Prostate surgery

[Klong Song]

Just trying to gather as much information as possible so as to make an informed decision. Not volunteering for anything at the moment.


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[al007]

This topic is near to my heart at the moment

 

Prior to going to India for holeps my PSA had risen to 13.2 over 3 yrs, I am 71, I and seen the same urologist in KhonKaen for 3 yrs.

 

And he always said to me up to you he gave little advice, I did try avodaat for a few months but it did little

 

It was not sleeping at night and having to awake to pee 2/3/4 times a night that pushed me to doing something, in the day time I would sometimes go all day without a pee

 

I need my sleep and it is important

 

It was for this reason alone I chose Holeps

 

The surgeon who does many Holes every week said he finds cancer with the post surgery biopsy, in 40% of those who had had a biopsy showing NO cancer

 

The problem on the prostrate biopsy done at the moment is that it is  based on 12 needle samples taken from the prostate, compare it to putting 12 needles into an orange, if there is abad bit it may well miss it, I also had MRI and CT scans that both said cancer unlikely, within the last year

 

However cancer was found at an early stage and is very treatable

 

I also had a colonoscopy, just as a precaution and check and cancer was found there, and thats not a nice one

 

Had all this done because I needed to pee 2/3 times at night

 

I am very grearful I went for the Holeps because I also stopped that problem, at four weeks post op I can sleep through the night, and whilst bladder control in the early days was difficult it is now returning 85/90% of the time, it is still early days

 

My strong suggestion is do not be put off by people saying so whats the problem you need to pee in the night, If the Holeps had only solved that problem I would have been very happy, but I was also fortunate to discover two cancers relatively  early, and that is the way I look at it

 

 

 

[xylophone]

On 10/15/2016 at 4:01 PM, al007 said:

This topic is near to my heart at the moment

 

Prior to going to India for holeps my PSA had risen to 13.2 over 3 yrs, I am 71, I and seen the same urologist in KhonKaen for 3 yrs.

 

And he always said to me up to you he gave little advice, I did try avodaat for a few months but it did little

 

It was not sleeping at night and having to awake to pee 2/3/4 times a night that pushed me to doing something, in the day time I would sometimes go all day without a pee

 

I need my sleep and it is important

 

It was for this reason alone I chose Holeps

 

The surgeon who does many Holes every week said he finds cancer with the post surgery biopsy, in 40% of those who had had a biopsy showing NO cancer

 

The problem on the prostrate biopsy done at the moment is that it is  based on 12 needle samples taken from the prostate, compare it to putting 12 needles into an orange, if there is abad bit it may well miss it, I also had MRI and CT scans that both said cancer unlikely, within the last year

 

However cancer was found at an early stage and is very treatable

 

I also had a colonoscopy, just as a precaution and check and cancer was found there, and thats not a nice one

 

Had all this done because I needed to pee 2/3 times at night

 

I am very grearful I went for the Holeps because I also stopped that problem, at four weeks post op I can sleep through the night, and whilst bladder control in the early days was difficult it is now returning 85/90% of the time, it is still early days

 

My strong suggestion is do not be put off by people saying so whats the problem you need to pee in the night, If the Holeps had only solved that problem I would have been very happy, but I was also fortunate to discover two cancers relatively  early, and that is the way I look at it

 

 

 

 

Good post al007 and may your return to good health continue.

 

Your information regarding the presence of early cancer was something I hadn't really thought about and I thought your analogy about the orange was spot on.

 

I also noted with interest your comments about your doctor in Khon Kaen, because I've had the same experience here and if you don't push/prompt the doctors (in the right way of course) even that which would be normal in other countries, will not be undertaken here.

 

I wish you all the very best and thank you for your post as hopefully it will give the OP a little more "encouragement" and assistance.

[Klong Song]

I talked with my urologist and it seems I am a good candidate for PVP. Bumrungrad is quoting 234,000-406,000 Baht with 1-2 day stay in hospital. Looking into whether PVP is available in another hospital in BKK and the cost. HOLEPS in India is becoming more attractive.


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[xylophone]

32 minutes ago, Klong Song said:

I talked with my urologist and it seems I am a good candidate for PVP. Bumrungrad is quoting 234,000-406,000 Baht with 1-2 day stay in hospital. Looking into whether PVP is available in another hospital in BKK and the cost. HOLEPS in India is becoming more attractive.


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Both PVP (green light laser) and Holeps are good and modern alternatives to the "old-fashioned" TURP procedure and I wanted the PVP when I had my operation, however the surgeon (at one of the best hospitals in Australia for this type of thing) suggested that it would not be best for me because there is a chance that with PVP that the bladder neck can be damaged because of the way the laser fires (?) And he wanted to have more control over that part because it seemed as if I had some scar tissue there.

 

It would appear from all that I've read that the Holeps may well have the edge over PVP, this especially as some tissue can be salvaged from the Holeps procedure and this can be evaluated for early stages of cancer, whereas with PVP everything is basically evaporated/destroyed.

 

Retrograde ejaculation is something to consider in all of these and despite some earlier articles I read suggesting that the Holeps procedure would almost certainly result in this, others have suggested that although this can be encountered initially, it does improve and some figures I've seen quote that between 30% and 50% of men will experience this. Of course this may well be of secondary importance to you and anyway from other research I did when I was having my operation, it would appear that although retrograde ejaculation occurs (and nothing comes out from the end of the penis) the sensation of a normal ejaculation is still there.

 

I took a chance with the TURP and although there were a few problems with it afterwards, so far everything works fine.

 

I encourage you to do as much research as you can regarding both of these laser surgeries and I did read that Holeps seems to be better for larger prostates and is now considered the/a "gold standard".

 

This may help....

 

SCIENCE DAILY.

 

………………The researchers point out that HoLEP is more effective at adequately treating all sizes of prostatic enlargement, whereas other laser techniques, such as Green Light Laser, is effective on small to moderate size prostates, similar but not better than TURP and lacks the same long-term durability. Green Light Laser has been used at the MUHC since 2005. The results of a study comparing Green Light Laser in different sized prostates showed it to be less effective in treating larger prostates. This study was also presented at the AUA meeting May 18, 2011.

 

[justintimetoday2016]

I had a Holep carried out at the Addensbrooke Hospital by a consultant - Mr Tev Aho - who is first class.  He is regarded as the number one specialist in this field in the UK.   It was done privately on a Saturday morning at a cost of 3000 pounds.  I went home on the following day.

 

Mr Aho is a very approachable guy - a New Zealander - and extremely accommodating.

I have not had any problems post surgery, which was a couple of years ago.

Look him up under 'Cambridge Urology Centre'.

 

My Prostate by the way was the size of a small orange.

 

Hope this helps

[Klong Song]

Thanks for your reply xylophone. Many things to consider and I am getting more useful on this forum than I am from my urologist.


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[Klong Song]

Thanks justintimetoday2016


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[Craig krup]

Just a question - watching this surgery online, I take it when they "core" the prostrate out this means that (effectively) the prostrate wall becomes a functional part of the urethra? I can't see how they get to the prostrate otherwise. They, like Prince's muse, go "in through the out door", so they're first move must be a rotational cut through the urethra. No?

[thaibeachlovers]

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Edited October 18, 2016 by thaibeachlovers

[al007]

19 hours ago, Klong Song said:

I talked with my urologist and it seems I am a good candidate for PVP. Bumrungrad is quoting 234,000-406,000 Baht with 1-2 day stay in hospital. Looking into whether PVP is available in another hospital in BKK and the cost. HOLEPS in India is becoming more attractive.


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Some observations if you decide on India I can point you in the right direction, I would even let you see the invoice I paid, I can also help you avoid the middle man

 

I am not sure where you live in thailand, my Urologist in KK is a lovely man but give no real advice

 

If you are a UK citizen or visit the UK regularly,

 

I would without any question to quote justintime today  "I had a Holep carried out at the Addensbrooke Hospital by a consultant - Mr Tev Aho - who is first class.  He is regarded as the number one specialist in this field in the UK.   It was done privately on a Saturday morning at a cost of 3000 pounds.  I went home on the following day."

 

Before you go to most places they will want a biopsy done on the prostate, remember the results take around a week to ten days, also an unto date PSA result same day

 

Even if you have Holeps in India it is strongly recommended you stay close to the hospital for around 9 days just in case

 

My surgeon would likely do Holeps without biopsy, (He did on me)the American recommendations so far as I understand do not say biopsy is required

 

In any case after the procedure the tissue is sent for checking, which gives a much safer result

 

Remember I am not medically qualified only talking from my own experience and what I have learnt over the last year or so

[xylophone]

22 hours ago, Klong Song said:

Thanks for your reply xylophone. Many things to consider and I am getting more useful on this forum than I am from my urologist.


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Re. the most helpful posts by Al007 and Justintimetoday2016, please see the link below for more info on the Holeps procedure, and good to know it was developed by a couple of Kiwis!!

http://www.camurology.org.uk/laser-prostate-surgery/ 

[xylophone]

17 hours ago, Craig krup said:

Just a question - watching this surgery online, I take it when they "core" the prostrate out this means that (effectively) the prostrate wall becomes a functional part of the urethra? I can't see how they get to the prostrate otherwise. They, like Prince's muse, go "in through the out door", so they're first move must be a rotational cut through the urethra. No?

 

As far as I can ascertain, at one point the urethra becomes a part of the prostate and is more or less a channel through the prostate (after which it continues as the urethra proper), so that means once this channel is impinged upon by a swollen prostate, then the excess can be cut away by the laser treatment or any other treatment for that matter.

 

Access is gained via the urethra in the penis and all of the material is flushed out one way and another (depending upon the procedure used). 

[Craig krup]

On 10/19/2016 at 11:37 AM, xylophone said:

 

As far as I can ascertain, at one point the urethra becomes a part of the prostate and is more or less a channel through the prostate (after which it continues as the urethra proper), so that means once this channel is impinged upon by a swollen prostate, then the excess can be cut away by the laser treatment or any other treatment for that matter.

 

Access is gained via the urethra in the penis and all of the material is flushed out one way and another (depending upon the procedure used). 

 

Yeah! The old boy I know who got rushed in for the emergency version - bladder like Boris Johnson's head - was peeing big "chunks" and blood clots afterwards. The thought fill me with horror. 

[xylophone]

8 hours ago, Craig krup said:

 

Yeah! The old boy I know who got rushed in for the emergency version - bladder like Boris Johnson's head - was peeing big "chunks" and blood clots afterwards. The thought fill me with horror. 

 

Been there, done that with my TURP operation and it wasn't pleasant and to top it off I was rushed into Emergency 3 days later as couldn't pass water at all...........thought I was going to pass out and when the medic put in a catheter he filled a one liter bag plus part of another one.

 

I was amazed at the volume and asked it it was a record, his reply, "don't know what the record is, but this is the most I have ever seen".

 

Was taught how to self catheterise after that and did it for a week or so and although a little "frightening" at first, I became a dab hand at it and it and it was good to know that I wasn't going to have to be rushed into Emergency again......and the relief and feeling of an empty bladder was sublime!!

 

I do believe that the newer Holeps, for example, means less debris left inside, plus is  "cleaner"  and less "damaging" procedure.

[Craig krup]

10 hours ago, xylophone said:

 

filled a one liter bag plus part of another one.

 

I was amazed at the volume and asked it it was a record, his reply, "don't know what the record is, but this is the most I have ever seen".

 

At the risk of sounding indelicate, a crate of homebrew, a load of laziness, a locked bathroom door and an old stainless steel flask allowed me to establish that mine holds (disastrously) quite a bit over a litre. I had the facial expression of a man with a burning backside who has just sat on a mound of ice cream. 

[lopburi3]

I have easy measurement available now that using a pouch rather than a bladder and nightly range is between .5 and 1.5 liters.  Most nights it is almost exactly 1 liter.  Bladder would have had to hold about the same when sleeping through the night.

[Craig krup]

9 hours ago, lopburi3 said:

I have easy measurement available now that using a pouch rather than a bladder and nightly range is between .5 and 1.5 liters.  Most nights it is almost exactly 1 liter.  Bladder would have had to hold about the same when sleeping through the night.

 

If your main meal is a mound of rice and veg - as mine was last night - then you can be up twice (as I was). The actual dry content of 1300 kcals of rice and veg is probably about a cup of dry matter, so you're looking at 2 litres seeping out over the course of the night as you digest it. 

[xylophone]

On 10/18/2016 at 5:18 PM, Klong Song said:

I talked with my urologist and it seems I am a good candidate for PVP. Bumrungrad is quoting 234,000-406,000 Baht with 1-2 day stay in hospital. Looking into whether PVP is available in another hospital in BKK and the cost. HOLEPS in India is becoming more attractive.


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Well I've had a lot going on in my life since you posted this and all of it has to do with the inability to pass water! But before I get onto that, the cost you have quoted seems quite high if it is the standard PVP operation?

 

About a week ago it became almost impossible for me to pass urine, so I went to see the urologist at Bangkok Phuket Hospital and initially he was good because he said well if you've got time we will go in and have a look around via a cystoscopy and I can do it today, which was music to my ears.

 

I did mention to him that I had had a TURP about nine years ago and I wasn't keen on that operation again.

 

Anyway, into the room and stripped off in a matter of minutes, the urologist came then put on some rubber gloves squirted in the Xylocaine medication and promptly stuck his camera up the old fella and within seconds said, "ah yes, you have some scarring on the bladder neck and that's what's causing it". I asked him if the prostate was okay and he said that it was, but the bladder neck needed attention.

 

That took less than 10 minutes in all and after he had pulled out the cystoscope, he then started to walk out of the room and suggested I went back to NZ to get something done, which I thought was quite strange, but thinking about it, it probably made sense and I will explain. Before doing that, this whole lot cost a total of 21,000 baht, which I thought was a little excessive for probably less than 10 minutes of treatment.

 

He did ask if I had self cathetered before and I said that I had, so he prescribed a catheter and some Xylocaine jelly and off he went.

 

Unfortunately the catheter has been very necessary since this and nothing seems to have gone right up until a couple of days ago, this because I really couldn't get any answers from anyone in the two major hospitals in Phuket with regards to whether or not they could carry out some form of laser surgery on my prostate/bladder neck – – nobody seemed to know whether the hospitals had the equipment to do this, not even the people working in the urology department!

 

I tried to contact the urologist who did the cystoscopy, and because he comes and goes at the hospital, his surgery was the following week and nobody knew where he was outside of this, so I searched the Internet for him and again had no luck with a contact number or anything, so then I phoned various hospitals here and some had heard of him and others hadn't!

 

I contacted the urology department at Bangkok Phuket Hospital and they didn't know, so I contacted the international department at that same hospital and they didn't know and couldn't give me any leads as to whether I could find out. Obviously I tried Phuket International Hospital, but to no avail.

 

Getting desperate now so I took the advice from here and sent an email for the attention of Dr Viroj at Bumrungrad Hospital, which went to the administration department who got back to me within three days telling me that they wanted copies of medical reports and just about everything, so I managed to send them everything I had and waited and as yet have not had a reply.

 

Tried Yanhee hospital and nobody seemed to know if they had the equipment to perform that laser surgery. Then became more desperate and contacted the Adventist hospital in Penang, where a friend of mine had just had some surgery on his eye and thought the service and hospital were great, and although it's taken a few days, they have finally gotten back to me and that remains an option.

 

I was searching around and also contacted Bangkok Pattaya hospital, and after a few days they said that this surgery was available.

 

To try and put some timescales on it, by Tuesday after the cystoscopy the previous Saturday I had heard nothing from anybody and really didn't know where to look, and more to the point, what surprised me no end was the fact that Bangkok Phuket Hospital which advertises itself as a major medical tourism hub, had no idea about this and couldn't help me.

 

I did have a major flash of inspiration because I remembered a professor who had opened up the colorectal unit at the hospital and he was a great guy, very approachable and very knowledgeable, so I made an appointment really out of desperation to get to talk to him. And it proved successful because he put me onto a couple of departments in the hospital but neither of them knew, however he also gave me the name of a urologist from Hat Yai who visits the hospital from time to time and who had a website on which he advertised green light laser surgery for prostate/urology problems!!!!!!!!!

 

I also got his phone number and telephoned him for an appointment this coming Friday afternoon.

 

Finally after hours and days of searching, I seem to have made some progress and I am really hoping that if the appointment goes well tomorrow, I will be able to go to Hat Yai and have some green light laser surgery on my bladder neck – – not what I really wanted, because Holmium laser is the "better one" by all accounts however desperation has set in and I think this will do the job as I only require an incision in the bladder neck or something similar.

 

Getting back to my earlier comment regarding the urologist who did the cystoscopy suggesting I went back to New Zealand to get the bladder neck operation done........well I think this was because he knew that the hospital had no laser equipment to treat the bladder neck, but was reluctant to get into that territory, this especially as I had suggested that I did not want a TURP, and that's probably all they specialised in, although they can do bladder neck incisions with it, it certainly remains the most invasive of procedures.

 

The other thing I find amazing is that nobody but nobody would tell me, or even knew, if laser surgery was available/used for prostate problems in the hospitals here. Having said that, it probably follows the normal pattern that I found here, and that is if they don't know, they won't tell you that they don't know for fear of losing face, so it makes life very difficult when all you want is a simple answer and can't get it.

 

I would be interested to hear what the urologist says tomorrow afternoon and also to find out what the cost would be of having this operation in Hat Yai as it's a damn sight better to travel there then have to go all the way back to NZ, or even Penang for that matter. For the record, I did try hospitals in the India (getting desperate) and one in Chennai has gotten back to me, so at least now I have alternatives.

 

Just before I close, it would appear that the urologist I am seeing tomorrow, who practices in the hospital at Hat Yai does quite a few of these operations using green light laser and also advertises on the website that side-effects like retrograde ejaculation and incontinence are rare with the operations that he carries out.........I live in hope.

 

PS. I have been in contact with another poster here, Al007, and he has been very helpful and supportive, even though he is going through some of his own battles, so it's great to know that there are some people here who are prepared to go out of their way to help. Thanks Al007.

 

Edited October 27, 2016 by xylophone

[Klong Song]

Thanks for the post xylophone, my symptoms are still not intolerable but I would be very interested the outcome to you visit to Hat Yai.


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[xylophone]

1 minute ago, Klong Song said:

Thanks for the post xylophone, my symptoms are still not intolerable but I would be very interested the outcome to you visit to Hat Yai.


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You must be psychic because I was just about to post, asking you how you were getting on with your situation.

 

I can update you Klong Song and will try to keep it a lot shorter than my previous post.........I saw a youngish urologist who had come up from Hat Yai, because he visits Bangkok Phuket Hospital for a couple of weeks every month and I have to say he was a very good, if slightly gung ho specialist. More to the point he took a lot of time listening to what I had to say and in answering my questions and backing his answers up with video proof.

 

He looked at the cystoscopy report and I suggested that I would prefer green light or holmium laser for the bladder neck surgery, which was what the cystoscopy had highlighted needed to be done, and I told him that after my last experience with a full TURP, I was not over enamoured at having a similar operation with similar equipment again.

 

However he changed my mind and he did it with the assistance of his laptop computer on which he had short videos of the operations he performed and he set about explaining why he thought laser would not be a good option for the bladder neck, although it is for reaming out the prostate.

 

With the bladder neck there is a small amount of tissue to work on and it is imperative that only small amounts of tissue are "shaved off" at a time, and a new "bipolar cauterisation methodology" was what he used and believed it was best because it gave him much more control over how much tissue he was removing – is very important at the bladder neck he said. He also showed me the operation on his computer and sure enough it was very delicate and only very small amounts of tissue were removed at a time. Contrast that with his short video on the laser technology and you can immediately see that bursts of laser do not seem as "controllable or selective" because the tissue is just blasted away.

 

Now I had been convinced that laser surgery was what I wanted, but after our consultation I agreed to go ahead with this operation, and he informed me that he could perform that procedure at Bangkok Phuket Hospital (no travelling to Hat Yai) and although an overnight stay is just about certain, another day or two depends upon my recovery rate.

 

So there you have it, and since he has shown me the short videos of the operations, I can see exactly where he is coming from. Sure enough, laser enucleation/vaporisation of the prostate is becoming the "gold standard" and where there is quite a bit of tissue to remove, then all well and good, however apparently this new take on an old procedure allows much finer work to be done – – and that's quite probably what the specialist at the hospital in Melbourne was meaning all those years ago.

 

I have booked the surgery for November 11th and in the meantime I am having to use a catheter once or twice a day, which one gets used to after a while. It will be worth the wait and I am looking forward to getting it over and done with...........

 

What is your current situation and how are you progressing? (If you don't want to post then by all means send me a PM which is what I have done with Al007 and it's working well).

 

[Sheryl]

OP and Klong San, keep in mind that Xylophone is suffering fro ma different condition than you are (post-surgical scarring at the bladder neck) so the procedure that works for him is not nece4ssarily appropriate to your situation of an enlarged prostate. His prostate has already been treated.

 

 

[Klong Song]

Thanks xylophone, good to hear that you have decided on a way to progress and I hope it all works out for you. My situation remains pretty much the same. After seeing my urologist and having him comment on the size of my prostate a couple of days later I experienced some discomfort in my kidneys and began worrying that the restricted flow was causing damage to my kidneys. So Back to see him again last Saturday and he assured me that all is well with the kidneys and I am no longer having discomfort so I guess it was all a bit of an over reaction on my part. I quizzed him a bit on PVP and didn't really get a straight answer. He says that most doctors in BKK do TURPS because they are comfortable with it and resist change. Previous conversations with him made me think that he prefers to go in and ream everything out with disregard to undesirable side effects. It was this attitude that set me off on the quest to learn more. My PSA remains at 2.1 and my prostate was estimated to be 67 grams. I still get up 1-4 times a night with urine flow being slow to very slow at night and almost normal during the day. All in all the situation remains tolerable so I am not anticipating any immediate action but if things change for the worse at least I have some idea about how to proceed.


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[SaintLouisBlues]

I find it amazing that guys still get prostate cancer in the sex capital of the entire world - http://www.harvardprostateknowledge.org/does-frequent-ejaculation-help-ward-off-prostate-cancer

 

The other thing that causes cancer is too many free radicals in the body. What causes too many free radicals? Too much exercise! As I say to my married buddies, if your wife isn't putting out but she's encouraging you to exercise a lot, she's got a plan for her future and it doesn't include you

[xylophone]

Hi Klong Song, good to hear that your situation is tolerable and that you are managing it okay, and I do agree with what your urologist said with regards to the old-fashioned TURP procedure, because it has been around for almost 90 years, and although it must have improved over the time, it is still the one that a lot of urologists were trained on and feel comfortable with.

 

For your reference and possible future use, you may be pleased to know that Bangkok Pattaya Hospital do have the laser facility there for treatment of the prostate, and this is the website of the young urologist I am seeing (as I said, from Hat Yai) who does PVP laser surgery and also states on his website that when he does this procedure, side-effects are minimal!

http://www.eternityclinic.co.th/index.php/en/ 

 

Of course as Sheryl has quite rightly said, what I am suffering from now is not what you are suffering from although the symptoms are the same, as I had a TURP nine years ago, and if I had to do it again, I would certainly go the holmium or PVP laser way now

 

From my perspective, and my perspective only, your PSA reading of 2.1 is still regarded as normal, and it sounds like you're suffering from BPH which is not life-threatening but can and does restrict urine flow. 

 

I will let you know how the operation goes just by way of keeping in touch, and in the meantime good luck with managing your situation and I wish you all the best.

 

 

[xylophone]

I was in touch with Klong Song before posting this, because I’d was aware that I might be hijacking his thread and I didn’t want to do this, however he has said it would be fine to post.

 

There may be others like him who have learned something from these posts, so I will carry on……….

 

I had an operation to widen my bladder neck on Friday, 11 November and although I initially believed it would be just an incision, the urologist showed me the operation on his laptop later on and he has removed tissue from around the whole bladder neck as he thought it would give a better result.

 

Catheter was in place for the rest of Friday and Saturday morning and it was then removed to see if the process of passing water would start – – which it didn’t! Managed to deliver a few dribbles during the day and at 2:30 a.m. the next morning an emergency ensued and the nurse inserted a catheter and drained 1.34 L of water from my overstretched and painful bladder.

 

I was told I could go home if I could then start passing water, which did happen albeit in dribs and drabs. So I was sent home and told to self-catheterise again if necessary and come back in two weeks to see the urologist.

 

I’m in no pain apart from some burning of the urethra which is only natural considering what has been done and anyway I have numerous tablets, antibiotics and painkillers to help me through.

 

Now something which other folk may want to pay heed to is the fact that when I look back I have been having problems with complete bladder emptying for about a year now, although initially I didn’t realise it. However an ongoing kidney/UTI infection really brought that to light. On top of that, my stream has never been that brilliant since as long as I can remember, so something else to take into consideration (and of course I had a TURP nine years ago because of BPH and prostate calcification).

 

According to the urologist, if this sort of condition, with regards to poor emptying, continues over time, the bladder tends to stretch and also tends to lose its ability to sense when it should be working properly, and the symptoms present by not being able to empty ones bladder, feeling the urge to go and not being able to, getting up many times during the night and having a poor stream (resulting in residual urine which can back up to the kidneys and which also can cause infection).

 

Now it seems as if I’m going to have to “train” my bladder to start functioning properly again, this through timing of toilet visits and set timing of the use of the catheter and this can take some time.

 

So if the above symptoms are being experienced, it may pay to speak to a urologist to see what the long-term prognosis is, because if one can avoid the problems with an ill functioning bladder as one gets older, by perhaps what is now viewed as a "simple" operation (either a TURP, TUIP, BNI or similar), then perhaps that should be considered?

 

Please remember that this is my experience and the information given to me was through my own urologist and I’m not advocating one thing or another, just that some symptoms may need dealing with earlier than anticipated.

 

Finally, all the best in what you decide to do Klong Song and by all means keep in touch via PM as before. Also many thanks to Al007 for his support.

[xylophone]

Now this is interesting and something which I hope will prove successful, although a long way to go yet.

Man 'cured' of prostate cancer after doctors shock tumour to death with testosterone.

 

http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=11759015

[Flanno]

Hi Guys  Maybe someone can give me advice here. About 6 weeks ago I had a Trans Urethral Resection (TURP) in Australia and I came over to Thailand about 2 weeks later. While my condition did improve initially, though not as much as I had hoped for, the last few days has seen my prostate condition revert to what it was prior to TURP. Very frequent urination, a poor urine stream flow and urgency to urinate at very short notice are the main symptons.

I'm not sure if I will be able to see my Urologist in Australia until mid January and am just wondering if I should get it treated sooner and also does anyone have a similar experience and can advise me on.

Also am wondering if it's likely I would be undergoing another TURP or a different procedure to fix the problem.

Any advice would be appreciated. Thanks.

[xylophone]

1 hour ago, Flanno said:

Hi Guys  Maybe someone can give me advice here. About 6 weeks ago I had a Trans Urethral Resection (TURP) in Australia and I came over to Thailand about 2 weeks later. While my condition did improve initially, though not as much as I had hoped for, the last few days has seen my prostate condition revert to what it was prior to TURP. Very frequent urination, a poor urine stream flow and urgency to urinate at very short notice are the main symptons.

I'm not sure if I will be able to see my Urologist in Australia until mid January and am just wondering if I should get it treated sooner and also does anyone have a similar experience and can advise me on.

Also am wondering if it's likely I would be undergoing another TURP or a different procedure to fix the problem.

Any advice would be appreciated. Thanks.

 

Sorry to hear about this, however it seems to be quite common, this especially as I had a TURP about nine years ago in Australia and about a week afterwards I couldn't pass water at all and had to have an emergency catheter to drain out almost 1.5 L of urine!

 

And just recently I have had a bladder neck operation to widen it because of the very symptoms you describe.

 

Not a lot of help to you, however I can suggest a few things: –

 

– Depending upon where you are in Thailand, you may be able to find a good urologist who will help (perhaps Sheryl will be able to help here).

 

– Firstly, I don't suppose you would need another TURP right now because in effect they have reamed out the prostate to allow a more free passage of urine.

 

– What can sometimes happen when this operation is performed is that scar tissue forms around the bladder neck which is to all intents and purposes  joined at the top of the prostate. This scar tissue can prevent free passage of urine which may be what you are experiencing.

 

– Another possibility is that you have a UTI (urinary tract infection) which has caused some inflammation thereby reducing the urine flow. The urologist can take a sample to test the urine to see if this is the case and treat it with antibiotics.

 

– In my opinion, there's not a lot that your urologist in Australia could do, that couldn't be done here by a good urologist. Again, in my opinion, this sort of surgery can sometimes be a bit hit and miss.

 

– My urologist in Australia suggested that I self catheterise for a period of time (not as bad as it sounds by the way) in order to drain and train the bladder and to get it working "normally" again. Apparently years of poor emptying means that your bladder gets used to holding a lot of urine, so a little emptying every so often helps to take away the urge to pass water, but still doesn't fix it because you have a lot of residual in the bladder. That is the very thing I am doing now after my bladder neck surgery and although I'm not too happy about it, there is not a lot I can do at the moment.

 

– If you can see a good urologist here, then a couple of things you might want to suggest to him (always best I have found in Thailand) is that they do an ultrasound on the bladder to find out if there is any other obstruction which might be preventing the flow of urine, and/or to ask for a cystoscopy, by which they will put a probe into the prostate/bladder, via the urethra, to see exactly what is going on. It isn't as drastic as it sounds as they will put some numbing lubricant into the old fella and then put the camera in and it is basically a quick outpatient procedure and not painful.

 

– If you have been drinking alcohol, then that can irritate both the bladder and the urethra, especially after such an operation, and cause inflammation.

 

– There is not a lot in the way of medication they can give you, although one particular tablet, ucholine, is supposed to help with getting the bladder responses working better and they do prescribe Cialis in some cases, however I have not found that works for me.

 

– Make sure that you are drinking plenty of water and I have found carbonated water (for some obscure reason) seems to work best and you will need to drink at least a couple of litres a day.

 

I hope the above is of help, but one thing I will stress again is that unless you suggest to your urologist that you want your urine tested, an ultrasound conducted and quite possibly a cystoscopy, then they are not always offered, which I find quite strange in the circumstances.

 

Feel free to send me a PM if you wish and for the record I see my urologist again on Friday and I will be suggesting/demanding, exactly what I have outlined above. Just to underscore my case, it has been a month since I've had my bladder neck cut, and although I have seen my specialist twice since then, he has never suggested any of the above – – and I thought the urine sample testing for infection would have been of primary concern.

 

 

 

[lopburi3]

Quote

It isn't as drastic as it sounds as they will put some numbing lubricant into the old fella and then put the camera in and it is basically a quick outpatient procedure and not painful.

Although it was not much more unpleasant that an extremely full beer bladder at a private hospital a second one done at a government hospital was extremely painful in my experience - not all doctors/teams are the same.  But yes it is a simple procedure and should not take too long - and there should not be much pain.