Looking For Urologist Recommendation In Pattaya

[WyattEarp]

As the title says ....

I know there are recommendation for Bangkok but I would like to avoid the trip if possible.

The usual middle-age problem, prostate.

[Sheryl]

Frankly it would be a mistake not to travel to Bangkok.

If you insist on something closer to home the best option would be Queen Sirikit in Sattahip, but be prepared for lots of red tape and long waits, and bring a Thai speaker along for the first visit.

[Mobi]

There are no less than 7 Urologists listed at Bangkok Pattaya Hospital.

http://www.bangkokpa...tnsearch=search

I am no great fan of BP hospital, but is obvious that most if not all the urologists listed are actually based in BKK and just come to Pattaya for special clinics, so if the OP just requires an initial opinion/diagnosis, and does not wish to travel to BKK then it might be worth giving one of these docs a try.

If it comes to an operation, then he might want to consider alternative, cheaper hospitals in BKK or elsewhere, but I doubt if an initial consultation plus some blood tests would break the bank.

[WyattEarp]

Thanks Sheryl and Mobi. I just had the results of my blood tests and my PSA is a little high so I want to check with a specialist and perhaps have a biopsy to see if it's serious or not. If it is serious I will certainly go to Bangkok, but just for the test I guess there are limits to how much BPH can mess it up.

Can you recommend any of the urologists listed at BPH?

[Mobi]

Actually, i've never had any issues with their competence per se. My gripe is high prices and unnecessary tests and treatments.

Good luck.

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[AbeSurd]

I've seen Dr Pornchai at BHP urology a couple of times (PSA, enlarged prostate blah blah) over the last year and I have no complaints. He comes over as a bit humourless but what the hell.

I was impressed - he's twice turned down the opportunity to sell me stuff I probably would've bought.

So all I pay is for a consultation and a DRE (digital rectal examination) - about 800 baht.

I'd say the same about my visits to cardioligy and dermatology at BHP. Both departments could've tried to sell me further tests and stuff etc. But they didn't.

[uhuh]

I can second that Dr Pornchai is very good.

And if BPH is too expensive for you he may even be willing to treat you in Bangsaen, as he works there too.

[WyattEarp]

I finally got around to see Dr Pornchai at BPH. He did indeed seem very competent and after a through examination gave me some tabs to take for a week to see if things improve. I got him to write up the names so I could get the tabs at Facino, but still around 400 baht for 10 tabs -- Facino claimed there are no generic alternative, but Wikipedia mentions Flomax - is that or any other generic version available in Thailand? I assume the 10 first days is just to see if it takes care of the issue, and if so, I'll have to take these daily, and it would be nice to be able to reduce that 1,400 baht/month.

[Sheryl]

I finally got around to see Dr Pornchai at BPH. He did indeed seem very competent and after a through examination gave me some tabs to take for a week to see if things improve. I got him to write up the names so I could get the tabs at Facino, but still around 400 baht for 10 tabs -- Facino claimed there are no generic alternative, but Wikipedia mentions Flomax - is that or any other generic version available in Thailand? I assume the 10 first days is just to see if it takes care of the issue, and if so, I'll have to take these daily, and it would be nice to be able to reduce that 1,400 baht/month.

Generic version of what, you didn't tell us the name of the medication(s) the doctor prescribed?

[WyattEarp]

I finally got around to see Dr Pornchai at BPH. He did indeed seem very competent and after a through examination gave me some tabs to take for a week to see if things improve. I got him to write up the names so I could get the tabs at Facino, but still around 400 baht for 10 tabs -- Facino claimed there are no generic alternative, but Wikipedia mentions Flomax - is that or any other generic version available in Thailand? I assume the 10 first days is just to see if it takes care of the issue, and if so, I'll have to take these daily, and it would be nice to be able to reduce that 1,400 baht/month.

Generic version of what, you didn't tell us the name of the medication(s) the doctor prescribed?

Yes that was dumb of me, sorry. Harnal OCAS 0.4 mg.

[Sheryl]

Unfortunately there is no generic equiavelnnt for this in Thailand, only the imported brand so it will be costly. It is newer and I think still under patent.

There are other drugs that are less expensive used to treat this condition, did they not work for you or was this the first thing prescribed? If the latter you might tell the doctor that cost is an issue and ask about trying doxasin which is available in many local brands, or finesteride (ditto).

[WyattEarp]

Is Tamsulosin or Flomax not the generic version of Harnal OCAS?

This is the first thing he has prescribed.

[Sheryl]

Tamsulosin is the generic name for both Harnal and Flomax. Flomax brand is not available in Thailand. the only brand of Tamsulosin available in Thailand is Harnal.

[WyattEarp]

Isn't that strange that there isn't a generic in Thailand? I understand you say it's a new product - does it offer any substantial advantage over doxasin or finesteride?

[Sheryl]

The drug is still under patent.there is more than one brand of it 9e.g. Flomax as well as harnal) because the patent holder has licensed some other companies to make it under some sort of financial arrangement. it is not open for generic copying whereas finestrade and doxasin are.

Finestride is a different class of drug with different mode of action than tamulosin and doxazosin, these last 2 are the same type of drug. Some patients do best with finestride (or dutraise, a related drug) plus one of the alpha antagonists (doxasin or tamulosin).

I haven't done extensive research in this but the literature I have seen doesn't seem to indicate tamulosin to be any better than doxazosin, though it has a more convenient dosing schedule. Worth noting that it is also more likely to cause "abnormal ejaculation" than is doxazosin.

Long story short, if Harlan was the only drug prescribed you should tell the doctor that its cost is a problem and ask about subsitituting doxazosin and/or trying finesteride. The latter, by the way, is also used for male pattern baldness so if you are bald/balding you may find that it has the fortuitous effect of stimulating some hair growth. Side effects can sometimes be desirable!

[WyattEarp]

Thanks Sheryl, you're truly a treasure trove of medical information. I wish the doctors would be equally forthcoming with details on diagnose and prescriptions and reasons.

I checked the two drugs you suggest, and it looks like both have added (but different) advantages: As you already mentionned the added hair growth for Finestride, Doxazosin on the other hand cites reduced blood pressure and some suggestions of viagra-like qualities.

Finestride seems to have some nasty side effect including high risk of increased Anxiety and Depression.

On balance I think I'd prefer Doxazosin.

I'm already on a mix of Prenolol, Loranta and HCTZ for HBP, might even be that Doxazosin could replace one of them?

Prenolol btw is a beta blocker. I notice Doxazosin is an alpha blocker. Are these related?

I have a good quality Spygo and check my BP regularly.

[Tolley]

What is the condition you were diagnosed with?

If it is only an enlargement it would be far better using herbal alternatives eg saw palmetto

[WyattEarp]

He didn't say exactly, just that my prostate was a little enlarged. I assume technically it would be benign prostatic hyperplasia (BPH).

Never heard of Saw Palmetto but a quick check in WikiPedia says "Review of clinical trials, including those conducted by the National Center for Complementary and Alternative Medicine, found that the extract is no more effective than placebo for BPH."

[Tolley]

He didn't say exactly, just that my prostate was a little enlarged. I assume technically it would be benign prostatic hyperplasia (BPH).

Never heard of Saw Palmetto but a quick check in WikiPedia says "Review of clinical trials, including those conducted by the National Center for Complementary and Alternative Medicine, found that the extract is no more effective than placebo for BPH."

I think you need to do a bit more research. There is a quite a bit of scientific evidence supporting it. Further to this a low-fat diet, zinc supplements, and essential fatty acids (from sources such as flax oil) and another herb, Pygeum africanum, are useful for treating BPH.

You should also lose weight, exercise and avoid alcohol.