 

What Sheryl says!!!!!

This seems to be a very overpriced supplement.  It sells on Amazon AU for around $58+  per bottle (45 day supply) as compared to 11 or 12 dollars a bottle for similar supplements.

Take Sheryls advice and get another opinion at least.  You have a choice,  live with care a fairly normal extended lifespan or die much sooner in pain.  The choice IS yours.

[xylophone]

8 hours ago, ourdon said:

What Sheryl says!!!!!

This seems to be a very overpriced supplement.  It sells on Amazon AU for around $58+  per bottle (45 day supply) as compared to 11 or 12 dollars a bottle for similar supplements.

Take Sheryls advice and get another opinion at least.  You have a choice,  live with care a fairly normal extended lifespan or die much sooner in pain.  The choice IS yours.

Agree with what you and Sheryl have said, because I investigated that supplement, mainly because of its aggressive marketing stance and claims, however it contains the usual supplements which are touted for prostate problems, just about all of which I have tried and apart from beta sitosterol which seemed to help a little bit, and nothing else of any note.
 

[xylophone]

Posters who may have been following this thread may have seen my last very large post about prostate problems and being unable to pass any water whatsoever, and my efforts to be able to fix this.

 

I was having to use a catheter three times a day to empty my bladder, and the urologist could only offer "neurogenic bladder" as the cause. However all of the research I have done, and believe me it has been extensive, suggests that neurogenic bladder mainly occurs after surgery in that area, an injury, damage to the spine and/or the nerves supplying the bladder, none of which I have had.

 

The cystoscopy, according to the urologist, showed nothing out of the ordinary, even though I asked about the condition of the prostate because I naturally thought that was the culprit, and he suggested it was fine and could find nothing wrong.

 

So his answer to my question about using the catheter was that it would probably be for the rest of my life, something I was not keen on. So I asked him to put the "film" of the cystoscopy onto a USB for me, which he kindly did, and I sent it to my fantastic doctor/surgeon in NZ and begged him for an answer or something to follow up on, not wanting to use a catheter three times a day for the rest of my life.

 

Well, true to form this really fantastic doctor/surgeon put me on to a top urologist in NZ, who replied that even though he couldn't see much from the cystoscopy film, he would suggest that my bladder neck was the culprit, and suggested a bladder neck incision.

 

I did say that I've had one previously here, some four years ago, however it appears that this operation sometimes has to be performed more than once to be fully successful.

 

If I was going to have this done, then I would go back to NZ to have it done, this especially as I don't have faith in the urologist here, however in the meantime I had to find a solution, and I did.

 

Given that my problem seems to be with the bladder neck and possibly muscles in the bladder itself, I decided to go on Doxazosin XL 4 mg once a day, because it can relax the muscles and assist with bladder emptying, and it works fairly quickly.

 

Sure enough within a week I was able to pass a small amount of water, not huge amounts, but enough to take the pressure off the bladder and allow me to use the catheter just once a day before I went to bed, and I was delighted.

 

I have continued with this and am hoping to see even more of an improvement, and my NZ doctor has suggested that I could change the medication to just Doxazosin 4 mg in the morning, and once again in the evening, rather than using the XL (extended release) version.

 

I haven't done this yet, as I've been reasonably happy with what's happening at the moment and I want to keep on this route.

 

I suppose the "eye-opener" for me has been the fact that all the time I thought the prostate was the problem, when it appears it was not (and the cystoscopy seems to confirm that) and now I have to consider where I go from here. However if the medication I'm currently on continues to work, then there is no urgency, and perhaps at a later date, but not too distant future, I could travel back to NZ for the operation on the bladder neck, or at least see a urologist in whom I would have confidence.

 

Here's hoping.