Mild BPH symptoms, unclear treatment path — anyone in a similar situation?

[scubascuba3]

Symptoms don't seem too bad, I get up 2-3 times at night, just get used to it, better than kicking off drugs and ops at a youngish age

[Sheryl]

2 hours ago, Globenauta said:

 

Since your last reply, I’ve started tracking my urination frequency more precisely. It turns out I’m averaging about every 2.0 to 2.5 hours while awake, which is more reasonable than the 1–2 hours I initially estimated. That said, I still get that uncomfortable “need to hold” sensation and urgency, even shortly after going.
 

 

Still seems odd for such small enlargement. 26 ml is almost normal dize. I continue to suggest ruling out infection. 

[rumak]

10 hours ago, scubascuba3 said:

Symptoms don't seem too bad, I get up 2-3 times at night, just get used to it, better than kicking off drugs and ops at a youngish age

 

what supplements or drugs (if any)  have you tried ?     Any other changes you have made to alleviate urgency, or tightness at times ? 

[TedG]

On 5/25/2025 at 12:11 PM, Lacessit said:

Rezum was one of the options I discussed with my urologist.

 

 I prefer the advice of someone with the qualifications of FRCS, FRACS over your statistical sample of one.

I underwent Aquablation which is simular to Rezum last January, and five months later things are much better.  

[scubascuba3]

4 hours ago, rumak said:

 

what supplements or drugs (if any)  have you tried ?     Any other changes you have made to alleviate urgency, or tightness at times ? 

I don't have urgency or tightness, I just get up 2-3 times at night, women with no prostate can get up more times than that

[xylophone]

On 5/27/2025 at 2:17 PM, connda said:

TURP is brutal and I've seen too many bad outcomes.  However, the options for surgery and competent surgeons are few and far between here in Thailand.  If I ever decide to go the surgery route I'd go with laser surgery, but only with a surgeon who has a lot of these surgeries under his belt and can provide patients who would provide testimonials.  Imho, surgery is the last option.  Not the first for mild BPH.

I agree that surgery is the last option and TURP would be the last of the last options in my experience. I had tried everything from the medicines available as well as the "natural remedies" and none worked, hence settling for a TURP at Epworth Hospital in Melbourne by a top urological surgeon, but it hasn't been smooth sailing ever since and now it's come to the point that my bladder has stopped working and I put that down to a bladder neck incision operation I had here in Phuket.

 

That's why I said in my previous post that if I had my time again I would look at Urolift or iTind, which are considered minimally invasive.

 

As regards "competent surgeons" in Thailand, well that's the reason I chose Melbourne, however I do know of a guy here who had a TURP done locally and he is "peeing like a racehorse", in his words, and as I said, my Melbourne operation wasn't a great success.

[K2938]

On 5/23/2025 at 6:58 PM, Globenauta said:

• Did your symptoms improve over time, stay stable, or eventually require treatment?

• Has anyone regretted or benefited from doing UroLift or similar procedures relatively early?

• Did anyone find alternatives to tamsulosin that helped without sexual side effects?

As your prostate keeps growing, things will never improve long-term.  However, in the initial phases of BPH things might sometimes improve/sometimes deteriorate on a kind of random basis.   And many people die before they have any need for operations.

UrloLift does not really last very long.  So if you have it already at your age and your prostate keeps growing, you are highly likely to need a further operation later on.

Tadalafil also helps, so if you took off the tadalafil things might be worse.

Did you see a doctor in Thailand or in the West?

 

[xylophone]

57 minutes ago, K2938 said:

UrloLift does not really last very long. 

 I recall looking at this when doing my research and it looked promising.........

How long does UroLift last for BPH relief?

Like almost any treatment or procedure, the results (and their longevity) of UroLift for BPH can vary somewhat from patient to patient. Generally speaking, however, most men who are otherwise in good urologic health can expect their UroLift results to last for many years and, in some cases, indefinitely. The UroLift implants themselves are typically considered safe and appropriate as lifelong devices. Should a patient's BPH symptoms worsen or change over time, a revision procedure may help restore their initial results, or Dr. Kasraeian may recommend another treatment mechanism to provide the most adequate level of relief possible.

 

source: https://kasraeianurology.com/blog/how-long-can-the-results-of-a-urolift-procedure-last

[K2938]

9 minutes ago, xylophone said:

 I recall looking at this when doing my research and it looked promising.........

How long does UroLift last for BPH relief?

Like almost any treatment or procedure, the results (and their longevity) of UroLift for BPH can vary somewhat from patient to patient. Generally speaking, however, most men who are otherwise in good urologic health can expect their UroLift results to last for many years and, in some cases, indefinitely. The UroLift implants themselves are typically considered safe and appropriate as lifelong devices. Should a patient's BPH symptoms worsen or change over time, a revision procedure may help restore their initial results, or Dr. Kasraeian may recommend another treatment mechanism to provide the most adequate level of relief possible.

 

Depends on your age.  But if you already have prostate problems as young as the OP, then you are virtually guaranteed to need a further operation as the prostate keeps growing and growing.  You can look up what the independent guidelines in the U.S. or Europe say rather than some doctor who wants to sell you something and you will see this.  But depending on your age and prostate size, it might well be ok for you.

 

[Sheryl]

25 minutes ago, xylophone said:

 I recall looking at this when doing my research and it looked promising.........

How long does UroLift last for BPH relief?

Like almost any treatment or procedure, the results (and their longevity) of UroLift for BPH can vary somewhat from patient to patient. Generally speaking, however, most men who are otherwise in good urologic health can expect their UroLift results to last for many years and, in some cases, indefinitely. The UroLift implants themselves are typically considered safe and appropriate as lifelong devices. Should a patient's BPH symptoms worsen or change over time, a revision procedure may help restore their initial results, or Dr. Kasraeian may recommend another treatment mechanism to provide the most adequate level of relief possible.

 

source: https://kasraeianurology.com/blog/how-long-can-the-results-of-a-urolift-procedure-last

I added the source, please do not post unsourced quotes.

 

Urolift has not been around enough to have data on very long term use.  To date studies show only 5 year use data:

https://pubmed.ncbi.nlm.nih.gov/28646935/

 

Basically, about 14% of patients required and receive additional surgical intervention within a 5 year period.  (Study only tells what percent had surgery, could have been additional ones with an indication for surgery who did nto receive it for one reason or another).

 

Note that improvements were statistically significant but not as complete &  dramatic as some might expect, i.e. average 36% improvement in International Prostate Symptom Score, 52% improvement in BPH Impact Index Score. These  are averages, and likely conceal considerable variation among patients i.e. there may have been some with dramatic improvement and some with little to none. 

There are likely individual factors that may help predict which patients will get the most benefit from this, and that should be discussed in detail with a urologist with extensive experience in it. It is nto a panacea nor suitable for everyone. 

[K2938]

16 minutes ago, Sheryl said:

Urolift has not been around enough to have data on very long term use.  To date studies show only 5 year use data:

https://pubmed.ncbi.nlm.nih.gov/28646935/

 

Basically, about 14% of patients required and receive additional surgical intervention within a 5 year period.  (Study only tells what percent had surgery, could have been additional ones with an indication for surgery who did nto receive it for one reason or another).

Thank you for this.  And please also kindly note that this is a manufacturer sponsored study which sometimes clouds the results a little even with the best of intentions.  The lead author for example is paid by Neotract, the manufacturer of Urolift.

Nevertheless, it is also undeniable that Urolift has a lower sexual function impairment risk.  So everything has its pluses and minuses.