Klong Song Posted October 12, 2016 Share Posted October 12, 2016 I went to see my urologist on September 3rd and my current PSA is 2.1 and the ultrasound showed my prostate to be over 5cm. I am getting tired of getting up 2-3 times a night and have decided to have something done. I would appreciate a recommendation for a doctor in BKK to discuss the possibility of having a DaVinci procedure. A ballpark number on the cost would be appreciated if someone has current information. Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
Sheryl Posted October 12, 2016 Share Posted October 12, 2016 http://www.si.mahidol.ac.th/th/department/surgery/urogicalWebsite/ http://www.si.mahidol.ac.th/th/department/surgery/urogicalWebsite/team.html Prof. Sittiporn Srinualnad there is a key person, you can see his bio here as he also has hours at Bumrungrad (where you don't want to go if paying out of pocket, but good dr bios) https://www.bumrungrad.com/doctors/Sittiporn-Srinualnad HOWEVER, I suggest you question closely re number of procedures done as I don't think there have been that many in Thailand and this makes a big difference. Robotic surgery is not a magic bullet, it is only as good as the operator is experienced and skilled. They will be eager to do it as they want more cases but you really don't want to be part if someone's learning curve IMO...so ask specifically how many cases they've done. I believe it started here just some 8 years ago or so. No idea of cost, can't help you there. Another option to consider is HOLEPs, in India (or elsewhere but India would be least expensive option and they have a lot of experience). Not much if any experience with it in Thailand yet. I assume you've already maxed out options with meds? Link to comment Share on other sites More sharing options...
Klong Song Posted October 12, 2016 Author Share Posted October 12, 2016 Thanks for your help!Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
offset Posted October 13, 2016 Share Posted October 13, 2016 Over 7 years ago I spoke to Prof. Sittiporn Srinualnad about having Robotic Prostate surgery and as Sheryl said it was very new here then so I decided to not to go that route and have an open surgery carried out if I remember correctly the cost then was about 460000 baht for the Robotic and the operation was to be carried out in Siriraj hospital which is a Government hospital (the only one at that time had a machine) I hope this is of some help Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 Thanks Sheryl, HOLEPS may be a good alternative for me. Not keen on going to India at the moment and would like to research costs in BKK first. I have been seeing a urologist at Bumrungrad but since this will be out of pocket for me I would appreciate learning of a good doctor at another hospital. As for the med's, I have taken both Harnal and Xatral which help but do not provide much relief. My urologist hasn't mentioned other meds. Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 offset, thanks for the info. Much appreciated!Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
Sheryl Posted October 13, 2016 Share Posted October 13, 2016 AFAIK no one doing HOLEPS in Thailand yet.It is a very new technique, onl;y developed in the past 10 years. If you want HOLEPS you would need to travel for it. Besides India, it is available in Singapore but just a few doctors and not sure how many cases they have done. http://bkpohurology.com/clinical-services/holep-holmium-laser-enucleation-of-prostate/ Also available in Hong Kong and in China, in fact was first developed in China. From page 40-ish onward in this link has some info and names of doctors/hospitals http://www.hkcs.hk/member/2010_ASM/Surgical_Tx_BPH.pdf Link to comment Share on other sites More sharing options...
ScotBkk Posted October 13, 2016 Share Posted October 13, 2016 Thanks for your help!Sent from my iPad using Thaivisa ConnectI had exactly the same problems. Dr in UK prescribed these. Problem Solved!!Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
al007 Posted October 13, 2016 Share Posted October 13, 2016 I had Holeps in India three and a half weeks ago Cost US $3500 But beware, despite putting everything in writing five mins before the procedure I was advised by spinal injection, not general anaesthetic and with my low pain threshold they had me screaming while administering the anaesthetic whilst there two different types of cancer were found and then I was in the wrong place I understand there may be a couple of hospitals in BKK that can do Holeps, I heard a price from the most expensive one around 800,000batt Next week i start radiology and chemotherapy, in BKK for six weeks If you want to talk about India pm me and I will give you my phone number Link to comment Share on other sites More sharing options...
1FinickyOne Posted October 13, 2016 Share Posted October 13, 2016 4 minutes ago, ScotBkk said: I had exactly the same problems. Dr in UK prescribed these. Problem Solved!! Sent from my iPhone using Tapatalk Do you know if that is available in Thailand? Link to comment Share on other sites More sharing options...
ScotBkk Posted October 13, 2016 Share Posted October 13, 2016 Do you know if that is available in Thailand? I don't know I'm in UK at moment but I went through all that urinating nightmares and within 2 days everything is completely normal. Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
1FinickyOne Posted October 13, 2016 Share Posted October 13, 2016 1 minute ago, ScotBkk said: I don't know I'm in UK at moment but I went through all that urinating nightmares and within 2 days everything is completely normal. Sent from my iPhone using Tapatalk ok, thanks - I have been taking Permixon, which helps but does not eliminate the issue... Link to comment Share on other sites More sharing options...
ScotBkk Posted October 13, 2016 Share Posted October 13, 2016 ok, thanks - I have been taking Permixon, which helps but does not eliminate the issue... Ken, I know the hell your going through. Go do a bit of research in Thailand and see if you can get it prescribed for you it really is a Godsend mateSent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Sheryl Posted October 13, 2016 Share Posted October 13, 2016 It is, and OP is already taking it (brand name Harnal) Link to comment Share on other sites More sharing options...
ScotBkk Posted October 13, 2016 Share Posted October 13, 2016 It is, and OP is already taking it (brand name Harnal)Well' SherylMaybe doesn't work for everyone but did wonders for me !!! No disrespect.However, I don't trust pharmacies drugs in Thailand or on the Net unless direct from the hospitals Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 Bumrungrad advertises a procedure called PVP (Photoselective Vaporization of Prostate). How does this compare to HOLEPS?Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
kannot Posted October 13, 2016 Share Posted October 13, 2016 My Grandfather died of prostate cancer and last year my Father aged 85, the last 12 months he had terrible pain and even morphine did little to help, Im only 53 but will be looking at prostate removal when Im older as seeing my own Father in such agony was almost unbearable thats if I get it but odds are higher than normal so i would be interested what you find out for this type of work here. Cost would not be an issue for me but not being left incontinent would although I have 3 reports from this work done in the Uk with great success. Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 I'm 73 so ending up impotent would not be the end of the world but I agree being incontinent would certainly be inconvenient. Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
Sheryl Posted October 13, 2016 Share Posted October 13, 2016 15 minutes ago, Klong Song said: Bumrungrad advertises a procedure called PVP (Photoselective Vaporization of Prostate). How does this compare to HOLEPS? Sent from my iPad using Thaivisa Connect It is a different procedure. There are a number of surgical procedures that are alternatives to tradition TURP. PVP is similiar in outcomes to HELOPS but same caveat as earlier applies: beware of having it done by doctors who have limited experience. Another consideration is that both PVP and HOLEPS are not suitable if the prostate is too small - but not likely a problem in your case. Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 Thanks Sheryl, the doc's last words were "that's big". Will go back to see him soon to try to pry some more information out of him. Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
ScotBkk Posted October 13, 2016 Share Posted October 13, 2016 Thanks Sheryl, the doc's last words were "that's big". Will go back to see him soon to try to pry some more information out of him. Sent from my iPad using Thaivisa ConnectHope he was looking at your prostate - hahaha Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
Klong Song Posted October 13, 2016 Author Share Posted October 13, 2016 Good one 555Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
CharlieK Posted October 13, 2016 Share Posted October 13, 2016 (edited) When I first came to Thailand had food poisoning from the flight, They did a full body scan MRI, Not that I was looking for other medical conditions. They said I had an enlarged prostate which is normal as you get older. They told me it was calcified. They gave me a course of drugs called Cardurox or some such name? Anyway it cleans out the pipes down there, and have had no problem since. Surgery is a bit extreme IMO, unless there is worry of cancer? Edited October 13, 2016 by CharlieK Link to comment Share on other sites More sharing options...
Sheryl Posted October 13, 2016 Share Posted October 13, 2016 People who opt for surgery are generally ones for whom constant urination and inability to completely empty the bladder has become intolerable...and it can. Link to comment Share on other sites More sharing options...
Blue bruce Posted October 14, 2016 Share Posted October 14, 2016 I think volunteeringfor prostate surgery just to stop waking up to go to the bathroom is bit radical. Link to comment Share on other sites More sharing options...
xylophone Posted October 14, 2016 Share Posted October 14, 2016 Klong song........I'm not sure exactly what you are looking for and if my understanding is correct you may be mixing up a few procedures? Firstly your PSA score of 2.1 is not a worrying figure, but would be if it has increased to this from a much lower figure, over relatively small period of time. The Da Vinci procedure is great for removal of the prostate and usually results in much less "collateral damage" than normal procedures, but do you need the prostate removed? This is normally done when cancer is detected. If however you have an enlarged prostate on its own, with no other signs of cancer or the like, then there are drugs to help that, and also the TURP (transurethral resection of the prostate) is the gold standard procedure, which basically "reams out" the prostate, allowing proper urination and bladder emptying. The Holep (laser) procedure will also do the same thing and is less invasive than the TURP and usually results in quicker recovery although retrograde ejaculation is pretty well standard with this procedure, whereas with the Turp procedure this is not necessarily the case. So if removal of the prostate is your goal, then the Da Vinci procedure, in the right hands as Sheryl has said, is probably the best option, however if you are basically looking to alleviate the symptoms caused by an enlarged prostate, then the Holep or Turp procedures should be investigated. When I was investigating the very same thing about 10 years ago, my doctor said exactly what Sheryl has said in as much as I should seek out the urologist/surgeon who has undertaken the most procedures, and this is particularly the case with the da Vinci procedure because it does entail operating in areas where nerves can be inadvertently severed by the "inexperienced" hand. This was also the case with the TURP I had and if I had to do it again, and this can happen, then I would certainly investigate the Holep procedure although I'm not sure that I would relish the retrograde ejaculation aspect of it. Link to comment Share on other sites More sharing options...
Sheryl Posted October 14, 2016 Share Posted October 14, 2016 It is a lot more than just waking up to go to the bathroom. Nobody undergoes surgery just for that. It is: having to go to the bathroom pretty much all the time. constant pain due to inability to empty the bladder frequent urine infections (which can become quite serious) predisposition to bladder and kidney stones and sepsis. Link to comment Share on other sites More sharing options...
Klong Song Posted October 14, 2016 Author Share Posted October 14, 2016 Thanks everyone for your replies. At this point it has not been determined if any cancer is involved. The situation is I have to get up 2-4 times to urinate every night and sometimes it is difficult to pass urine causing some pain, no problems during the day. Now I am experiencing some back pain and am aware of my kidneys when lying in bed at night so I think it is time to do something. The purpose of my original post was to start the learning process to decide what will be the best course of action and I think I am well on the way. Will be seeing the urologist tomorrow to gather more information. Sent from my iPad using Thaivisa Connect Link to comment Share on other sites More sharing options...
SaintLouisBlues Posted October 14, 2016 Share Posted October 14, 2016 2 hours ago, Blue bruce said: I think volunteeringfor prostate surgery just to stop waking up to go to the bathroom is bit radical. I couldn't agree more. Does the OP realise that he'll likely be wearing incontinence gear for the rest of his life? http://www.dailymail.co.uk/health/article-2163640/Dont-rush-prostate-operation--worst-thing-do.html Link to comment Share on other sites More sharing options...
xylophone Posted October 14, 2016 Share Posted October 14, 2016 8 minutes ago, SaintLouisBlues said: I couldn't agree more. Does the OP realise that he'll likely be wearing incontinence gear for the rest of his life? http://www.dailymail.co.uk/health/article-2163640/Dont-rush-prostate-operation--worst-thing-do.html It's not that simple – – please read Sheryl's post, and anyway if cancer is not involved then it's very unlikely that the prostate will have to be removed, more probably "reamed out" with an operation which is very commonplace these days and has been for many, many years. If this is done, and done well, then side-effects can be kept to a minimum. I've been through years of what Klong song describes, with the infections as a result of this going from the bladder to the kidneys and then to the prostate and they were never-ending, and resulted in prostatitis which is very, very hard to clear, not to mention about 25 years of antibiotics in one form or another. I only hope that the OP doesn't have any other problems and that he can get his situation cleared up as I described in my previous post. Good luck to the OP. Link to comment Share on other sites More sharing options...
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