The diverticle (very big) has to be removed because of residual urine and recurrent urinary tract infections.

Dr Teerapon, Bumrungrad, was recommended to me, but it seems he usually does robotic surgery. Because of intestinal surgery before, probably open surgery is needed, and I have no idea whether he is good at that, too.

Dr Kamol, Chula, was reluctant to accept me, maybe I asked too many questions, don't know.

Anyone has experience with this?

11 hours ago, Hish said:

The diverticle (very big) has to be removed because of residual urine and recurrent urinary tract infections.

Dr Teerapon, Bumrungrad, was recommended to me, but it seems he usually does robotic surgery. Because of intestinal surgery before, probably open surgery is needed, and I have no idea whether he is good at that, too.

Dr Kamol, Chula, was reluctant to accept me, maybe I asked too many questions, don't know.

Anyone has experience with this?

Was there any DOCTOR who diagnosed you or is it just your asumption? I ask you because of your remarks of Dr. Kamol being reluctant to accept you?

1 hour ago, D Peter said:

Was there any DOCTOR who diagnosed you or is it just your asumption? I ask you because of your remarks of Dr. Kamol being reluctant to accept you?

Dr Teerapon and Dr Kamol have both seen me, after my regular urologist had done an ultrasound and MRI of bladder and prostate and had recommended diverticulotomy and TURP or TUIP.

(The big diverticle and a narrow bladder outlet have been known for decades, a bladder neck incision was made 10 years ago in my home country, this improved the flow for several years)

Dr Teerapon would proceed with open resection of the diverticle (he originally suggested robotic surgery, which he specializes in, but when he heard of previous enterotomy and previous pancreatic surgery, he suggested open resection).

Dr Kamol didn't like that an MRI had been done, would do urodynamic studies first (Dr Teerapon dismissed them as not conclusive with these conditions), mentioned intermittent self catheterization, and was quite clear that he wasn't interested.

I agree with Dr. Kamol. Do Urodynamic Studies first.

UDS: These tests are especially useful when symptoms have multiple possible causes, or when surgery is being considered.

The tests will show the bladder pressure, capacity, flow, contractions, compliance, but also sphincter funtion.

It's important to know whether the bladder muscle still works.

At the end he/ you will know what kind of surgery is necessary. Is TURP/TUIP is the best or conservative management.

Thanks a lot.

Sounds very reasonable.

(Even I am not really convinced, as I did video UDS 10 years ago in my home country, they introduced multiresistent germs into my bladder, and noone was ever interested in the results. Nice colorful pictures, though)

So, where would one go to do this in Thailand? Preferably private, but the urologists in the usual private hospitals have so far never even mentioned this possibility.

If in Chula, I probably better do it in Europe as it will take time (I am scheduled to fly there in July or August anyway)

PS "conservative treatment" of a big diverticle and almost 300ml residual urin very possibly means intermittent self catheterization?

Edited June 2Jun 2 by Hish

1 hour ago, Hish said:

Thanks a lot.

Sounds very reasonable.

(Even I am not really convinced, as I did video UDS 10 years ago in my home country, they introduced multiresistent germs into my bladder, and noone was ever interested in the results. Nice colorful pictures, though)

So, where would one go to do this in Thailand? Preferably private, but the urologists in the usual private hospitals have so far never even mentioned this possibility.

If in Chula, I probably better do it in Europe as it will take time (I am scheduled to fly there in July or August anyway)

PS "conservative treatment" of a big diverticle and almost 300ml residual urin very possibly means intermittent self catheterization?

PS "conservative treatment" of a big diverticle and almost 300ml residual urin very possibly means intermittent self catheterization?

Yes, (probably)

Thx for your posts.

They are very helpful