enlarged prostate.

[Ben Zioner]

1 hour ago, Yellowtail said:

Egg cup quickly or slowly? 

Used to ejaculate that much, now it goes back to the bladder and clouds the next quarter pint i'll be pi$$ing.

[HappyExpat57]

Be VERY CAREFUL about being misdiagnosed. For obvious reasons I can't name and blame. A doctor in Pattaya performed an ultrasound then recommended a procedure (can't remember the name but it's basically shoving a steam cleaner up my urethra and blasting away a portion of the prostate). Would have cost over 200k baht. I have health care in the US, so during my annual family visit, I got a very thorough exam. They told me I was NOT a likely candidate for this procedure. That would have been money and 6-12 months of suffering/bleeding for NOTHING!

 

Get at least another exam, maybe two. This is not a thing you want to get wrong.

 

 

 

Edited July 6 by HappyExpat57

[Lacessit]

I have known my urologist in Australia for 18 years. He has the suffixes FRCS, FRACS after his name. Which means he is at the top of the tree in qualifications and surgery experience.

 

When I broached the subject of a TURP or Rezum treatment with him last year, he advised me to stay on medication as long as possible. According to him, surgery should be a last resort, due to the high risk of side effects such as incontinence, UTI's, and retrograde ejaculation.

[p414]

1 hour ago, Sheryl said:

 

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.

 

.

 

Thanks again for your replies and for your time,Sheryl.

I am most interested in the 'Urolift' treatment.. This sounds much better to me than surgery.

I will check with my doctor in England and with Bumrungard hospital re cost.

As I paid 44 years National Insurance in England I am not happy to pay huge sums for any medical costs but will check all pros and cons..

 

 

[Ben Zioner]

2 hours ago, xylophone said:

I flew back here with an in-dwelling catheter and a bag

All the way from UK? Business class?

[p414]

2 hours ago, Yellowtail said:

Egg cup quickly or slowly? 

 

Flow and volume are not the same. 

Sorry Y.T. I should have written 'volume'..flow is not fast but not a problem

[p414]

42 minutes ago, Lacessit said:

I have known my urologist in Australia for 18 years. He has the suffixes FRCS, FRACS after his name. Which means he is at the top of the tree in qualifications and surgery experience.

 

When I broached the subject of a TURP or Rezum treatment with him last year, he advised me to stay on medication as long as possible. According to him, surgery should be a last resort, due to the high risk of side effects such as incontinence, UTI's, and retrograde ejaculation.

Thanks for the info, Lacessit..I thought that surgery should be only a last resort..Is why I am now interested in Sheryl's mention of Urolift treatment..

[Lacessit]

27 minutes ago, p414 said:

Thanks for the info, Lacessit..I thought that surgery should be only a last resort..Is why I am now interested in Sheryl's mention of Urolift treatment..

There are other risks with Urolift. Ask Gemini.

[xylophone]

1 hour ago, Ben Zioner said:

All the way from UK? Business class?

I stated that I had the op in Melbourne!

[Ben Zioner]

14 minutes ago, xylophone said:

I stated that I had the op in Melbourne!

Yes Melbourne, in Derbyshire I guess?

[mfd101]

3 hours ago, novacova said:

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.

I entirely agree. Saw palmetto (sold in Thailand as 'Sametto') certainly helps. And the change in diet as mentioned here is REALLY good.

 

My personal experience (now age 75) is that if I'm strict on my diet as above - low low sugar is the key - then I have no problems and get up only once a night. But if I overindulge - my b/f likes to bring me chocolate or sweet cakes which I find hard to resist - then the next day I may have to piss every 15 or 20 minutes and up 3 times in the night. Then back to normal the following day.

 

Can't help noticing - with this example and so many other health issues - how people get all caught up in the medical processes and drug taking, when quite simple changes in diet and physical exercise can cure and prevent a long list of ailments caused by 'modern living'.

[Yellowtail]

5 minutes ago, mfd101 said:

I entirely agree. Saw palmetto (sold in Thailand as 'Sametto') certainly helps. And the change in diet as mentioned here is REALLY good.

 

My personal experience (now age 75) is that if I'm strict on my diet as above - low low sugar is the key - then I have no problems and get up only once a night. But if I overindulge - my b/f likes to bring me chocolate or sweet cakes which I find hard to resist - then the next day I may have to piss every 15 or 20 minutes and up 3 times in the night. Then back to normal the following day.

 

Can't help noticing - with this example and so many other health issues - how people get all caught up in the medical processes and drug taking, when quite simple changes in diet and physical exercise can cure and prevent a long list of ailments caused by 'modern living'.

Yeah, ask Steve Jobs

[Lacessit]

12 minutes ago, mfd101 said:

 

Can't help noticing - with this example and so many other health issues - how people get all caught up in the medical processes and drug taking, when quite simple changes in diet and physical exercise can cure and prevent a long list of ailments caused by 'modern living'.

Agree. I fixed my high blood pressure and gastric reflux with diet and exercise changes, and weaned myself off anti-inflammatories and anti-depressants.

 

Having said that, I can't do much to reverse BPH, or bulging spinal discs and chronic osteo-arthritis of the lower spine. For those ailments, I am grateful for modern medicine.

[xylophone]

2 hours ago, Ben Zioner said:

Yes Melbourne, in Derbyshire I guess?

That is a strange post??? Epworth hospital in Melbourne, Australia in 2009, so why the strange/odd post of yours??? Have you been drinking?

 

And for the record, I flew Business Class with my G/F from Melbourne to Phuket.

 

 

 

 

Edited July 6 by xylophone

[Etaoin Shrdlu]

1 hour ago, mfd101 said:

But if I overindulge - my b/f likes to bring me chocolate or sweet cakes which I find hard to resist - then the next day I may have to piss every 15 or 20 minutes and up 3 times in the night. 

 

 

 

Those sound like symptoms of diabetes.

[Ben Zioner]

22 minutes ago, xylophone said:

That is a strange post??? Epworth hospital in Melbourne, Australia in 2009, so why the strange/odd post of yours??? Have you been drinking?

 

 

 

 

No.

[JetsetBkk]

I recently had a major checkup at Bangkok Phuket hospital - their "Emporer checkup program". 

One curious result was that my testosterone level is 50% higher than the top of the normal range. My doctor explained that Dutasteride, which I take for BPH, prevents an enzyme from converting testosterone into dihydrotestosterone (DHT). 

He recommended changing to saw palmetto, which I have done. 

[scubascuba3]

3 hours ago, JetsetBkk said:

I recently had a major checkup at Bangkok Phuket hospital - their "Emporer checkup program". 

One curious result was that my testosterone level is 50% higher than the top of the normal range. My doctor explained that Dutasteride, which I take for BPH, prevents an enzyme from converting testosterone into dihydrotestosterone (DHT). 

He recommended changing to saw palmetto, which I have done. 

What is the problem with DHT in adults? what did the Dr say? i had a quick look and it's linked to prostate enlargement and hair loss but it isn't clear if having less of it helps or not

 

https://www.ncbi.nlm.nih.gov/books/NBK557634/

Edited July 6 by scubascuba3

[mfd101]

8 hours ago, Etaoin Shrdlu said:

 

Those sound like symptoms of diabetes.

Yes, early stage. Whence the need for fairly strict diet control (which I'm usually but not always reasonably good at).

[JoseThailand]

@Sheryl What are the options if one has Thai social security?

[Ralf001]

2 minutes ago, JoseThailand said:

@Sheryl What are the options if one has Thai social security?

 

Prolly best to ask the Uroligist at your nominated hospital.

[JoseThailand]

1 minute ago, Ralf001 said:

 

Prolly best to ask the Uroligist at your nominated hospital.

 

I just wanna know what types of treatment are covered by Thai social insurance

[p414]

12 hours ago, Lacessit said:

There are other risks with Urolift. Ask Gemini.

Thanks lacessit..

Where is 'gemini?..I want something that means I do not have to keep taking the medicine I am now taking daily.

[JimHuaHin]

My recommendation - follow Sheryl's advice, closely.

 

I have had prostrate issues for about 6-7 years.  I have been seeing two very good urologists at my local government hospital, both of who provided similar advice as Sheryl.

[p414]

19 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 all of your info,Sheryl..

I believe my prostate is twice normal size.Is this considered 'too large' for Urolift ?.

I cannot find if I would still have to take my full medication should I have Urolift done? 

Do you know if I would still have to take all medicine?

 

 

 

 

[actonion]

18 hours 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.

 

 

Bangkok Pattaya Hospital does the Rezum procedure, hot steam, at a cost of 200,000b, 18 months ago, and go home the same day,  I had it done  because of Enlarged Prostate  that was causing too many  Urinary Tract Infections, I no longer get  the infections  but  Incontinence and symtoms of over active Bladder that I never had before the operation which the doctor says I  don't have..so I'm a bit confused

[connda]

19 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.

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.

Look into India if cost is a factor. 

[Doctor Tom]

16 hours ago, HappyExpat57 said:

Be VERY CAREFUL about being misdiagnosed. For obvious reasons I can't name and blame. A doctor in Pattaya performed an ultrasound then recommended a procedure (can't remember the name but it's basically shoving a steam cleaner up my urethra and blasting away a portion of the prostate). Would have cost over 200k baht. I have health care in the US, so during my annual family visit, I got a very thorough exam. They told me I was NOT a likely candidate for this procedure. That would have been money and 6-12 months of suffering/bleeding for NOTHING!

 

Get at least another exam, maybe two. This is not a thing you want to get wrong.

 

 

 

So long as I'm peeing and ejaculating, nothing on Earth would make me undertake a procedure for just having an enlarged prostate, especially in LOS, where the priority in healthcare  is money.  

[p414]

58 minutes ago, actonion said:

Bangkok Pattaya Hospital does the Rezum procedure, hot steam, at a cost of 200,000b, 18 months ago, and go home the same day,  I had it done  because of Enlarged Prostate  that was causing too many  Urinary Tract Infections, I no longer get  the infections  but  Incontinence and symtoms of over active Bladder that I never had before the operation which the doctor says I  don't have..so I'm a bit confused

 

Thanks actonion..

I need to know these facts before I go forward.

[Moonlover]

17 hours 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.

 

This is a very important issue @p414. I reached your stage after being on meds for a few years. I live in the sticks and all the local urologist could offer was surgical removal. No way Jose! I was aware of the risk of kidney damage as described above by @BuddyPish and decided to chance my arm at self catherization in order to relieve the pressure on the bladder and kidneys. 

 

That was over a year ago and it's been so successful that I 've continued using this method. I'm no longer 'toilet hunting' whenever we go out anywhere as I can last for up to 4 hours between pees and importantly I only need to visit the loo once during the night so my sleep has greatly improved. Like you I practice intermittent fasting, nothing after 6pm which also helps and I've also come off the meds which were, by now ineffective and giving me nasty side affects, notably weight gain and edema.

 

There's a very interesting website right here if you'd like more details and you can PM me if you'd like to discuss further. You should of course also chat with Sheryl about it.