Enlarged Prostate/BPH - What is the best/most effective operational procedure ?

[Pumpuynarak]

Now i'm rapidly approaching the time when i'm gonna need an operation to hopefully cure/help my enlarged prostate/BPH problems as the meds i'm taking are not really doing anything positive.

Can anyone share their experiences/knowledge as to what is the most effective operative treatment ? I'm reading via Google that there are many procedures ie, Turp, Rezum, Urolift and a recently announced ''Steam'' treatment but i believe not all of these procedures are available in Thailand.

I'm seeing my Urologist in a few weeks time for a discussion on operative procedures but would like to be informed as to which procedure is the most effective and the least invasive.

Thanks for any help guys.

[carlyai]

Not sure if this is available in Thailand.

I had a kidney tumor removed in Australia and the guy I was staying with in the hospital accommodation had prostrate cancer surgery. Same Dr as me used a robot that cut the cancer out of the prostrate, but left the prostrate and he was all good to go back to New Zealand after 2 weeks.

I also had the robotic kidney surgery and recovered very quickly even though Dr said a major operation.

So a good surgeon and using the robot for any operation may be good to investigate.

 

[phetphet]

There was another poster discussing his prostate problems on here and  treatment a week or so ago. Maybe search for that. Might help you.

 

Edit: Just had a quick look. I think this was it:

https://aseannow.com/topic/1274732-rezum-experience/#comment-17663937

Edited December 27, 2022 by phetphet

[mackayae]

Get it done. The longer you wait the more damage to the bladder.

[GarryP]

There is some information on this thread too. https://aseannow.com/topic/1238152-enlarged-prostate-treatment-rezum/

 

[Boomer6969]

I am 70 and have a very large prostate with a small low grade cancer, under "Active surveillance" since 2018.

 

Currently I am under medication: Finasteride 5mg, Doxazosin 2mg and Taladafil 5mg, this gives me very acceptable quality of life, while I can have sex at any time of the day without planning.

 

If my hyperplasia gets worse, I'll get prostatic embolisation first, and only consider other surgeries if this fails.

 

Of course, if my cancer wakes up I'll have to change plans..

[garmat]

I had a successful TURP operation at St. Mary’s 4 months ago. Dr. katowat(sp) the urologist was excellent. A bit uncomfortable having to keep a catheter for 8 days following procedure, but worth it. 140,000B included everything. Money well spent.

[Tracyb]

TURP utilizing a laser is the treatment I had in Chiang Mai at Bangkok Hospital here a couple of years ago.  Out of the hospital in four days….no catheter when I went home.  My urologist is first rate.  After care consisted of rest. pain was minimal to non existent after I went home.  Even in hospital I didn’t require pain meds after the first day.  No painkillers, no opioids, nada.  Oddly, it was about two weeks or so before I was comfortable  sitting in and traveling in a car for more than a few minutes.  Reclining at home was fine.  No follow on symptoms and no negative effects.  Fully continent and functional.  
 

(your results may vary)

[Russell17au]

I am 78 years young now and I had a TURP procedure in Australia 16 years ago so this is not about my procedure but just a little bit of comfort information for after any of the procedures.. I found like Tracyb in the post above that the biggest problem was being able to sit comfortably after the procedure. The thing that I found which worked was one of those horse shoe shape travel cushions that go around your neck. Sit with your old mate and your testies hanging down where the opening is and that way there is no pressure on that area. You can even put it in the car and it will be quite comfortable for travelling. What ever procedure you have Good Luck

[sagra]

I think I will be needing one in the next few years. My biggest concern is what impact a procedure may have on my sexual function. It would be good to know the experience of anyone here who had a procedure, including which procedure they had.
 

From what I’ve read, photoselective vaporization of the prostate (PVP) is the one with the least impact, though it is quite expensive.

[xylophone]

I had a TURP done in Epworth Hospital in Melbourne about 12 years ago and there were a few hiccups after the operation, whereby I had to use a catheter for quite a few weeks to be able to get the bladder working again.

 

Things seemed to be just okay for a few years, but in recent times I've been having problems and one urologist here operated on on me to widen my bladder neck, because there was some scar tissue there, probably from the TURP operation, and it's been downhill from there, whereby my bladder has stopped working, so the small catheter is my best friend before I go to bed, although I can expel a little urine sometimes during the day which eases the pressure.

 

I did a lot of research after this last episode, and before I realised that the bladder had actually ceased to work I was thinking that the prostate might be at fault and was considering various operations to rectify this, and I came to this conclusion: –

 

– If I could get the Urolift done here or in some country nearby, that would be my first option.

– Rezum would be my next option, and I noticed they do have it available in Bumrungrad hospital here.

– A further TURP was an outside possibility if indeed the prostate had grown again, and the TURP can be done using a Laser.

 

For those folks with prostate cancer, the da Vinci robotic machine is an absolute must for prostate removal, or prior to this of course, brachytherapy is an option to consider.
 

Edited December 27, 2022 by xylophone

[PeVee1st]

I currently take a 400mg tablet called Tamulosin daily and it has kept my enlarged prostrate in good order for the last 12 years.

My PSA Tests are always very good and my prostrate has not enlarged further in that time.

I saw a Urologist 4 months ago and he told me that I had no problems and my urine flow rate was good.

In Thailand the drug is marketed under the name "Harnal".

A druggist in Bangkok on Sukhumvit Soi 15, PS Pharmacy, Google them, will post it to you at a very good price plus 100 thb postage.

I hope this helps.

[allanos]

Recently, I investigated going to India for robotic surgery

to have my prostate removed, cost-efficiency being a

major factor for me.

 

However, my cancer was localised and, in my case, the

best option with the lowest level of invasive surgery and

potential side-effects was a brachytherapy procedure,

which I underwent three months ago.

 

So far, so good, with a minor level of discomfort when

urinating. From a PSA of 7.34 when the cancer was 

confirmed, a recent PSA test level came out at 0.87.

[swm59nj]

I have an enlarged prostate. I have been taking many years medication for it.  It is very large. 

But you need to talk to your urologist what is the best option for you.  Each individual case is different.  And what might have been effective for one, might not be good for you. 
It’s good you are gathering information here.  You can use the information as questions for your doctor.  And people are trying to help  But as you know.  They cannot tell you which one is best for your specific situation. 

[Wardp]

So what tests are needed pre surgery? Apart from psa and digital exam, do es an ultrasound give the urologist enough info etc?

[Boomer6969]

3 hours ago, sagra said:

I think I will be needing one in the next few years. My biggest concern is what impact a procedure may have on my sexual function. It would be good to know the experience of anyone here who had a procedure, including which procedure they had.
 

From what I’ve read, photoselective vaporization of the prostate (PVP) is the one with the least impact, though it is quite expensive.

Go for Prostate artery embolisation, it may even improve sexual function. It isn't available in Thailand, while it is in Europe and Singapore. 

[norbra]

I had external radiation therapy (36 doses) 8 years ago in Australia for prostate cancer. I had some side effects, blood traces in my seman ,for around 2 months. My prostate was enlarged but not causing problems,but a BPH of 17 sent me to Chula for MRI,sent copy to oncologist in Australia who arranged for my treatment. Now I still have full flow as well as being sexually active. I have seen some Thai hospital ads that include pictures of their radiation therapy machines

Edited December 27, 2022 by norbra

[Lancelot01]

I have written about this situation here before.

I was diagnosed with an enlarged prostate late last year. 

I decided I didn't want to continue with the prescribed medication and so, after consulting Dr Google, I changed my diet (to Keto) and took more exercise. That was in January. 

After four months I had lost 20kg (+/-45lbs), the prostate reduced and, in consultation with my doctor, I discontinued the medication. 

A further 'side effect' was that my blood pressure returned to normal and, again after speaking with my doctor, I  no longer take bp medication. 

Eight months later, I am still reasonably fit, the weight has not returned and I can still enjoy a eating and drinking. 

 

 

[riclag]

7 hours ago, garmat said:

I had a successful TURP operation at St. Mary’s 4 months ago. Dr. katowat(sp) the urologist was excellent. A bit uncomfortable having to keep a catheter for 8 days following procedure, but worth it. 140,000B included everything. Money well spent.

 

7 hours ago, Tracyb said:

TURP utilizing a laser is the treatment I had in Chiang Mai at Bangkok Hospital here a couple of years ago.  Out of the hospital in four days….no catheter when I went home.  My urologist is first rate.  After care consisted of rest. pain was minimal to non existent after I went home.  Even in hospital I didn’t require pain meds after the first day.  No painkillers, no opioids, nada.  Oddly, it was about two weeks or so before I was comfortable  sitting in and traveling in a car for more than a few minutes.  Reclining at home was fine.  No follow on symptoms and no negative effects.  Fully continent and functional.  
 

(your results may vary)

Did they put you to sleep for your procedures

 

[sagra]

10 hours ago, Boomer6969 said:

Go for Prostate artery embolisation, it may even improve sexual function. It isn't available in Thailand, while it is in Europe and Singapore. 

Thank you!

[drtreelove]

8 hours ago, Lancelot01 said:

I have written about this situation here before.

I was diagnosed with an enlarged prostate late last year. 

I decided I didn't want to continue with the prescribed medication and so, after consulting Dr Google, I changed my diet (to Keto) and took more exercise. That was in January. 

After four months I had lost 20kg (+/-45lbs), the prostate reduced and, in consultation with my doctor, I discontinued the medication. 

A further 'side effect' was that my blood pressure returned to normal and, again after speaking with my doctor, I  no longer take bp medication. 

Eight months later, I am still reasonably fit, the weight has not returned and I can still enjoy a eating and drinking. 

 

 

I have a similar experience. With a wellness-oriented MD's guidance, low carb diet, exercise and TCM, I have been able to drop all Rx meds for BP, BPH and GERD and have those conditions reversed, as well as full recovery from hip replacements, and a to return to an active life style.  

[PeterCouling]

I had the TURP procedure done in Samitiwej Hospital in Bangkok 2 years ago following a need for an urgent catheter prior to that. Mine was done under local anesthetic so was wide awake during the procedure. Not cheap but successful. Three nights in hospital with catheter not needed after 2 days but had diapers for 2 days after for security and about a week to clear blood in urine. So far so good and mine was not cancerous.

[carlyai]

14 hours ago, xylophone said:

I had a TURP done in Epworth Hospital in Melbourne about 12 years ago and there were a few hiccups after the operation, whereby I had to use a catheter for quite a few weeks to be able to get the bladder working again.

 

Things seemed to be just okay for a few years, but in recent times I've been having problems and one urologist here operated on on me to widen my bladder neck, because there was some scar tissue there, probably from the TURP operation, and it's been downhill from there, whereby my bladder has stopped working, so the small catheter is my best friend before I go to bed, although I can expel a little urine sometimes during the day which eases the pressure.

 

I did a lot of research after this last episode, and before I realised that the bladder had actually ceased to work I was thinking that the prostate might be at fault and was considering various operations to rectify this, and I came to this conclusion: –

 

– If I could get the Urolift done here or in some country nearby, that would be my first option.

– Rezum would be my next option, and I noticed they do have it available in Bumrungrad hospital here.

– A further TURP was an outside possibility if indeed the prostate had grown again, and the TURP can be done using a Laser.

 

For those folks with prostate cancer, the da Vinci robotic machine is an absolute must for prostate removal, or prior to this of course, brachytherapy is an option to consider.
 

The robotic prostrate cancer operation I posted about before, they didn't remove his prostrate, but just cut the cancer out of his prostrate. He was a very happy man.

Dr said for tricky precise, minimal damage operations the De Vinchi robot is the best way to go.

Don't know about Thailand, but in Aus. It's expensive because not on the government claimable items.

[Tracyb]

9 hours ago, riclag said:

 

Did they put you to sleep for your procedures

 

They administered a spinal block and propofol.

[actonion]

The steam treatment known as Rezum is available only in Bangkok Pattaya hospital, & Bumrungrad in  Bangkok  as  far as i know, Bangkok Pattaya have just raised their price  to match that of Bumrungrad  250.000b,  for day Surgery.....I have'nt had it done  (yet)...

[Pumpuynarak]

18 hours ago, garmat said:

I had a successful TURP operation at St. Mary’s 4 months ago. Dr. katowat(sp) the urologist was excellent. A bit uncomfortable having to keep a catheter for 8 days following procedure, but worth it. 140,000B included everything. Money well spent.

Good news, where in Thailand is St Mary's hospital ?

[GarryP]

1 hour ago, actonion said:

The steam treatment known as Rezum is available only in Bangkok Pattaya hospital, & Bumrungrad in  Bangkok  as  far as i know, Bangkok Pattaya have just raised their price  to match that of Bumrungrad  250.000b,  for day Surgery.....I have'nt had it done  (yet)...

Rezum is also available at BNH.

[Boomer6969]

2 hours ago, actonion said:

The steam treatment known as Rezum is available only in Bangkok Pattaya hospital, & Bumrungrad in  Bangkok  as  far as i know, Bangkok Pattaya have just raised their price  to match that of Bumrungrad  250.000b,  for day Surgery.....I have'nt had it done  (yet)...

Rezum isn't for everyone, so far it isn't the first choice for prostates larger than 80cc. This is what makes embolisation attractive, as it would shrink my prostate and give a wider choice of treatments both for BPH and Cancer.

Edited December 28, 2022 by Boomer6969

[Dan747]

Interesting Video on Treatment of an Enlarged Prostate with info on Supplements like Saw Palmetto etc.: 

 

[rhodie]

2 hours ago, Pumpuynarak said:

Good news, where in Thailand is St Mary's hospital ?