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Treatment of benign prostatic hyperplasia (BPH)

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I use. Avodart And something like maxi flow it’s a pill and now I basically never really wake up during the night in my flow and everything seems to be getting better

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  • BritManToo
    BritManToo

    0.5g of cannabis smoked before bed every night 60 percent Indica hybrid or higher works best.

  • I’m 75 and have suffered from enlarged prostate (BPH) for a long time, and it came to the point where I could not pee at all without a catheter.  Neither herbal or standard medicinal remedies had help

  • FolkGuitar
    FolkGuitar

    I can tell you what works for me. I didn't care for the side effects of the meds that a doctor prescribed for me, so I went more 'natural.'  I found the following combination to be very effective

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4 minutes ago, TheFishman1 said:

I use. Avodart And something like maxi flow it’s a pill and now I basically never really wake up during the night in my flow and everything seems to be getting better

 

I wonder if that is the same as Duodart?

 

I started to take that and read it was safe, BUT .......if you do develop a  cancerous tumour it can promote a much more aggressive form of cancer!!!

On 7/27/2025 at 11:35 AM, sardine said:

Could you advise me on an alternative treatment ?

If not caused by infection, as Sheryl mentioned, Alcohol (&caffeine) and dehydration (perhaps you even don't know) are 2 important factors, all prostate & bladder problems. 
 

I was on Avodart for 6 months and Harnal Ocaz (I stopped it after 30 days due to side effects, breathing problem at night).

My urine flow is good and no more pain and prostate discomfort. But I'm sensitive to alcohols (wine and beer are the worst). 
I drink sometimes, perhaps once a week and very limited. 

11 hours ago, connda said:

can also be a prostate or bladder infection

You could get a urine test. If it shows white or red blood cells in your urine, then there is a good chance you might have an infection. Best to check with a doctor.

On 7/27/2025 at 7:22 PM, Tazmo said:

I saw a Urologist 3 years ago, had MRI and found out it was benign and again with a repeat MRI a year after.

I was prescribed Finesteride 5 mg which I take at night and never had any problems.

I do get up at night to urinate twice, but good stream and bladder feels empty.

if I were you I would see a Consultant Urologist and get advice/ proper treatment and follow up if necessary.

You’re young and it could cause serious problems by the time you’re 70.

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

15 hours ago, TedG said:

I was on finasteride for a while.  It makes your hair grow back, but other than that, the side effects were nasty. 

True. I'm thinking to change medication too. 

18 hours ago, Acharn said:

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

 

This is precisely my concern for the OP.

 

In his 50's, benign enlargement would usually not cause the degree of  symptoms he reports, he needs to rule out infection. 

 

It can be difficult to confirm infection in the prostate.

21 hours ago, Acharn said:

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

 

The Urologist I chose was one who had treated me for kidney stones in the past by a non invasive method.

 

 I chose MRI, because I have myself worked in Urology for a few years and although there are modern treatments now, I am aware that different Urologists have different approaches. I had consulted with several Urologists before here and in 2 other countries.

 

I had the option of a cheaper procedure ie a scan, but because of my family history of prostate cancer I was prepared to pay more and get confirmation of no cancer.

 

 know the signs and symptoms of urinary tract or other infections in the prostate region and that was not a concern. In fact my enlarged prostate was diagnosed a few years before I had the MRI.  But my PSA kept increasing, so I wanted to get a proper diagnosis.

 

There are good and bad Specialists everywhere. You did the right thing to get a second opinion. I had already had more than 2 opinions.

 

I am aware of options and costs and haven’t got money to throw away, but it was the best option for me at that time. I had had scars before but they are not able to detect cancer.

On 7/30/2025 at 2:09 PM, connda said:

I know people who had Turp and now have nothing but problems.  It's brutal.  Some hospitals do green-light laser surgery but I wouldn't have it don't unless I know the surgeon has done a lot of these procedures. And it's expensive. Up in the ฿250K and above range. I get the distinct feeling that BPH is more of a "farang" condition so the surgical options, in Thailand, are limited. As long as drugs at least marginally work, stick with drugs.  Surgery is a crap-shoot and you can end up worse off then you were. You just learn to live with it.  

I had the H.O.L.E.P. procedure done 6 years ago and very happy with it.

9 hours ago, Sheryl said:

 

This is precisely my concern for the OP.

 

In his 50's, benign enlargement would usually not cause the degree of  symptoms he reports, he needs to rule out infection. 

 

It can be difficult to confirm infection in the prostate.

Go to Bangkok or Khon Kaen just has good as the UK in my opinion 

8 hours ago, Expat68 said:

Go to Bangkok or Khon Kaen just has good as the UK in my opinion 

No one suggestd he go to the UK. 

 

Just that he get another opinion. Here as elsewhere, individual doctors vary greatly in their competence and thoroughness. 

14 hours ago, Sheryl said:

No one suggestd he go to the UK. 

 

Just that he get another opinion. Here as elsewhere, individual doctors vary greatly in their competence and thoroughness. 

I am not suggesting, all I am saying is in my experience Thailand (I have had an operation and stayed one week) is just as good as the UK.

On 7/27/2025 at 2:31 PM, Will B Good said:

I was prescribed Duodart........but chickened out from taking it.......not a huge fan of meds if I can avoid them.

 

That was four years ago......don't take anything now........touch wood....getting away with it.

I am on Duodart - side effects for me have been minimal, Urinary frequency slightly better, main benefit is much improved urinary flow; emptying bladder still a bit of a problem, but maybe slightly better. Sex still possible.

On 7/30/2025 at 11:03 AM, connda said:

3000 THB per box of 30 at a pharmacy in CM.  Like 100 THB per pill.  It's expensive. I use it on occasion.  If anyone knows a cheaper source, let me know. It is effective.

 

Are these 30 20mg pills?  I get 20mg tabs and cut them into 1/4 to get 5mg so that would be 120 or 25 baht per day (USD $0.77/day) for you.  Can attest that at 5mg, does work and I have a big prostate, still have to get up 1x per night if drinking. Ya, a bit of a side benefit 🙂

On 8/1/2025 at 5:51 AM, Tazmo said:

The Urologist I chose was one who had treated me for kidney stones in the past by a non invasive method.

 

 I chose MRI, because I have myself worked in Urology for a few years and although there are modern treatments now, I am aware that different Urologists have different approaches. I had consulted with several Urologists before here and in 2 other countries.

 

I had the option of a cheaper procedure ie a scan, but because of my family history of prostate cancer I was prepared to pay more and get confirmation of no cancer.

 

 know the signs and symptoms of urinary tract or other infections in the prostate region and that was not a concern. In fact my enlarged prostate was diagnosed a few years before I had the MRI.  But my PSA kept increasing, so I wanted to get a proper diagnosis.

 

There are good and bad Specialists everywhere. You did the right thing to get a second opinion. I had already had more than 2 opinions.

 

I am aware of options and costs and haven’t got money to throw away, but it was the best option for me at that time. I had had scars before but they are not able to detect cancer.

I'm a little confused.  How can an MRI detect prostate cancer?  It can detect 'something' in the prostate, but (as in my own case), the 'something' that was thought to be cancer growths turned out to be benign calcium stones, and that could only be confirmed by a biopsy.

  • Popular Post

Simon43, the best I can answer you to clarify any confusion is as follows:

 

With an enlarged prostate plus a very high PSA, the medical recommendation is usually a prostate biopsy.

But this is an invasive procedure and uncomfortable. Also is is not always 100% accurate. Although they take several tissues samples during the procedure, they can miss tissues that are carcinogenic ( have cancer).

 

From my experience and further research and second/ third opinion I chose a non-invasive procedure, MRI. Some hospitals have an MRI machine that can detect cancer. It is very sophisticated and updated.

 

My report listed findings on all parts of the bladder, prostate and they gave a rating to indicate the possibility of cancer.

 

PI-RADS ( prostate Imaging Reporting and Data System). My score was 2.

A score of 2 indicates a low risk of clinically significant prostate cancer. This means based on the MRI findings, it is unlikely that a Clinically significant tumour is present.

 

Of course a biopsy is much cheaper but you have to consent that there could be complications, though rare.  Also the results can be inconclusive.

 

It’s entirely up to the Individual, but it would depend on several factors, price, affordability, informed choice, family history and of course the ‘do nothing option’, ‘ wait and see’.

 

Hope this helps somewhat.

Simon43, I forgot to mention, the MRI also showed that I had a stone in my bladder ( which I knew about several years ago).

2 hours ago, Tazmo said:

Although they take several tissues samples during the procedure,

Can take 2-30 cores depending on the method used, many people like you think it's just several

  • 3 months later...
On 7/31/2025 at 7:46 AM, Acharn said:

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

Any idea which antibiotics he prescribed?

2 hours ago, roo860 said:

Any idea which antibiotics he prescribed?

 

Sticking my oar in......I was in agony for months with an infection....took one single dose of Monurol......GONE!!!

49 minutes ago, Will B Good said:

 

Sticking my oar in......I was in agony for months with an infection....took one single dose of Monurol......GONE!!!

Yes Monurol (Fosfomycin) is my "go to" now that I have to use a catheter and am therefore prone to UTIs. This antibiotic was the one recommended by two different Urology professors when I was suffering from what I/they thought was "prostatitis".......and it stopped it after two doses, yet urologists in NZ and Thailand prescribed other antibiotics over many years!!!

 

It has been a 'godsend" for me.

1 hour ago, xylophone said:

Yes Monurol (Fosfomycin) is my "go to" now that I have to use a catheter and am therefore prone to UTIs. This antibiotic was the one recommended by two different Urology professors when I was suffering from what I/they thought was "prostatitis".......and it stopped it after two doses, yet urologists in NZ and Thailand prescribed other antibiotics over many years!!!

 

It has been a 'godsend" for me.

 

 

Yep, only used it the once.......but it was nothing short of a miracle cure for me.

Two years ago I had a blood test and amongst the results was a PSA reading of 19 , my Doctor in Ao Nang immediately suggested a Urologist in Krabi. I of course went to see him and after the examination he recommended a MRI, needed to go to Surat Thani as Krabi has no MRI machine. The results classed me as a three which can be interpreted as maybe but I suggested we just monitored for a while, I hate needles especially big ones. The Doctor prescribed a tablet called UROFLOW to be taken once a day and this minimized the nocturnal toilet visits, if I need to get up before 0800 it's unusual. Twelve months later another MRI and I was downgraded to a two , a pleasant result indeed. I now see the Doctor every four months to report no change , collect only two months supply of tablets as I only take one every second day and also take a Saw Palmetto every morning ,  PSA now about seven and neither of us is concerned. I am seventy nine and and as long as things stay the same I will be happy.

8 minutes ago, PJPom said:

Two years ago I had a blood test and amongst the results was a PSA reading of 19 , my Doctor in Ao Nang immediately suggested a Urologist in Krabi. I of course went to see him and after the examination he recommended a MRI, needed to go to Surat Thani as Krabi has no MRI machine. The results classed me as a three which can be interpreted as maybe but I suggested we just monitored for a while, I hate needles especially big ones. The Doctor prescribed a tablet called UROFLOW to be taken once a day and this minimized the nocturnal toilet visits, if I need to get up before 0800 it's unusual. Twelve months later another MRI and I was downgraded to a two , a pleasant result indeed. I now see the Doctor every four months to report no change , collect only two months supply of tablets as I only take one every second day and also take a Saw Palmetto every morning ,  PSA now about seven and neither of us is concerned. I am seventy nine and and as long as things stay the same I will be happy.

 

No biopsy?

 

I was a level 4, but the biopsy showed a benign lesion.....and relax.

On 7/26/2025 at 9:35 PM, sardine said:

Hi, I'm 52 years old, and for more than 5 years, I've been experiencing the following symptoms: feeling like my bladder doesn't empty completely, frequent urination, and a weak urine stream. I've already had my prostate checked, and it's benign. I usually take Silodosin 7 mg, but it doesn't seem to be working as well anymore.

 

Could you advise me on an alternative treatment ?

 

 

Cheers

 

Yes, eat a small handful of raw unsalted pumpkin seeds, about 30 or 40 grams, every day and chew them very well until they are like a paste in your mouth before swallowing them. You can usually buy them at Makro. Also, in my opinion, the pumpkin seeds sold here in Thailand are of a much better quality than the ones I used to buy in California. 

17 hours ago, Will B Good said:

 

No biopsy?

 

I was a level 4, but the biopsy showed a benign lesion.....and relax.

Same here.  Level 4 according to an MRI at Bumrungrad, but biopsy only found benign calcium stones... and relax!

1 hour ago, simon43 said:

Same here.  Level 4 according to an MRI at Bumrungrad, but biopsy only found benign calcium stones... and relax!

 

 

When I was told level 4.....in my ignorance that translated into stage 4......had a lot to drink that night before some explained the difference.......555

  • 1 month later...
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On 7/30/2025 at 1:09 PM, Will B Good said:

 

That is rough....especially having gone through the Rezum treatment. Did you get any feedback as to why that wasn't successful?

 

Obviously very personal, so just ignore if you wish.....but can you tell if you have or might suffer from the well documented 'side effects' of the TURP?

I don't have any problems since my TURP surgery in July 2025 (in Bangkok). I had rather alarming bloody urine for several days after, but that ended within a week. I feel quite normal again. At age 75, I still have to pee during the night, but not as much as before.

I did have to stop exercising for a while as my gut was healing, but after my doctor said I was healed I re-started my old exercise program -- Three times a week, I smoke a micro-dose (2 tokes) of Cannabis sativa (which motivates me to exercise with a concentration and an intensity like nothing else); then I warm up with Tai Chi, Yoga stretches and USMC calisthenics; then I grab a pair of dumbbells and go out for a march, and I climb half a dozen high stairways (pedestrian flyovers, etc). It is building my core muscles back up, especially when hefting dumbbells. (I suspect that by my doing these same exercises Before TURP surgery, I went into it with strong core muscles, which possibly caused quicker recovery.)

Now I am wielding 2kg weights in each hand in my stair-climbing, and I feel strong (for an old guy!). TURP surgery wiped out my meager finances, but I feel good about going into my 76th year.

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