Prostate surgery user reviews .... turp? rezum? other ?

[Lacessit]

12 minutes ago, Peterphuket said:

To be honest, I would like to mention precisely that I drink a lot of water and then also with the addition of 2 slices of lemon, it is even so that I also take the water to bed with me and when I have gone to pee, always take a sip before going back to sleep.

I did not have my usual drink of water before going to bed last night.

 

I don't think it made any difference.

[Moonlover]

45 minutes ago, Peterphuket said:

It is striking what you say there, because of austerity I started drinking Hong tong/cola every other day, the other day I drink 2 glasses of wine.
The remarkable thing is that last night, as happens more often, I had trouble falling asleep, it took 1.5 hours before I slept also I perspired more than usual.
That can't be from the coffee, I only drink that in the morning, so it could well be because of the cola.
I always drink those two glasses before dinner, but because of your comment and last night's experience, I am considering quitting that mix, and stick to wine again.
Thanks for sharing your experiences.

 

It is surprising the number of ways caffeine creeps in under the radar. I discovered the caffeine link one evening when I drank a bottle of soda water without any whisky. Having established a stable one pee a night routine I was  suddenly going 3 times!

 

I tried it 2 more times and I was convinced it was the soda water. From then on its been whisky on the rocks for me. (and back to 1 pee per night)

 

Good luck. I hope you find the above useful.

[LarryLEB]

On 12/5/2024 at 3:36 PM, StraightTalk said:

I have an enlarged prostate, and my urologist recommended an MRI, which thankfully confirmed there is no cancer. He prescribed DUODART, but I still find myself needing to use the bathroom 3-4 times a night. My annual checkup is approaching, and there’s a possibility the gland may not have shrunk enough. While I haven’t been advised to undergo surgery yet, my query is precautionary in case my urologist recommends gland removal or another procedure. I am open to seeking treatment in Bangkok or even Singapore if necessary.

How long have you been taking Duodart?  I had first been put on Tamsulosin (about 2 years go) to improve urine flow at the toilet.  This was very effective.  No problem with flow any more.  But, I was still going to the bathroom 4 to 6 times a night.  About a year ago, urologist added Dutasteride.  After about 6 months, I was down to only 1 or 2 times per night.  Then, after about another 6 months, I had the MRI for prostate cancer -- turned out negative.  While in the MRI, they measured prostate size.  The Dutasteride had reduced its size by 30%.

 

The reduction in size of my prostate was the reason for the reduced number of trips to the toilet at night.  

 

(PS:  Duodart is the medication which combines Tamsulosin and Dutasteride.)

[LarryLEB]

19 hours ago, Sheryl said:

No doctor will recommend (or perform) complete removal of the prostate for benign enlargement. Only resection which can be achieved in a variety of ways - TURP, laser enuclueation, steam (Urolift) etc etc.

 

Complete removal of the gland carries considerably more risk of impaired sexual function etc than resection does.

The great boogeyman of prostate surgery is always the high incidence of some kind of incontinence.  Sheryl, I have often wondered WHY these prostate procedures always involve cutting the urethra.  Why can't the surgery be done by directly accessing the prostate without slicing through the urethra or bladder?

[Tropicalevo]

I had an enlarged prostate for about 10 years.

I asked about Rezum (and others) but was told 'not available in Thailand back then.

The bathroom visits eventually became hourly.

Medications did not work, having spent 100,000's of baht over those 10 years on many different types as well as MRI's and even a biopsy once.

Went to a urologist in Phuket last year and he began to tell me about this wonderful 'new' Rezum treatment. (I was already there for eye surgery.)

I said 'book it Danno'. He looked into it, then apologised and said that he could not. My prostate was far too large.

After another failed try of medicine and still no real sleep I said sod it. Take it out. (End of 2023.)

I was not worried about most side affects as my wife died about 7 years ago.

Had the operation - successful, which surprised the surgeon. Biggest prostate he had removed.

One major problem though was they stuffed up the catheter insertion or removal - caused damage to the end of my urethra at the tip of the penis. Almost completely blocked/scarred.

I could not urinate. Penis would swell up with urine and it just dribbled out.

Multiple visits for a 'rebore' and in the end, the doc said, here are some catheters, save money and do it yourself.

After about three months after the TURP, all good.

Sleep has improved slightly. Now 2-3 hours between bathroom visits. I suspect some permanent damage after so many years of the enlarged prostate.

I never sleep more than 6 hours anyway.

Bladder control is OK but I would not impress anyone in the 'pizzing up the wall' contest.

Some very attractive nurses 'attended' to me during my hospital stay and the rebores, but no reaction from the John Thomas.

[BigStar]

Prostatic artery embolization (PAE) seems a thing now, better than Urolift even and much cheaper. Evidently not yet available in Thailand but India has it. I don't have any BPH symptoms yet, which I attribute to a healthy lifestyle, If I did, I think I'd go to India and get a few checks done there as well.

 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/prostatic-artery-embolization

 

[Moonlover]

14 minutes ago, BigStar said:

Prostatic artery embolization (PAE) seems a thing now, better than Urolift even and much cheaper. Evidently not yet available in Thailand but India has it. I don't have any BPH symptoms yet, which I attribute to a healthy lifestyle, If I did, I think I'd go to India and get a few checks done there as well.

 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/prostatic-artery-embolization

 

This method was featured in a BBC documentary a couple of years. It was, apparently very successful.

[simon43]

I've had BPH for at least 10 years.  I had an MRI 2 years ago after my PSA levels increased, but a subsequent biopsy found no cancerous cells, but did find 2 benign calcium stones inside my prostate.  I have taken alfusolin daily for maybe 5 years, as my flow got worst 5 years ago.

 

However, i recently (4 weeks ago), stopped taking this medication, (primarily because I am working in Myanmar and supply of medicines is difficult).  Well, I haven't noticed any difference in my flow after stopping the medication!  I do get up 1 or 2 times per night to pee, AND I do have antibiotic-resistant e-coli infections.  But I've got used to these issues and can live with them.  To summarise, my flow rate is acceptable even after stopping the alfusolin medication.

 

Addendum:  I now teach at a school, and have no problems with the urge to pee, no need to rush out of the classroom! I can wait an hour or 2 without issue.

[StraightTalk]

2 hours ago, simon43 said:

I had an MRI 2 years ago after my PSA levels increased, but a subsequent biopsy found no cancerous cells

That's interesting. My urologist recommended an MRI to detect any cancerous cells, explaining that this approach would eliminate the need for a biopsy.

[Sheryl]

19 hours ago, StraightTalk said:

That's interesting. My urologist recommended an MRI to detect any cancerous cells, explaining that this approach would eliminate the need for a biopsy.

MRI (spevial type for prostate) does not eliminate need for biopsy in all cases. What it does do, is help identify which men may need biopsy thus avoiding many unnecessary ones. 

[simon43]

16 hours ago, StraightTalk said:

That's interesting. My urologist recommended an MRI to detect any cancerous cells, explaining that this approach would eliminate the need for a biopsy.

My PSA is typically around 6, but stable, raised because of my BPH.  However, it jumped up to 14, which warranted an MRI.  That showed up 2 'lumps' which the Bumrungrad doctors suspected were cancerous growths, and a biopsy was therefore the next action. Happily for me, that biopsy found no cancer, just these 2 calcium stones.  My raised PSA was also caused by UTIs, which I get regularly.  Right now, my PSA has reduced to about 8, but again stable.

[BKKKevin]

Has anyone considered trying iTnd or Urolift as a treatment?

Both seem to be available at BNH…

 

[Mark Nothing]

The tone of your questions indicates you lack confidence in the bph treatments and it sounds like you don't want to get financially fleeced or permanently maimed. You seem to be balancing on a fence unsure which way to jump.

 

I chose to jump on the opposite side of the fence from your urologist. I could not accept the treatment theories or prices of those who can't even explain what causes bph, so disregarded the info they provided as useless knowing the correct answer was available.

 

My personal  strategy was to make a goal to permanently fix the bph, keep a positive attitude, and persistently make it happen.  Previously I assumed my dietary changes and magic bullet were the key.  Helpful, but not where the true power lies.

 

The true power lies in the nonphysical realm.  Along the way I found the Holy Bible to be the best, most powerful health book I have ever read.  The theory is we are a soul housed in a physical body and to fully activate the immune system both components require active stimulation.

 

So now I say a daily prayer thanking God for full health and vitality, plus a good night of uninterrupted sleep.  And combine it with proper diet and exercise eliminating poisoned food and water.  The bph is no longer a nuisance, just disappearing into thin air.

 

The best selling book of alltime was written over 2,000 years ago so this information is not exactly new and tells me the current medical industry used to be unecessary as we are all endowed with the ability to control our own health, should we choose to activate it. As a consumer, I demand permanent results and am happy to report being a satisfied customer.  This method is simple, free with no side affects. 

 

Interesting the Biblical punishment for worshipping false idols, like some do the medical industry, is stoning.  As in  calcified stones growing inside the body to include bladder and prostate, leading to bph.

 

Another prayer I found helpful is "Thank you for removing the stone from my flesh and replacing it with a heart of flesh".

[magpie3]

My reading regarding prostate enlargement led me to find that doctors measured blood levels of testosterone and found them relatively 'normal', which was counter intuitive as bph was  thought to be at least partly testosterone induced. Research I read dated as far back as 2005 documented the 'leaking' by gravity of testosterone into prostate tissues via dysfunctional blood vessels (described as varioceles - sp?) between testes and prostate, which increased local levels of testosterone levels hundreds of times and caused bph. 

Not certain if this led to PAE - prostatic artery embolisation - as a treatment, but I believe I read treatment of varioceles -if present - can also be achieved by surgery and may provide another bph treatment possibility. 

All this from memory and just to add to the discussion. 

[Ben Zioner]

On 12/6/2024 at 5:16 AM, StraightTalk said:

I would opt for the least invasive method available, which, to the best of my knowledge, is the da Vinci robotic-assisted procedure. 

This is not correct. Da Vinci prostate enucleation (as opposed to Da Vinci radical prostatectomy), can be substituted with Holep prostate enucleation. This procedure is less invasive with the added benefit of being possible for very large glands (>100 grams).

 

But our days things have changed a bit as the classic path (medication and then surgery) should be reconsidered and become (medication, prostatic artery embolisation and then surgery ,if needed.

[rumak]

3 hours ago, Ben Zioner said:

This is not correct. Da Vinci prostate enucleation (as opposed to Da Vinci radical prostatectomy), can be substituted with Holep prostate enucleation. This procedure is less invasive with the added benefit of being possible for very large glands (>100 grams).

 

But our days things have changed a bit as the classic path (medication and then surgery) should be reconsidered and become (medication, prostatic artery embolisation and then surgery ,if needed.

i have read one article ( actually more of an advertisement) ... from Yale . Unfortunately there is no date :  https://www.yalemedicine.org/conditions/prostatic-artery-embolization

Sure SEEMS like something to be considered .  I surely doubt anyone here has had one, and don't yet know if it is offered in Thailand .   I will be reading up on it some more.

Thanks for posting .

[Ben Zioner]

13 minutes ago, rumak said:

I surely doubt anyone here has had one, and don't yet know if it is offered in Thailand . 

Here you are

 

 

[Sheryl]

48 minutes ago, rumak said:

i have read one article ( actually more of an advertisement) ... from Yale . Unfortunately there is no date :  https://www.yalemedicine.org/conditions/prostatic-artery-embolization

Sure SEEMS like something to be considered .  I surely doubt anyone here has had one, and don't yet know if it is offered in Thailand .   I will be reading up on it some more.

Thanks for posting .

I am not aware  of anyplace in Thailand doing PAE. 

[Ben Zioner]

16 minutes ago, Sheryl said:

I am not aware  of anyplace in Thailand doing PAE. 

My above link had a wrong URL.

[rumak]

28 minutes ago, Ben Zioner said:

My above link had a wrong URL.

this is only result i got on my first google search .....https://doctor.global/results/asia/thailand/all-cities/vascular-surgery/procedures/prostatic-artery-embolization-pae

[Ben Zioner]

5 minutes ago, rumak said:

this is only result i got on my first google search .....https://doctor.global/results/asia/thailand/all-cities/vascular-surgery/procedures/prostatic-artery-embolization-pae

I don't trust these sites too much.

 

Siriraj is a sure thing and might contact them if the results of my next MRI show that I am suitable candidate.

 

Otherwise I have met Dr Goh who contributed to this paper. But he since he is a robotic surgeon he seemed reluctant to let business go to the Interventional Radiologists. This may slow down adoption of PAE. 

 

My case is somewhat different from the other guys here as I have been for six years on AS for low risk PCA and have a very large prostate. Shrinking my Prostate would open the possibility of getting SBRT radiotherapy if the need arises. Otherwise I'll just opt for ADT/Orchiectomy and subsequently Chemo if/when the cancer spreads. I won't consider surgery, as it is a major mutilation that gives less than a year of life expectancy gain, while it pays for the surgeon's new Porsche.

[olongapo]

Hi I had aquablation never worked much for me, now because of scarring from aqua I need turp apparently, I'm loath to do that I don't like the retrograde retro or worse complications rezum not suitable in told I wonder is pae done in Thailand?

[Sheryl]

18 hours ago, olongapo said:

Hi I had aquablation never worked much for me, now because of scarring from aqua I need turp apparently, I'm loath to do that I don't like the retrograde retro or worse complications rezum not suitable in told I wonder is pae done in Thailand?

As far as I know, no

[Sheryl]

An unhelpful post has been removed

[ClaySmc]

For what it's worth, being treated for BHP at Thammasat University Hospital, a government hospital, in Rangsit, I know that they do 3 procedures at very good cost. The lowest being TERP for $20,000, HoLEP for 70,000 and Rezum for 100,000. Those are approximate as I was verbally given those figures, not a written estimate.

 

I'm still researching procedures and haven't decided if I should have one of them at Thammasat or look at other procedures to do. I don't have specific information on the urologists, but the doctor who does HoLEP has just come back from a year in the UK for further training and work experience.

[scubascuba3]

6 hours ago, ClaySmc said:

For what it's worth, being treated for BHP at Thammasat University Hospital, a government hospital, in Rangsit, I know that they do 3 procedures at very good cost. The lowest being TERP for $20,000, HoLEP for 70,000 and Rezum for 100,000. Those are approximate as I was verbally given those figures, not a written estimate.

 

I'm still researching procedures and haven't decided if I should have one of them at Thammasat or look at other procedures to do. I don't have specific information on the urologists, but the doctor who does HoLEP has just come back from a year in the UK for further training and work experience.

You say $? of course different to THB

[ClaySmc]

16 hours ago, scubascuba3 said:

You say $? of course different to THB

Sorry, it should be in Baht.

[jmd8800]

Just finished a visit with the urologist yesterday. I have had BPH for a couple of years now and it is treated with DuoDart. Over the last few months urine flow has slowed a bit during the day, but at night the flow is very slow. Not even a stream. And it feels like there is an obstruction that I don't feel during the day.

 

The doctor suggested I take another tamsulosin 0.4 at night. A quick search on Kagi and perplexiy said that was an uncommon dosing. Rather than 0.4 2 times per day the recommended dose is 0.8 once a day.

 

Anyone here that does tamsulosin 0.4 2x per day? What are your results?

 

In the evaluation the doctor said the prostate was enlarged but not terribly big and he did not recommend surgery. Personally I'd like to see what happens if I stop the dutasteride and if the prostate enlarges again then I would check out a UroLift procedure.

[Sheryl]

2 hours ago, jmd8800 said:

Just finished a visit with the urologist yesterday. I have had BPH for a couple of years now and it is treated with DuoDart. Over the last few months urine flow has slowed a bit during the day, but at night the flow is very slow. Not even a stream. And it feels like there is an obstruction that I don't feel during the day.

 

The doctor suggested I take another tamsulosin 0.4 at night. A quick search on Kagi and perplexiy said that was an uncommon dosing. Rather than 0.4 2 times per day the recommended dose is 0.8 once a day.

 

Anyone here that does tamsulosin 0.4 2x per day? What are your results?

 

 

The dosage range for tamsulosin is .4 - .8 mg daily. Since you are already on DuoDart which contains .4mg,  you would add no more than another .4mg to that.

 

It is usually taken as a single dose, true. Assuming you take the DuoDart in the morning, doctor may have suggested the additional .4 at night to help maintain blood levels through the night since this is when your symptoms are worst. Best to ask him rather than try to second guess about it.

[jmd8800]

1 hour ago, Sheryl said:

The dosage range for tamsulosin is .4 - .8 mg daily. Since you are already on DuoDart which contains .4mg,  you would add no more than another .4mg to that.

 

It is usually taken as a single dose, true. Assuming you take the DuoDart in the morning, doctor may have suggested the additional .4 at night to help maintain blood levels through the night since this is when your symptoms are worst. Best to ask him rather than try to second guess about it.

Thanks for the info. I assumed the nighttime dose was to balance things out, and that is what I'll do. I do trust him a LOT more than I trust search engines... 😁