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

[Jonnapat]

On 12/5/2024 at 10:24 AM, StraightTalk said:

In hindsight would you have opted for the da Vinci Prostatectomy?

https://www.urologists.org/article/procedures/da-vinci-prostatectomy

 

Therein lies the problem. How would one determine a "good surgeon"? Robotic surgery for prostate removal seems to be the least invasive procedure unfortunately not (yet) available in Thailand.

https://www.ttsh.com.sg/Patients-and-Visitors/Pages/Find-Specialist-Details.aspx?specialist=Chong-Yew-Lam

 

[Jonnapat]

Not true ,I had robotic protastectamy in 2008 at Siriraj hospital. There were only 2 da Vinci machines in Thailand at the time, although that was 16 years ago.

[StraightTalk]

8 minutes ago, Jonnapat said:

Not true ,I had robotic protastectamy in 2008 at Siriraj hospital. There were only 2 da Vinci machines in Thailand at the time, although that was 16 years ago.

Thanks for keeping me up to date.

[rumak]

2 hours ago, actonion said:

I had the Rezum Op 2 years ago.. on the advice of  the Urologist  because i take Blood thinning Pills  & the Rezum causes little bleeding..

Reasons for the Op were  night time Urination  5 or 6 times  plus frequent UTI's, the frequent UTI's have disappered  & the night time Urination has reduced to 2 times a night  depending on if you have had a night out  drinking..

What i am left with is  an urge to Urinate  now & again, & slight Incontinence when coughing sneezing etc, the useless Urologist suggests Kegel Exercises,  which have'nt worked after 6 moths of trying.. I asked if i have Over Active Bladder,  I was told no, but i thought i would self Medicate on  Bladder control Medication 3 months ago,  just to see,  and  hey presto,  they work, so now no more Incontinence  & no more  Urges to Urinate, lets see what happens if  /when I  stop the Bladder Medication which is recommended to do after  3 months

what medication are you taking ?

 

[Moonlover]

16 minutes ago, Peterphuket said:

It is nice to read your experiences.
Like many elderly people, I too have the same prostate problems and that means I have to get out on average 3 times a night to pee.
But what concerns me and I therefore wonder: do you drink alcohol? I drink 2 glasses a day, but I think it affects the number of times you have to get out of bed at night.

From what I have read (and I've done a lot) both alcohol and caffeine have a negative impact when it comes to night-time urination. It is suggested that one should cut back on both and to abstain from alcohol for at least 4 hours before bed time and from caffeine even longer. 8 hours is suggested.

 

In fact I now practice intermittent fasting which means I do not partake of anything after 6pm. This has improved my situation a lot and generally I only need to pee once in the night.

 

I do have one more trick up my sleeve. I keep a stock of single use catheters and use one just before sleep time to ensure that my bladder is completely empty. 

[rumak]

52 minutes ago, Peterphuket said:

It is nice to read your experiences.
Like many elderly people, I too have the same prostate problems and that means I have to get out on average 3 times a night to pee.
But what concerns me and I therefore wonder: do you drink alcohol? I drink 2 glasses a day, but I think it affects the number of times you have to get out of bed at night.

i don't drink alcohol any longer ( would like to )........ but COFFEE really messed up my system .  If i went for a drive in the morning i would be having a strong urge to pee almost immediately... then stop and have little flow... then get in car and within a short time have urgency again.   Finally i stopped coffee (its the caffeine) cold turkey... and it helped a lot.  

[scubascuba3]

5 hours ago, jcmj said:

The only side effect that I have is not being able to “squirt” after sex.

Strange that, usually that's why people do Rezum to avoid retrograde ejaculation

[scubascuba3]

I'm ok getting up 3 times a night, i drink whatever drink right up to sleep time. 

 

Women can also get up many times a night and no prostate 

[Lacessit]

4 hours ago, Dr B said:

I had misunderstood the OP, because the TURP was described to me as a procedure, and was done as an outpatient. I had had an enlarged prostate for a few years (85 ml) with increasing issues of getting caught short, especially when driving. Had a TURP with no unusual issues, just a bit of stinging and bleeding for a few days, but the TURP debris showed some signs of cancer. Carried on for a few years monitoring PSA, which rose from 2+ to just over 4. Was then recommended either surgical removal or radiotherapy, and opted for the latter. Had to have a minor procedure to remove a bit of scarring from the TURP, and also have ADT. The combination of the TURP and the ADT had reduced my prostate back to 25 ml! That meant that I could have the more intensive radiotherapy in 4 weeks not 8. All went well and the therapy was very easy, would have gone back for more! The after effects, stinginag and bleeding, including blood clots, started a few months later and went on for18 months. Now all over, no more stinging, no more blood, quite often do not even need to go once in the night, e.g. last night 6 am. PSA has been between 0.1 and 0.2 since the therapy in late 2019, in Australia. I have now found an excellent urologist at Krabi Hospital. Carried out a endoscopy, and sees me very 6 months. Just one medication which my Australian urologist confirmed was good.

Hope that helps.

Endoscopy seems to be a catch-all term in Thailand for anything using a camera.

 

Gastroscopy = inspection of esophagus and stomach.

 

Colonoscopy = inspection of rectum and bowel.

 

Cystoscopy = inspection of prostate and bladder.

[Presnock]

On 12/4/2024 at 7:39 PM, rumak said:

This subject never gets old .... for those contemplating surgery for an enlarged prostate.  Hopefully there are a number of members that can share their FAIRLY RECENT  experiences.

I have read past threads so please DO NOT  repost old stories about what your doctor or friend told you ,  or give the Google or Youtube info which I and most others have seen for ourselves.

 

Personal experiences of course vary ..... but rarely if ever have i read an account of someone who had prostate surgery and did not have complications.  It would be really nice to hear at least one or two stories where its been a few years and all is well .  Maybe i am hoping for too much 🙂

 

but....... worth a try .  ( i have been to a good urologist... so also no need to tell me to go to one) 

My father had prostrate cancer and went for a 'trim" and radiation.  Afterwards he told me if it came back then he would die as the treatment was worse than the disease.   dR. William Li a reknown Harvard heart specialist and researcher in 2023 wrote two books on preventing disease and treating disease with natural foods which have much fewer side effects.  For any prostate problems. in the lab, they found that soy contains high bioactives known as isoflavins and a dietary supplement called genistein concentrated polysaccharide (GCP) could also directly kill prostate cancer. As for tomatoes, lycopene in an experiment at  Harvard examined 46,719 men found that consuming two to three cups of tomato sauce saw a 30% decreased risk og prostate cancer.  I read recently (forgot where but think it was lifeline newsletter - anyway BPH sufferer was advised to eat 3 tablespoons of tomato paste for 10 weeks to shrink his protate and also lowered his PSA levels.  Just saying, as I am 78, eat a lot of tomatos plus tomato paste dail plus pomegranate juice/seeds regularly and although my male familiy members have all had enlarged prostate problems, I have avoided them and hope that continues.  I drink a half glass of water just before sleep, sleep 7-8 hours and never wake up having to go to the bathroom during the night.  I do wish you luck with whatever you try to do.  And just this week in a weekly health letter it mentioned that a "healthy" diet with lots of fruits and veggies helped alleviate some prostate problems.  Sorry I can't be more specific on where I read those articles but If I see any more I will pass them on.

[AgMech Cowboy]

On 12/4/2024 at 7:39 PM, rumak said:

i have been to a good urologist... so also no need to tell me to go to one

Best wishes with whatever decision you make regarding any procedures. 

[rumak]

1 hour ago, scubascuba3 said:

Strange that, usually that's why people do Rezum to avoid retrograde ejaculation

despite the published claims of low side effects .... it is my opinion from user reviews that many have issues , one of which is the one you mention.  What is the exact percentage ??   i don't know .    

funny thing about "staying hydrated" :   i was drinking a lot till recently and just the other day a Chinese "master"  said that it is not true ( how many ounces, etc should one take) .   Yes,  i know what all the "real science"  says.   He says simply "drink only when you are thirsty" .   

Last night i hardly drank any water after 7pm ..just some sips.. and woke up only one time instead of my usual two.    Now that's definitely conclusive evidence !   tongue in cheek, (AN members that look for debates  ) 

[rumak]

42 minutes ago, Presnock said:

lycopene

This use of natural remedies , from my experience here on AN , is only met with derision by most of the participants.  No problem , as i am not trying to convince anyone.   BUT...... great that you mention tomatoes ( and we can add watermelons, papayas, and some others) .   Very high in lycopene which as you say has been shown to have a similar effect on the prostate as some meds.  Maybe not as "potent" ... but also no bad side effects.   We have been cooking tomatoes to make a nice sauce, which i recently started eating every day.  Have just ordered supplements also.  My symptoms have already improved a little.   Might just be mind over bladder . 

just sayin '

anyone seriously interested PM me for a very good video on the subject

[rumak]

28 minutes ago, AgMech Cowboy said:

Best wishes with whatever decision you make regarding any procedures. 

 

thank you .  ( sorry if my Opening Post was a little blunt... but I am really trying to get some real feedback instead of the usual quotes and links to mainstreem "news"  promoted on google and other sites.)

i think that there have been many good posts already

[Sheryl]

1 hour ago, Lacessit said:

Endoscopy seems to be a catch-all term in Thailand for anything using a camera.

 

Gastroscopy = inspection of esophagus and stomach.

 

Colonoscopy = inspection of rectum and bowel.

 

Cystoscopy = inspection of prostate and bladder.

Anywhere in the workd, endiscopy neans use of an instrument with a camera.

 

There are many types of endoscopic procedures. 

[scubascuba3]

31 minutes ago, rumak said:

despite the published claims of low side effects .... it is my opinion from user reviews that many have issues , one of which is the one you mention.  What is the exact percentage ??   i don't know .    

funny thing about "staying hydrated" :   i was drinking a lot till recently and just the other day a Chinese "master"  said that it is not true ( how many ounces, etc should one take) .   Yes,  i know what all the "real science"  says.   He says simply "drink only when you are thirsty" .   

Last night i hardly drank any water after 7pm ..just some sips.. and woke up only one time instead of my usual two.    Now that's definitely conclusive evidence !   tongue in cheek, (AN members that look for debates  ) 

Yep cutting down fluid intake definitely works, experts recommend last drink 4 hours before sleeping, as it takes that long to urinate after that drink. Personally i like drinking, tea, smoothie, whatever so i don't do that

[rumak]

3 minutes ago, scubascuba3 said:

Yep cutting down fluid intake definitely works, experts recommend last drink 4 hours before sleeping, as it takes that long to urinate after that drink. Personally i like drinking, tea, smoothie, whatever so i don't do that

 

I understand .   There once was a time that i didn't mind getting up so often at night 😎

[Sheryl]

10 hours ago, StraightTalk said:

I am 76 years old, and I share the same preference. However, if my doctor were to recommend surgical removal, I would opt for the least invasive method available, which, to the best of my knowledge, is the da Vinci robotic-assisted procedure. I’d like to be well-prepared and informed about the best surgical options and specialists, should that path become necessary.

That said, I have been leaning toward complete removal of the prostate gland rather than undergoing a gland-reducing procedure like TURP, Rezum, or Urolift. But I wasn’t aware that the da Vinci method is typically reserved for cancerous glands and cannot be used as a precautionary measure, similar to preventive surgeries (mastectomy) some women undergo to reduce the risk of breast cancer.

In any case, if my condition becomes critical, I will follow Sheryl’s advice and seek a second opinion, likely from a reputable urologist (yet to be determined) at one of the major hospitals in Bangkok.

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.

[Lacessit]

3 hours ago, Peterphuket said:

It is nice to read your experiences.
Like many elderly people, I too have the same prostate problems and that means I have to get out on average 3 times a night to pee.
But what concerns me and I therefore wonder: do you drink alcohol? I drink 2 glasses a day, but I think it affects the number of times you have to get out of bed at night.

Alcohol is a diuretic.

 

I usually get up to pee 2-3 times a night.

 

If I have a couple of glasses of wine, it will be 5-6 times.

[Sheryl]

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 on the Duodart? I ask because it takes 12 months to see maximum effect on prostate size.

 

Besides the 2 drugs contained in Duodart (dutasteride and tamsulosin) there are other drug types that can be added to try to reduce urinary frequency. And/or, could switch the tamsulosin to silodosin (somewhat more effective drug of the same class) plus dutasteride.

 

No doctor is going to recommend complete gland removal in the absence of malignancy -- not necessary and carries greater risk of long term adverse effects than resection.

 

When it comes to deciding whether to have a resection of the prostate as opposed to continuing with medical management alone there are several considerations, some objective and some subjective.

 

Objective indications of a need for resection would be if, despite medical therapy, you were encountering significant urinary blockage leading to  a need for cathetrization and/or recurrent urinary infections, in such cases really no good option but to have a procedure done to reduce prostate size around the neck of the bladder.

 

Subjective indications relate to quality of life in the absence of problems such as the above. If, to you, the degree of retention/frequency is not tolerable, and assuming you have no unusual risk factors, then you might opt for a procedure. This is not something a doctor can tell you, only you know how you feel about living with the inconveniences etc.

 

Foir resection, besides TURP, laser enueculation (HOLEP) and other types of laser resection are options.

 

Assuming you have been on the Duodart at least 12 months, and find your current level of symptoms intolerable, I recommend you consult this US trained doctor at the private wing of Siriraj Hospital. He can perform HOLEP & laser procedures as well as TURP and should be able to review the various options with you:

 

Assoc. Prof Sunai Leewansangtong

https://www.siphhospital.com/en/medical-services/doctor-biography?id=247

 

 

 

 

[scubascuba3]

16 minutes ago, Lacessit said:

Alcohol is a diuretic.

 

I usually get up to pee 2-3 times a night.

 

If I have a couple of glasses of wine, it will be 5-6 times.

If you have a few more wines you probably won't get up, that's what i find with beer, if you're bladdered no get up

[Lacessit]

3 hours ago, scubascuba3 said:

If you have a few more wines you probably won't get up, that's what i find with beer, if you're bladdered no get up

If I was too "bladdered" to get up, I guess I would end up with a wet bed instead.

 

Not a problem for me, I only have one glass of wine about once every six months. Even then, there's a change in night frequency.

[Peterphuket]

9 minutes ago, Lacessit said:

If I was too "bladdered" to get up, I guess I would end up with a wet bed instead.

 

Not a problem for me, I only have one glass of wine about once every six months. Even then, there's a change in night frequency.

Yes that too takes place, if I consume more than 2 glasses of alcohol I start sweating heavily at night.

Edit: Just now I stopped after my second mix of Hon-Tong/cola

[Moonlover]

29 minutes ago, Peterphuket said:

Yes that too takes place, if I consume more than 2 glasses of alcohol I start sweating heavily at night.

Edit: Just now I stopped after my second mix of Hon-Tong/cola

Spirits and soda drinks are not a good mix. The Hong Thong contains alcohol and the cola contains caffeine, the twin enemies of our prostates.

 

I used to drink whisky and soda until I discovered that it was the soda (which also contains caffeine) that causing me problems at night. Once I switched to whisky on-the-rocks, the problem was greatly reduced.

 

Now it's one drink only and never later than 4 hours before bedtime. Usually I only need to visit the bathroom once during the night.

 

[Lacessit]

17 minutes ago, Peterphuket said:

Yes that too takes place, if I consume more than 2 glasses of alcohol I start sweating heavily at night.

Edit: Just now I stopped after my second mix of Hon-Tong/cola

When I used to drink, I preferred Sangsom and cola. Seemed to taste better than Hong Thong.

 

I was not referring to sweat as the cause of a wet bed.

 

Useful info here, I normally have a glass of water before going to bed. I'll try sleep without it tonight.

[BKKKevin]

Urolift seems to be becoming available in Thailand?…

 

https://bangkokpattayahospital.com/news_events/thailands-first-urologist-certified-in-the-urolift-procedure/

[StraightTalk]

16 hours ago, Sheryl said:

 

How long have you been on the Duodart? I ask because it takes 12 months to see maximum effect on prostate size.

 

Besides the 2 drugs contained in Duodart (dutasteride and tamsulosin) there are other drug types that can be added to try to reduce urinary frequency. And/or, could switch the tamsulosin to silodosin (somewhat more effective drug of the same class) plus dutasteride.

 

No doctor is going to recommend complete gland removal in the absence of malignancy -- not necessary and carries greater risk of long term adverse effects than resection.

 

When it comes to deciding whether to have a resection of the prostate as opposed to continuing with medical management alone there are several considerations, some objective and some subjective.

 

Objective indications of a need for resection would be if, despite medical therapy, you were encountering significant urinary blockage leading to  a need for cathetrization and/or recurrent urinary infections, in such cases really no good option but to have a procedure done to reduce prostate size around the neck of the bladder.

 

Subjective indications relate to quality of life in the absence of problems such as the above. If, to you, the degree of retention/frequency is not tolerable, and assuming you have no unusual risk factors, then you might opt for a procedure. This is not something a doctor can tell you, only you know how you feel about living with the inconveniences etc.

 

Foir resection, besides TURP, laser enueculation (HOLEP) and other types of laser resection are options.

 

Assuming you have been on the Duodart at least 12 months, and find your current level of symptoms intolerable, I recommend you consult this US trained doctor at the private wing of Siriraj Hospital. He can perform HOLEP & laser procedures as well as TURP and should be able to review the various options with you:

 

Assoc. Prof Sunai Leewansangtong

https://www.siphhospital.com/en/medical-services/doctor-biography?id=247

 

 

 

 

I have been on Duodart for almost 12 months, and while I still need to use the bathroom 3–4 times a night, it’s manageable. I have no issues passing urine and haven’t experienced any blockages. As far as I can tell, catheterization is not required, and I’ve never had any urinary infections.

I will soon be going for my annual medical check-up at Bangkok Pattaya Hospital, which will include an ultrasound of my lower abdomen. I’m hopeful that my urologist can address my concerns about my enlarged prostate. However, if the diagnosis indicates a deterioration and surgical treatment is recommended, I will definitely seek a second opinion.

Thank you for taking the time to respond in such detail and for recommending the US-trained doctor. Your advice is greatly appreciated.

[WDSmart]

I am now 78 and have had an enlarged prostate for about ten years. When I first went to a doctor here in Thailand, he wanted me to take tests, which would require the scraping of tissue from my prostate, to see if it was cancerous and, if it was, have it removed. I asked several of my long-time friends who were doctors in the USA about this, and they all said that even if I had prostate cancer, it would grow at a very slow rate. So, at my age, at the time, I should not have any problems with that cancer for the next 20 years or so. Therefore, unless I started having more severe problems, they discouraged me from having any scraping tests and especially from having my prostate removed.

 

So far, so good. I have to get up twice or sometimes three times every night to urinate, but other than that, my prostate (and PSA levels) have not gotten worse. 

[Peterphuket]

14 hours ago, Moonlover said:

Spirits and soda drinks are not a good mix. The Hong Thong contains alcohol and the cola contains caffeine, the twin enemies of our prostates.

 

I used to drink whisky and soda until I discovered that it was the soda (which also contains caffeine) that causing me problems at night. Once I switched to whisky on-the-rocks, the problem was greatly reduced.

 

Now it's one drink only and never later than 4 hours before bedtime. Usually I only need to visit the bathroom once during the night.

 

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.

 

[Peterphuket]

14 hours ago, Lacessit said:

When I used to drink, I preferred Sangsom and cola. Seemed to taste better than Hong Thong.

 

I was not referring to sweat as the cause of a wet bed.

 

Useful info here, I normally have a glass of water before going to bed. I'll try sleep without it tonight.

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.