enlarged prostate.

p414 · July 6

I have an enlarged prostate and have been taking medicine for 3 years.

I am now thinking of having an operation to have it cut back ..Has anyone had this operation here in Thailand ?

I saw a Dr Niti in Bangkok hospital Pattaya some 2 years ago who suggested surgery then.

I was hoping to get it done when in England but waiting lists are too long.

xylophone · July 6

2 hours ago, p414 said:

I have an enlarged prostate and have been taking medicine for 3 years.

I am now thinking of having an operation to have it cut back ..Has anyone had this operation here in Thailand ?

I saw a Dr Niti in Bangkok hospital Pattaya some 2 years ago who suggested surgery then.

I was hoping to get it done when in England but waiting lists are too long.

There was a thread on this subject with quite a few respondents, me included, so try to seek that out as it may answer some of your questions.

Sheryl · July 6

Yes, there have been innumerable threads on this.

There are many options, but before considering them, make sure you are already maxed out on medication, which would mean taking 2 drugs, one in the finasteride/dutasteride family and one an alpha blocker like tamsulosin/doxazosin.

As to alternatives when medications alone don't work, surgery is not the only one nor usually the best option. There are non-surgical approaches that have less risk of long term incontinence eg:

Rezum (a steam treatment) - only if prostate volume is below a certain size. It is available in Thailand, please do a search for the many recent threads there have been on this.

Laser treatment is another - HoLEP and newer lasers as well, less widely available but can get it at Siriraj.

You may be shocked at costs which are around 200 -250k baht, give or take depending on type of treatment selected.

If you want to pursue this here, I suggest going to Siriaj private wing as they have the widest range of options/newest lasers etc. See

Assoc. Prof. Sunai Leewansangtong there. https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=247&medical_id=0&day=&startTime=&endTime=

KhunBENQ · July 6

My TURP at Bangkok Hospital Khon Kaen cost 210'000 just for the operation and some four days inpatient. I have never made up the total sum including multiple outpatient visits plus extremely expensive antibiotics etc.

There was no more useful alternative at 125 ml size.

All went well, no pain. Just persistent/repeated urinary track infection (UTI).

Some bad lab results for kidney fortunately normalized.

You will pay more in Pattaya or Bangkok.

Got a ridicolous cost estimate from B.H. Pattaya.

TURP under general anesthetic and ONE night in room for 250'000.

One night would be a joke you can bet.

Edited July 6 by KhunBENQ

KhunBENQ · July 6

5 hours ago, p414 said:

I saw a Dr Niti in Bangkok hospital Pattaya some 2 years ago who suggested surgery then.

Did you get ultrasound and PSA lab values at the time.

2 years is a significant time span.

Do ultrasound to have size measured and PSA lab.

Before the operation I even had a pricey MRT scan to determine cancer risk.

p414 · July 6

3 hours ago, Sheryl said:

Yes, there have been innumerable threads on this.

There are many options, but before considering them, make sure you are already maxed out on medication, which would mean taking 2 drugs, one in the finasteride/dutasteride family and one an alpha blocker like tamsulosin/doxazosin.

As to alternatives when medications alone don't work, surgery is not the only one nor usually the best option. There are non-surgical approaches that have less risk of long term incontinence eg:

Rezum (a steam treatment) - only if prostate volume is below a certain size. It is available in Thailand, please do a search for the many recent threads there have been on this.

Laser treatment is another - HoLEP and newer lasers as well, less widely available but can get it at Siriraj.

You may be shocked at costs which are around 200 -250k baht, give or take depending on type of treatment selected.

If you want to pursue this here, I suggest going to Siriaj private wing as they have the widest range of options/newest lasers etc. See

Assoc. Prof. Sunai Leewansangtong there. https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=247&medical_id=0&day=&startTime=&endTime=

Thanks for the info,Sheryl.

I have been taking 0,5 mg dutasteride and 20.mg atorvastin plus 400 microgram tamsulosin daily for app 3 years now.

I need to pee often though .

I am surprised at the cost of the operation..

I read somewhere last year that there is a new operation that takes app 30 minutes and that you can return home on the same day..

I cannot remember where I saw this info but it was in England.

p414 · July 6

2 hours ago, xylophone said:

There was a thread on this subject with quite a few respondents, me included, so try to seek that out as it may answer some of your questions.

Thanks Xylo..will check back

p414 · July 6

2 hours ago, xylophone said:

There was a thread on this subject with quite a few respondents, me included, so try to seek that out as it may answer some of your questions.

22 minutes ago, KhunBENQ said:

My TURP at Bangkok Hospital Khon Kaen cost 210'000 just for the operation and some four days inpatient. I have never made up the total sum including multiple outpatient visits plus extremely expensive antibiotics etc.

There was no more useful alternative at 125 ml size.

All went well, no pain. Just persistent/repeated urinary track infection (UTI).

Some bad lab results for kidney fortunately normalized.

You will pay more in Pattaya or Bangkok.

Got a ridicolous cost estimate from B.H. Pattaya.

TURP under general anesthetic and ONE night in room for 250'000.

One night would be a joke you can bet.

Thanks Beno..I do not have to pay [any more than already paid to NHS ] in England..

But due to the hospitals being filled with foreign people who have not and will never pay, the waiting list is very long with no date offered.

Not sure But I have an appointment with Dr Niti on 15 th of this month [ July]

p414 · July 6

15 minutes ago, KhunBENQ said:

Did you get ultrasound and PSA lab values at the time.

2 years is a significant time span.

Do ultrasound to have size measured and PSA lab.

Before the operation I even had a pricey MRT scan to determine cancer risk.

I had all of that done 2 years ago. and a test last jume and again this year in England..

As I live mainly in Thailand it will not be simple for me to get surgery in England.

Yellowtail · July 6

Have you seen another doctor?

I took medication Xatral XL 10 mg for about five years. My prostrate shrunk, and I quit taking about two years ago and have not had any issues.

What are your symptoms? If you have no symptoms, and if you're getting screened for cancer (I don't think, Sheryl please correct me if I am wrong) there is no reason for surgery.

I do not think frequency and urgently are a result of an enlarged prostrate.

I think if there is no cancer, there's no hurry.

p414 · July 6

1 hour ago, Sheryl said:

Yes, there have been innumerable threads on this.

There are many options, but before considering them, make sure you are already maxed out on medication, which would mean taking 2 drugs, one in the finasteride/dutasteride family and one an alpha blocker like tamsulosin/doxazosin.

As to alternatives when medications alone don't work, surgery is not the only one nor usually the best option. There are non-surgical approaches that have less risk of long term incontinence eg:

Rezum (a steam treatment) - only if prostate volume is below a certain size. It is available in Thailand, please do a search for the many recent threads there have been on this.

Laser treatment is another - HoLEP and newer lasers as well, less widely available but can get it at Siriraj.

You may be shocked at costs which are around 200 -250k baht, give or take depending on type of treatment selected.

If you want to pursue this here, I suggest going to Siriaj private wing as they have the widest range of options/newest lasers etc. See

Assoc. Prof. Sunai Leewansangtong there. https://www.siphhospital.com/en/medical-services/find-doctor?doctor_id=247&medical_id=0&day=&startTime=&endTime=

Thanks Sheryl.

I answered some minutes ago but cannot see my reply..I take 5mg dutasteride...20mg Atorvastin and 400 micrograms of tamsulosin daily.

xylophone · July 6

5 minutes ago, p414 said:

Thanks Beno..I do not have to pay [any more than already paid to NHS ] in England..

But due to the hospitals being filled with foreign people who have not and will never pay, the waiting list is very long with no date offered.

Not sure But I have an appointment with Dr Niti on 15 th of this month [ July]

Good luck with whatever you choose......and have you thought of checking the prices at good hospitals in India? As I recall there was a poster who went there and had his op done and he was very pleased with it and the price. Also check to see if Urolift is available anywhere, as that would be my number one choice and doesn't need surgery per se.

p414 · July 6

10 minutes ago, Yellowtail said:

Have you seen another doctor?

I took medication Xatral XL 10 mg for about five years. My prostrate shrunk, and I quit taking about two years ago and have not had any issues.

What are your symptoms? If you have no symptoms, and if you're getting screened for cancer (I don't think, Sheryl please correct me if I am wrong) there is no reason for surgery.

I do not think frequency and urgently are a result of an enlarged prostrate.

I think if there is no cancer, there's no hurry.

Thanks very much for your reply Y.T. ..I will google Xatral XL ..I have never heard of it.

I have no cancer and at last check up [ England last month] my prostate has not grown any larger.

p414 · July 6

All reading this and taking medication ...Check on 'LINE' for medisafe...they deliver medicines [Cheaper than most chemists] and offer C.O.D

Thanks to everyone for your responses.

Yellowtail · July 6

1 minute ago, p414 said:

Thanks very much for your reply Y.T. ..I will google Xatral XL ..I have never heard of it.

I have no cancer and at last check up [ England last month] my prostate has not grown any larger.

To be clear, I am not advising you to change medication, I was only commenting on what I took.

If you do not have flow issue, I do not think surgery will help you.

p414 · July 6

2 minutes ago, Yellowtail said:

To be clear, I am not advising you to change medication, I was only commenting on what I took.

If you do not have flow issue, I do not think surgery will help you.

Yes I have 'flow' issue...

.sometimes app an eggcup full only.

Ben Zioner · July 6

32 minutes ago, xylophone said:

Good luck with whatever you choose......and have you thought of checking the prices at good hospitals in India? As I recall there was a poster who went there and had his op done and he was very pleased with it and the price. Also check to see if Urolift is available anywhere, as that would be my number one choice and doesn't need surgery per se.

All these operations bear the risk of full, partial, temporary or permanent incontinence. I find it difficult to picture myself on a five hours flight with a pee bag or worse in nappies. Better look for local suppliers and your health insurance should foot most of the bill anyway.

BuddyPish · July 6

6 minutes ago, p414 said:

Yes I have 'flow' issue...

.sometimes app an eggcup full only.

That's not good at all.
You must be pissing 50 times a day if all you can pass is an eggcup full.

Last thing you want is a distended bladder. If it gets too stretched, it loses its ability to contract/empty properly and you'll have to use a catheter every day. Worse still is hydronephrosis which is when urine backs up into the kidneys and effectively waterlogs them. This can seriously damage the kidneys and if left too long, you're talking about kidney failure and dialysis for life or a kidney transplant and immunosuppressants for life.

Too important to leave to the NHS.
If you've got the money, throw it at this problem ASAP after a consultation with a competent urologist either here or in the UK.

xylophone · July 6

3 minutes ago, Ben Zioner said:

All these operations bear the risk of full, partial, temporary or permanent incontinence. I find it difficult to picture myself on a five hours flight with a pee bag or worse in nappies. Better look for local suppliers and your health insurance should foot most of the bill anyway.

No problem if one has health insurance, as you say, however I had my TURP in Melbourne and although things did not go that smoothly, I flew back here with an in-dwelling catheter and a bag, and although there is a risk of the events you describe, in the main it is a fairly straight forward operation. AND if Urolift is available, then I would go for it in a heartbeat!!

p414 · July 6

38 minutes ago, BuddyPish said:

That's not good at all.
You must be pissing 50 times a day if all you can pass is an eggcup full.

Last thing you want is a distended bladder. If it gets too stretched, it loses its ability to contract/empty properly and you'll have to use a catheter every day. Worse still is hydronephrosis which is when urine backs up into the kidneys and effectively waterlogs them. This can seriously damage the kidneys and if left too long, you're talking about kidney failure and dialysis for life or a kidney transplant and immunosuppressants for life.

Too important to leave to the NHS.
If you've got the money, throw it at this problem ASAP after a consultation with a competent urologist either here or in the UK.

Only once or twice a day just an eggcup fulll..Maybe 8-10 times a day I have to pee..2-3 times at night and I do not drink anything [ I am teetotal] after 6.30 pm.

Yellowtail · July 6

Egg cup quickly or slowly?

Flow and volume are not the same.

novacova · July 6

My personal experience with this issue. Took some saw palmetto and went on a two week diet of raw food, no salt sugar or caffeine. First three days of only dark leafy greens juice with drastic improvements on the third day. The remainder of the two weeks just raw fruit and vegetables and raw veggie juice. Afterwards no fried food, white rice, grains or processed grains. No food laced with sugar. Pee like a fire hose now.

BigStar · July 6

1 hour ago, p414 said:

I have an appointment with Dr Niti on 15 th of this month [ July]

Excellent. Hope nothing drastic will be required. TURP has been mentioned, but it caused @ThaiPaulyterrible life-changing side effects; shouldn't have, but did. From reading about his experience, I'd never risk it.

Sheryl · July 6

1 hour ago, p414 said:

Thanks for the info,Sheryl.

I have been taking 0,5 mg dutasteride and 20.mg atorvastin plus 400 microgram tamsulosin daily for app 3 years now.

I need to pee often though .

I am surprised at the cost of the operation..

I read somewhere last year that there is a new operation that takes app 30 minutes and that you can return home on the same day..

I cannot remember where I saw this info but it was in England.

Atorvastatin is nto for prostate, it is for lipids (cholesterol).

But otherwise yes you are in usual medications.

The various non-surgical options I mentioned (rezum, laser) are likely what you read about. They are indeed day procedures though in Thailand they may like ot keep you as otherwise you have to go home in with a catheter -- there is initial urinary retention due to swelling.

Or you may have read about "Urolift" which is a surgical procedure but without any cutting of the prostate, they insert implants to push the prostate away from the opening of the bladder. This is i deed available in the UK . In Thailand it has only just become available and so far just at Bumrungard.

A technique that has only just (as in, last month) become available is sometimes better avoided until the surgeon(s) doing it have acquired a fair amount of experience, unless they already did a good number of procedures abroad. Be sure to ask about this.

As you can see, many choices - the traditional surgery (greatest risk of long term incontinince), laser treatments (several types), Rezumn, Urolift.

Discuss with urologist in detail the pros and cons of each in your specific case, ask how many such procedures he personally has performed to date.

.

Yellowtail · July 6

And the common medications have been used by tens or hundreds of millions of men long term without significant negative issues.

save the frogs · July 6

As I've mentioned in other threaads (and was ridiculed) ...

... If you can find alternative treatments such as herbal remedies, it may sometimes (not always) be better than going directly with medical intervention.

... as medical intervention can be fraught with problems

Saw Palmetto is one such herbal remedy for this condition. So I would consider contacting a Naturopath and asking them about it and testing it out as the side effects are minimal.

https://www.healthline.com/health/enlarged-prostate/natural-remedies#natural-treatments

Saw palmetto is an herbal remedy that comes from the fruit of a type of palm tree. It’s been used in alternative medicine for centuries to relieve urinary symptoms, including those caused by an enlarged prostate. According to the National Institutes of Health (NIH)Trusted Source, a few small-scale studies have suggested that saw palmetto might be effective for relieving BPH symptoms.

Sheryl · July 6

1 hour ago, p414 said:

Thanks very much for your reply Y.T. ..I will google Xatral XL ..I have never heard of it.

Xatral XL is alfuzosin . Same class of drug and action as the tamsulosin you are already taking.

Doubtful IMO that a change from tamsulosin to alfuzosin will make much if any difference.

Whatever you do, do not take the Xataral in addition to your current meds as you'd be double dosing on the alpha blockers (tamsulosin and alfuzosin )

Sheryl · July 6

2 hours ago, p414 said:

Not sure But I have an appointment with Dr Niti on 15 th of this month [ July]

The price estimates I gave were for less expensive places thatn BPH so be prepared for even greater price shock.

Also be prepared to be steered towards Rezum because, other than TURP (traditional surgery), I think that is all BPH can do. There is a much wider range of options in Bangkok.

To get full advice on all option, including laser and Urolift, and which are best for you, you need to see a doctor in a hospital that offers them all.

Tropicalevo · July 6

2 hours ago, KhunBENQ said:

My TURP at Bangkok Hospital Khon Kaen cost 210'000 just for the operation and some four days inpatient. I have never made up the total sum including multiple outpatient visits plus extremely expensive antibiotics etc.

My TURP last year was 330,000 baht at Bangkok Hospital Samui.

One of the main reasons for the high costs - the consultants that fly down every weekend insist of charging high fees for 'their inconvenience'. (Urologists are only available Saturdays and Sundays. Different one every three to four weeks.)

Having paid an 'arm and a leg, it was still worth it.

Enlarged prostate for 10 years. Tried every medicine under the sun - no change. Just carries on growing.

Some years I was paying 50,000 baht+ a year on meds and that was from the local pharmacy.

By the time they offered Rezum treatment, it way way too big. (180 to 200 grams they estimated)

Edited July 6 by Tropicalevo

Thailand J · July 6

iTind.

Something new at BNH.

Suitable for those with prostate volume <60ml. Treatment is effective for 3 yrs.

https://www.bnhhospital.com/itind_en_/

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