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

[Pumpuynarak]

15 hours ago, JimmyJ said:

@Pumpuynarak

 

"...the meds i'm taking are not really doing anything positive."

 

What meds were you taking?

Started off a year ago taking Cardura XL and Finnasteride, my BPH problem continued/did'nt improve and i started suffering side effects, lack of libido and depression so after a discussion with my urologist 6 months ago he suggested changing to Xatral XL and that is my current medication, my condition has not improved and is getting worse so i've now reached the stage of looking at some operative procedure.

Turp or Rezum but i don't know if Rezum is available in Korat where i live, BM garmat posts very positively regarding Turp he had carried out at St Marys hospital Korat so that is a definite possibility.

I really do need to sort something out otherwise i can see me becoming an emergency hospital admission unable to urinate.

[ozimoron]

What is duodart? A urologist told me I have BPH about 3.5 cm. He suggested duodart but I haven't have urinary issues yet. I did read that stinging nettle root powder can be effective but I only take some occasionally when I remember.

[simon43]

15 hours ago, MrMuddle said:

I had an MRI scan which confirmed the prostate cancer.

Strictly speaking, the MRI can show lumps/tumours, but they could be benign, and a biopsy will confirm the status of those lumps.  My recent MRI showed 2 growths inside my prostate which are 'grade 5' (ie very likely to be cancerous), but I'm waiting now to have a biopsy to confirm this.  (I am actually waiting on April Insurance France to give the go-ahead, and they are somewhat slow in giving the OK, perhaps still drunk after Xmas/New Year parties...)

[JimmyJ]

2 hours ago, simon43 said:

Strictly speaking, the MRI can show lumps/tumours, but they could be benign, and a biopsy will confirm the status of those lumps.  My recent MRI showed 2 growths inside my prostate which are 'grade 5' (ie very likely to be cancerous), but I'm waiting now to have a biopsy to confirm this.  (I am actually waiting on April Insurance France to give the go-ahead, and they are somewhat slow in giving the OK, perhaps still drunk after Xmas/New Year parties...)

Your April insurance covers Inpatient?

[BigStar]

21 hours ago, thaibeachlovers said:

Talk about leaping to conclusions. You need no other exercise, LOL.

And the correct conclusion. Good, na?

 

You’ve confused physical activity with exercise, LOL. A common self-serving mistake.

 

Here’s the difference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424733/

And the exercise needs to be moderate or vigorous, directed, sustained effort that significantly increases the heart rate. Why that’s metabolically important I leave you to discover. Effective physical activity would need to approximate exercise, as it might in jobs requiring significant physical effort (sustained heart rate elevation) or frequent strenuous participation in recreational sports.

Brisk walking, and the beneficial amount, in regular continuous sessions, is defined here:

https://www.medicalnewstoday.com/articles/brisk-walking

 

21 hours ago, thaibeachlovers said:

Before I got prostate cancer I'd walk for hours, or walk instead of taking the bus. Not forgetting that nurses walk miles a day as part of the job.

That wasn’t exercise (defined for you above), desultory, not continuous except perhaps when sometimes not taking the bus, probably not at least moderate in intensity, often; and so obviously suboptimal, esp given the matter of your diet, which you’ve ignored. That's my point.

 

Exercise can of course work synergistically with diet, even help compensate for a poor diet.

 

. . . it is essential to be aware that an enlarged prostate (BPH) also has a strong association with metabolic syndrome.

The metabolic syndrome includes abdominal obesity, elevated blood sugar and triglycerides, low high-density lipoprotein (HDL) cholesterol, and hypertension.

Men who had the highest levels of both occupational and recreational physical activity were 60% less likely to develop the condition [metabolic syndrome]

     --https://www.bensnaturalhealth.com/blog/exercise-prostate/ 

 

 

[thaibeachlovers]

Just now, BigStar said:

That wasn’t exercise (defined for you above), desultory, not continuous except perhaps when sometimes not taking the bus, not at least moderate in intensity; and so obviously suboptimal, esp given the matter of your diet, which you’ve ignored. That's my point.

You have no idea of what my walking was like, nor do you know what I eat.

I suggest you cease the sly attempts to denigrate me. I am not the topic, so enough of the personal attacks.

[BigStar]

20 minutes ago, thaibeachlovers said:

You have no idea of what my walking was like, nor do you know what I eat.

I suggest you cease the sly attempts to denigrate me. I am not the topic, so enough of the personal attacks.

Not a personal attack at all, but merely agreeing with the established correlations with BPH. YOU yourself brought up

 

On 12/30/2022 at 2:13 PM, thaibeachlovers said:

I used to walk a great deal. Made no difference to my hypertension, or my prostate.

And I merely pointed out that your walking, and also diet, wasn't in line with the correlation, so it should not be expected to make any difference. You gave examples of your walking, none of which appeared to substitute for exercise. Now, if it was, then you may certainly explain and I'll be happy to agree with you.

 

Moreover, you've in the past made specific reference to diet (e. g., dumping sugar in your coffee) and physical ailments (pre-diabetes, gout) consistent with metabolic syndrome, the causes of which are pretty well established.

 

So I made a valid point. Sorry you didn't like it and think it was a personal attack. Anyone who implied an expectation that walking was going to have much effect on hypertension or possibly mitigate the onset of BPH would receive the same response.

 

Your "details" led to an explanation that forum members may find informative, the younger the better.

 

I'm amused when I read in outside general forums what readers regard as "exercise" in response to the question, "What exercise do you do?" I'm led to believe that ignorance on the subject is pretty widespread.

 

[thaibeachlovers]

1 minute ago, BigStar said:

Not a personal attack at all, but merely agreeing with the established correlations with BPH. YOU yourself brought up

 

And I merely pointed out that your walking, and also diet, wasn't in line with the correlation, so it should not be expected to make any difference. You gave examples of your walking, none of which appeared to substitute for exercise. Now, if it was, then you may certainly explain and I'll be happy to agree with you.

 

Moreover, you've in the past made specific reference to diet (e. g., dumping sugar in your coffee) and physical ailments (pre-diabetes, gout) consistent with metabolic syndrome, the causes of which are pretty well established.

 

So I made a valid point. Sorry you didn't like it and think it was a personal attack. Anyone who implied an expectation that walking was going to much effect on hypertension or possibly mitigate the onset of BPH would receive the same response.

 

Your "details" led to an explanation that forum members may find informative, the younger the better.

 

I'm amused when I read in outside general forums what readers regard as "exercise" in response to the question, "What exercise do you do?" I'm led to believe that ignorance on the subject is pretty widespread.

 

I give up. I thought you'd take the hint and not make posts to me, but apparently not. Time to use the ignore function. Bye.

[Pumpuynarak]

3 hours ago, ozimoron said:

What is duodart? A urologist told me I have BPH about 3.5 cm. He suggested duodart but I haven't have urinary issues yet. I did read that stinging nettle root powder can be effective but I only take some occasionally when I remember.

Google is your friend.....

Duodart is indicated as combination therapy for the treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH). Duodart reduces the risk of acute urinary retention and the need for surgery in patients with moderate to severe symptoms of BPH.

 

Duodart Full Prescribing Information, Dosage & Side Effects

https://www.mims.com › malaysia › drug › info › duodart

 

 

[jerrymahoney]

On 12/29/2022 at 1:33 PM, BigStar said:

Well, that's IT then. Pig out, sit on the sofa, and paddle around in a pool. Chase after docs & meds, enjoy the problems and complications, get your scans, biopsies, TURP (if it's not cancer),

Thank you. I have a doctor who monitors PSA and free PSA but I do not take any prostate-related condition meds prescribed or otherwise.

BTW these are my favorite paddles.

 

 

 

[simon43]

On 1/2/2023 at 11:03 AM, JimmyJ said:

Your April insurance covers Inpatient?

Yes, it covers all inpatient costs, as well as outpatient costs for cancer/other serious illness investigations/treatment, such as MRI scans, biopsies, chemo, radiation etc. This is NOT April Insurance (Thailand), but April Insurance (France) - the 2 policies are very different.

[BigStar]

6 hours ago, jerrymahoney said:

Thank you. I have a doctor who monitors PSA and free PSA but I do not take any prostate-related condition meds prescribed or otherwise.

Congrats. The House doesn't always win, of course. In fact, the George Burns Hail Mary is first among the Principles of ANF Poster Longevity Science. You may give up your paddling, if you wish.

 

I'm not much of a gambler, however, don't believe in any Genetics Voodoo, so I'll merely soldier on with the obvious rationality of mitigating the known risk factors, thank you; and, in general, try to put off any chronic diseases as long as possible according to my understanding of the scientific probabilities. Are we done?

[xylophone]

Back on track.........and I just found this item in my files, and it was something I downloaded a couple of months ago and it may be of interest to those people who are worried about their prostate/prostate cancer and the like. Also good to see that one of these advances is available in the UK........

 

A recent Phase III clinical trial conducted by an international consortium of scientists from nine countries demonstrated some of the progress that has been made. It found that a potent new hormone therapy called darolutamide, produced by the pharmaceutical company Bayer, could significantly prolong survival in men with advanced forms of prostate cancer as well as reducing pain, when used in combination with standard therapies.

There have also been advances for patients who have been recently diagnosed with prostate cancer. A minimally invasive technique called NanoKnife, which uses bursts of quick electrical pulses guided by MRI scans to kill tumours, has been approved for use in the UK's National Health Service. Experts hope that it can help avoid many of the problems associated with conventional surgery.
 

[Jai Dee]

Several posts containing petty bickering have been removed.

[Sheryl]

On 1/2/2023 at 8:51 AM, simon43 said:

Strictly speaking, the MRI can show lumps/tumours, but they could be benign, and a biopsy will confirm the status of those lumps.  My recent MRI showed 2 growths inside my prostate which are 'grade 5' (ie very likely to be cancerous), but I'm waiting now to have a biopsy to confirm this.  (I am actually waiting on April Insurance France to give the go-ahead, and they are somewhat slow in giving the OK, perhaps still drunk after Xmas/New Year parties...)

Ask broker to help.

 

Normally only takes about a week (for non-emergencies). But sometimes there is back-and-forth with the hospital due to hospital not breaking costs out suffuciently.  Insurer might be awaiting info from hospital....and hodputal may have dropped the ball. 

 

While you might think a place like Bumrungrad would be skilled in dealing with insurers, they are not.

 

If broker can find out what the hang-up is then you can pursue it with the hospital.

[xylophone]

On 1/2/2023 at 8:15 AM, Pumpuynarak said:

Turp or Rezum but i don't know if Rezum is available in Korat where i live, BM garmat posts very positively regarding Turp he had carried out at St Marys hospital Korat so that is a definite possibility.

Back on to the subject of the Rezum procedure, there have been a few mixed reports about its efficacy from those guys who have had it performed, and just yesterday I met up with an Aussie guy who comes here for about four months of the year, and we were talking about prostates and procedures and he informed me that he had the Rezum procedure about three years ago!!

 

So I asked if it had made a difference, and his answer was surprising: – marginal difference to daytime peeing, but still having to get up four times a night to empty his bladder! Which I found very surprising, and indeed he was not too happy about it, so we talked about other options and I mentioned iTind, so he is going to investigate this when he gets back to Oz and is also considering a laser TURP.

[scubascuba3]

32 minutes ago, xylophone said:

Back on to the subject of the Rezum procedure, there have been a few mixed reports about its efficacy from those guys who have had it performed, and just yesterday I met up with an Aussie guy who comes here for about four months of the year, and we were talking about prostates and procedures and he informed me that he had the Rezum procedure about three years ago!!

 

So I asked if it had made a difference, and his answer was surprising: – marginal difference to daytime peeing, but still having to get up four times a night to empty his bladder! Which I found very surprising, and indeed he was not too happy about it, so we talked about other options and I mentioned iTind, so he is going to investigate this when he gets back to Oz and is also considering a laser TURP.

Getting up 4 times a night may be expected if he's drinking a fair bit during the day, bladder needs about half a litre to then wanting emptying. I get up 2-4 times a night since 30s, a girl i was talking to couple days ago got up 2-3 times a night. i suspect in some cases it's normal 

[xylophone]

25 minutes ago, scubascuba3 said:

Getting up 4 times a night may be expected if he's drinking a fair bit during the day, bladder needs about half a litre to then wanting emptying. I get up 2-4 times a night since 30s, a girl i was talking to couple days ago got up 2-3 times a night. i suspect in some cases it's normal 

I'm sure that we are all different with regards to our bladder emptying habits, however he is not a daytime drinker, and according to him is mostly a stay at home/watch a video type guy with maybe one beer.

 

I have got to say that learning to use a catheter last thing at night before I go to bed has been a godsend, because then I do get a full night's sleep.

[Pumpuynarak]

On 1/2/2023 at 8:15 AM, Pumpuynarak said:

Turp or Rezum but i don't know if Rezum is available in Korat where i live, BM garmat posts very positively regarding Turp he had carried out at St Marys hospital Korat so that is a definite possibility.

Well i confirmed that the Rezum procedure is not available in Korat so i've booked the Turp procedure with the same Urologist that BM garmat used at St Marys hospital in Korat. He carried out the ''camera up my ????'' test and Ultrasound and has scheduled my op for Saturday 14th.

Many thanks to BM garmat who i am in contact with, he has been a wealth of information.

[xylophone]

4 hours ago, Pumpuynarak said:

Well i confirmed that the Rezum procedure is not available in Korat so i've booked the Turp procedure with the same Urologist that BM garmat used at St Marys hospital in Korat. He carried out the ''camera up my ????'' test and Ultrasound and has scheduled my op for Saturday 14th.

Many thanks to BM garmat who i am in contact with, he has been a wealth of information.

Best of luck with your TURP, as it is the "gold standard" for this type of operation, and it would be great if you could report back on your progress.

[Pumpuynarak]

18 hours ago, xylophone said:

Best of luck with your TURP, as it is the "gold standard" for this type of operation, and it would be great if you could report back on your progress.

Thankyou and will do.

[GarryP]

On 1/8/2023 at 2:08 PM, xylophone said:

Back on to the subject of the Rezum procedure, there have been a few mixed reports about its efficacy from those guys who have had it performed, and just yesterday I met up with an Aussie guy who comes here for about four months of the year, and we were talking about prostates and procedures and he informed me that he had the Rezum procedure about three years ago!!

 

So I asked if it had made a difference, and his answer was surprising: – marginal difference to daytime peeing, but still having to get up four times a night to empty his bladder! Which I found very surprising, and indeed he was not too happy about it, so we talked about other options and I mentioned iTind, so he is going to investigate this when he gets back to Oz and is also considering a laser TURP.

There does indeed seem to be a wide difference in the results of Rezum from person to person. Some have very rapid improvement, for some others it takes time, and others do not seem to benefit much at all. 

 

I am getting up at night much less frequently than before and in the past 2 months or so saw a great improvement in night time visits to the bathroom, even after a few beers (up until recently, if I had a few beers, I would be up at least 4 times). Now only once or twice a night. This is 15 months post treatment. However, I have read previous reports of others that had the same experience, i.e. it took up to 12 months or more for their nocturia to improve. 

 

Were the results as good as anticipated? No, but there has still been a definite improvement in my case and in hindsight I would have still undergone the treatment. Now I just need to wait and see how long it lasts.

[Pumpuynarak]

On 1/9/2023 at 1:26 PM, xylophone said:

Best of luck with your TURP, as it is the "gold standard" for this type of operation, and it would be great if you could report back on your progress.

 

On 1/10/2023 at 7:49 AM, Pumpuynarak said:

Thankyou and will do.

Well i had the Turp procedure last Saturday 14th Jan, arrived at St Mary's hospital Korat at 7.30am underwent various tests/procedures including a cardiology test as i suffered a stroke back in March 2021 (good to hear the cardiologist state my heart was in good nick).

 

At 2.30pm they wheeled me in to the operating room and prepared me for the procedure which commenced at 3pm, all done by 4.15pm and i never felt a thing, no pain etc. The urologist fitted the catheter which had to remain in place until the 21st Jan when he will remove.

 

Back to my private room with wifey where i had to remain horizontal for 6 hours until 11pm, now this was a real problem for me as i hate lying horizontal, i find it so uncomfortable but needs must. The urologist came to see me at 11pm to check on how i was feeling and i reported that i was feeling no pain whatsoever.

 

In the morning i was feeling fine so i was allowed home after the urologist had seen me again, 12 noon we left the room and headed to the cashiers to pay the bill, 124,028bht, i was a happy man.....

 

Now i have to say since arriving home on the Sunday at 1pm i've started to feel pain when urinating which i am doing very frequently but the urologist did warn me of same hence he prescribed Tylenol 500mg every 6 hours. He also prescribed constipation medication as that is also a problem for many Turp patients.

Here i am 4 days later just getting on with life as best i can waiting for saturday to arrive and get rid of this damn catheter.

 

I have to say i am impressed with my Urologist Dr Kathawut Rerdwuttichaikoon and would not hesitate to recommend him, he knows what he is doing and has a wealth of experience.

 

Many many thanks to BM garmat for his recco and help and assistance, its been so comforting being able to call him to check/talk things over, thanks mate.

 

I'll conclude this report after the removal of the catheter on Saturday. 

[xylophone]

31 minutes ago, Pumpuynarak said:

 

Well i had the Turp procedure last Saturday 14th Jan, arrived at St Mary's hospital Korat at 7.30am underwent various tests/procedures including a cardiology test as i suffered a stroke back in March 2021 (good to hear the cardiologist state my heart was in good nick).

 

At 2.30pm they wheeled me in to the operating room and prepared me for the procedure which commenced at 3pm, all done by 4.15pm and i never felt a thing, no pain etc. The urologist fitted the catheter which had to remain in place until the 21st Jan when he will remove.

 

Back to my private room with wifey where i had to remain horizontal for 6 hours until 11pm, now this was a real problem for me as i hate lying horizontal, i find it so uncomfortable but needs must. The urologist came to see me at 11pm to check on how i was feeling and i reported that i was feeling no pain whatsoever.

 

In the morning i was feeling fine so i was allowed home after the urologist had seen me again, 12 noon we left the room and headed to the cashiers to pay the bill, 124,028bht, i was a happy man.....

 

Now i have to say since arriving home on the Sunday at 1pm i've started to feel pain when urinating which i am doing very frequently but the urologist did warn me of same hence he prescribed Tylenol 500mg every 6 hours. He also prescribed constipation medication as that is also a problem for many Turp patients.

Here i am 4 days later just getting on with life as best i can waiting for saturday to arrive and get rid of this damn catheter.

 

I have to say i am impressed with my Urologist Dr Kathawut Rerdwuttichaikoon and would not hesitate to recommend him, he knows what he is doing and has a wealth of experience.

 

Many many thanks to BM garmat for his recco and help and assistance, its been so comforting being able to call him to check/talk things over, thanks mate.

 

I'll conclude this report after the removal of the catheter on Saturday. 

Thanks for your feedback and I'm sure it will assist others considering undergoing this procedure. I had it done, but there were a few hiccups afterwards and I had to have a catheter for about three weeks, along with the associated bag strapped to my leg, which made a splashing sound whenever I walked, and I did a bit of it because I wanted to get out of the house!

 

Natural to feel some pain and you will probably feel a little more after the catheter is removed, although it gets better after a short while.

 

Good luck for the remainder of the time and please keep us informed of your progress. Well done on undergoing the procedure and for reporting back.

[Pumpuynarak]

1 minute ago, xylophone said:

Thanks for your feedback and I'm sure it will assist others considering undergoing this procedure. I had it done, but there were a few hiccups afterwards and I had to have a catheter for about three weeks, along with the associated bag strapped to my leg, which made a splashing sound whenever I walked, and I did a bit of it because I wanted to get out of the house!

 

Natural to feel some pain and you will probably feel a little more after the catheter is removed, although it gets better after a short while.

 

Good luck for the remainder of the time and please keep us informed of your progress. Well done on undergoing the procedure and for reporting back.

Many thanks for your post Xylophone, sharing of this info i feel is important for any propective Turp receiver.

 

''You needed a catheter for 3 weeks'', you have my deepest sympathy.

[JimmyJ]

3 hours ago, Pumpuynarak said:

 

I have to say i am impressed with my Urologist Dr Kathawut Rerdwuttichaikoon and would not hesitate to recommend him, he knows what he is doing and has a wealth of experience.

 

 

What city and hospital does he work at?

[scubascuba3]

6 hours ago, Pumpuynarak said:

He also prescribed constipation medication as that is also a problem for many Turp patients.

Any idea why?

[GarryP]

10 minutes ago, scubascuba3 said:

Any idea why?

I believe it is so you don't put too much pressure in that area when defacating. While your prostate is healing you want to minimize pressure in that area. Thus, relatively loose bowel movements are the best way to go, as squeezing one out could not only be painful but slow down healing.

[Pumpuynarak]

16 hours ago, JimmyJ said:

What city and hospital does he work at?

Korat, Nakhon Ratchasima, St Marys Hospital.

[Pumpuynarak]

14 hours ago, scubascuba3 said:

Any idea why?

Nope but i can confirm that constipation is deffo a problem for me. Here we are on Thursday morning and my last defacation was Monday morning and my food intake is normal for me.

I have to say i'm getting a little concerned, no pain though.