Prostate surgery, full removal, partial core removal, Holep and Cancer of both prostate and colon

[Sheryl]

4 hours ago, KiChakayan said:

Sheryl, don't you think that, for any medication, the strongest vested interests would be those of the labs producing the drugs. Especially in countries where vast amounts of money are spent on lobbying.

 

Thanks for your caution however, it may lead to some further research.

The companies manufacturing drugs are one vested interest, for sure. But so are malpractice lawyers and people seeking to sue/get attention...and many of the "alternative medicine" folk run multimillion dollar businesses selling unproven or quack cures.

[xylophone]

1 hour ago, nontabury said:

Your correct in stating that Turps is the old fashioned proceedure, there are now many other options that are available, and it is these that are Now considered the Gold Standard.

I looked into Turps a few years back, the potential side effects scared me to death. So why are some Dr still recommending this proceedure? Well the answers fairly simple. It requires special training, that is why I am under the impression, that this is the reason laser surgery is not available in Thailand.

 I don’t wish to get into an argument with you, but please for the second time of asking,WHERE in Thailand is the newer laser procedures performed.

How on earth could we get into an argument, because we are both "on the same page", as the saying goes?

 

You are right that the laser procedures require training and the more experience a surgeon has had, the better.

From my very limited research it appears that laser surgery for BPH is available at Vejthani and BNH hospitals in Bangkok and also at a hospital/clinic in Hat Yai...... 

http://www.eternityclinic.co.th/en/our-services-en/urinary-system/photo-selective-vaporization-of-the-prostate-pvp.html

 

I had a TURP about 10 years ago at Epworth Hospital in Melbourne, carried out by one of the leading surgeons (in Australia and worldwide).

 

I initially went to see him because I wanted the green light laser surgery and he said he would need to investigate before he recommended that. In the end he went with the old-fashioned TURP because he had more control over the cutting action and as I had a slight problem with the bladder neck, he considered the laser surgery would be too dangerous to use that close to the bladder neck.

 

What he was basically saying was that as he had to cut very close to the bladder neck, laser vaporisation could be tricky and I had to go along with this man because he was one of the leading urological surgeons.

 

That is one of the reasons I believe this procedure is still practised and not only because of the training needed with the laser method, but that there is more control and less likelihood of unintentional damage.

 

Sure, I read some of the "horror stories" about the TURP procedure, but then again you only ever read the bad experiences people have had, rather than the success stories and the success stories far outweigh the horror stories.

 

After my operation and a hiccup with regard to the use of a catheter, everything was back to normal and has been for many years, apart from a recent problem with my bladder neck, which had nothing whatsoever to do with the TURP I had.

[Sheryl]

1 hour ago, nontabury said:

Your correct in stating that Turps is the old fashioned proceedure, there are now many other options that are available, and it is these that are Now considered the Gold Standard.

I looked into Turps a few years back, the potential side effects scared me to death. So why are some Dr still recommending this proceedure? Well the answers fairly simple. It requires special training, that is why I am under the impression, that this is the reason laser surgery is not available in Thailand.

 I don’t wish to get into an argument with you, but please for the second time of asking,WHERE in Thailand is the newer laser procedures performed.

 

https://www.bumrungrad.com/en/urology-prostate-bladder-center-bangkok-thailand/procedures/pvp-photoselective-vaporization-prostate

 

Rumor has it Bangkok Pattaya Hospital also does this. And I am fairly sure siraj and Chulalongkhorn do as well.

 

Note that "TURP" as a procedure has evolved enormously over the past and nowadays nerve-sparing techniques are used which greatly reduce negative long term effects. There is also a robotic microsurgical variant. Hence "TURP" is far from an outdated option . In fact it remains the usual treatment of choice for patients who do nto respond adequately to conservative medical management.

[KiChakayan]

3 hours ago, xylophone said:

And the volume of 100cc......is that residual urine or that which is expelled?

The volume of my prostate as at January 2017...

[xylophone]

2 hours ago, KiChakayan said:

The volume of my prostate as at January 2017...

Volume 100cc, revealed through MRI Coil at Bumrungrad

PSA fluctuation between 6 and 13 over 8 years,

Urinary symptoms consistent with BPH come and go,

Previous MRI and Biopsy did not confirm cancer,

Lovely wife, sex about 3 times a week,

 

As you know, the prostate grows over time as we get older and as yet there has been nothing found which can stop this process, although a drug or two can slow it down and perhaps shrink it slightly.

 

So BPH is to a certain extent "the norm" for most men over the age of about 50 and for some this does affect the urine flow quite markedly, and for others it doesn't and they can get by without a problem.

 

Watchful waiting is what many urologists prescribe and this along with perhaps a prescription or two along the way can help. If the symptoms of poor urine stream, urine retention, infections caused by this (including kidney infections) and frequent trips to the bathroom become unmanageable, then something else is required, and as you know this is when surgery is considered.

 

Looking at that which you have posted, if it were me, I would be concerned about the PSA levels, but if an MRI and biopsy have not found cancer, then perhaps not, and not much else because if you can get by with the urinary symptoms because they are not consistently present or cause a major problem then what you are experiencing is just a sign of ageing. And if you can have sex three times a week, then you are a lucky man at age 65!

 

Surgery should be considered the last option and if your condition can be managed by a combination of watchful waiting and perhaps some drugs, then soldier on?

 

Interesting to note that some urologists are advocating Cialis as a potential treatment for BPH!

 

A good and informative link below.....

https://www.emedicinehealth.com/enlarged_prostate/article_em.htm   

 

[KiChakayan]

33 minutes ago, xylophone said:

Interesting to note that some urologists are advocating Cialis as a potential treatment for BPH!

 

Yes, and it is FDA approved.

 

Regarding the sex thing, it is all about the wife. Nine years together, two kids and still very good intimity. I am staggered  when I read some threads/post about Thai Marriages.

Edited December 13, 2017 by KiChakayan

[nontabury]

On 13/12/2017 at 12:24 PM, xylophone said:

How on earth could we get into an argument, because we are both "on the same page", as the saying goes?

 

You are right that the laser procedures require training and the more experience a surgeon has had, the better.

From my very limited research it appears that laser surgery for BPH is available at Vejthani and BNH hospitals in Bangkok and also at a hospital/clinic in Hat Yai...... 

http://www.eternityclinic.co.th/en/our-services-en/urinary-system/photo-selective-vaporization-of-the-prostate-pvp.html

 

I had a TURP about 10 years ago at Epworth Hospital in Melbourne, carried out by one of the leading surgeons (in Australia and worldwide).

 

I initially went to see him because I wanted the green light laser surgery and he said he would need to investigate before he recommended that. In the end he went with the old-fashioned TURP because he had more control over the cutting action and as I had a slight problem with the bladder neck, he considered the laser surgery would be too dangerous to use that close to the bladder neck.

 

What he was basically saying was that as he had to cut very close to the bladder neck, laser vaporisation could be tricky and I had to go along with this man because he was one of the leading urological surgeons.

 

That is one of the reasons I believe this procedure is still practised and not only because of the training needed with the laser method, but that there is more control and less likelihood of unintentional damage.

 

Sure, I read some of the "horror stories" about the TURP procedure, but then again you only ever read the bad experiences people have had, rather than the success stories and the success stories far outweigh the horror stories.

 

After my operation and a hiccup with regard to the use of a catheter, everything was back to normal and has been for many years, apart from a recent problem with my bladder neck, which had nothing whatsoever to do with the TURP I had.

Yes the eternity clinic does advertise the PVP treatment. So yesterday I rang their main branch to enquire. The receptionist has never heard of PVP, so I suggested that she asked a Dr to call me. 1/2 hr later the clinic manager phoned back, again never heard of PVP. So I explained to her what it is,and asked her to ask a a Dr to call me back, with the cost, and the experience of the Dr, including how many times they have carried out this proceedure, as I was interested in this treatment for myself. 30 hrs later, NO reply.

 I then tried without success to call  Vejthanie hospital, unfortunately their chat system is not working. So I then called BNH, leaving a message requesting information as to the full cost, expertise of the Dr, and again asking how many procedures they have carried out. The web page said someone would contact me within 24 hrs. Now 30hrs no reply.

  Contrast this with the service of my Dr in India. E- mailed him today, asking for the Biopsy result. He replied within 1 hr.

 Regarding Turps, this proceedure has been wildly used since the 1960,s. 

Now it is considered a rather old flashed proceedure, as I’ m sure Holep, Holap, PvP and other laser treatments will be in a few yrs time. As advances in the treatment of BPH seem to,be occurring very quickly. I’m just sorry that the Rezume proceedure was not available a few yrs back, before my prostrate increased in size above 80cc.

[nontabury]

On 13/12/2017 at 12:27 PM, Sheryl said:

 

https://www.bumru

On 13/12/2017 at 12:27 PM, Sheryl said:

 

https://www.bumrungrad.com/en/urology-prostate-bladder-center-bangkok-thailand/procedures/pvp-photoselective-vaporization-prostate

 

Rumor has it Bangkok Pattaya Hospital also does this. And I am fairly sure siraj and Chulalongkhorn do as well.

 

Note that "TURP" as a procedure has evolved enormously over the past and nowadays nerve-sparing techniques are used which greatly reduce negative long term effects. There is also a robotic microsurgical variant. Hence "TURP" is far from an outdated option . In fact it remains the usual treatment of choice for patients who do nto respond adequately to conservative medical management.

ngrad.com/en/urology-prostate-bladder-center-bangkok-thailand/procedures/pvp-photoselective-vaporization-prostate

 

Rumor has it Bangkok Pattaya Hospital also does this. And I am fairly sure siraj and Chulalongkhorn do as well.

 

Note that "TURP" as a procedure has evolved enormously over the past and nowadays nerve-sparing techniques are used which greatly reduce negative long term effects. There is also a robotic microsurgical variant. Hence "TURP" is far from an outdated option . In fact it remains the usual treatment of choice for patients who do nto respond adequately to conservative medical management.

Contacted Bamrungrad yesterday, as “yes” they do mention this proceedure( but do they actually do it) left a message on their web page asking for the total price, experience of the Dr, including how many times they had carried it out. The web page states that someone would call me back within 24 hrs. Still no reply.

What is a rumour? As I called Bangkok Hospital Pattaya, earlier this year, to be told they do not carry out this proceedure. But It’s possible that I spoke with a member of staff, who gave me the wrong information.

 Chulalongkhorm which many recommend as the best hospital in Thailand,except in regards to their waiting list, and none hotel rooms. Never mentioned that they carried out this proceedure, when I and others inquired earlier this yr. Myself after I had had an MRI.

 Sheryl, do you know of anyone who has had laser treatment for the Prostrate, here in Thailand, and if so where?

 

[xylophone]

39 minutes ago, nontabury said:

Yes the eternity clinic does advertise the PVP treatment. So yesterday I rang their main branch to enquire. The receptionist has never heard of PVP, so I suggested that she asked a Dr to call me. 1/2 hr later the clinic manager phoned back, again never heard of PVP. So I explained to her what it is,and asked her to ask a a Dr to call me back, with the cost, and the experience of the Dr, including how many times they have carried out this proceedure, as I was interested in this treatment for myself. 30 hrs later, NO reply.

 I then tried without success to call  Vejthanie hospital, unfortunately their chat system is not working. So I then called BNH, leaving a message requesting information as to the full cost, expertise of the Dr, and again asking how many procedures they have carried out. The web page said someone would contact me within 24 hrs. Now 30hrs no reply.

  Contrast this with the service of my Dr in India. E- mailed him today, asking for the Biopsy result. He replied within 1 hr.

 Regarding Turps, this proceedure has been wildly used since the 1960,s. 

Now it is considered a rather old flashed proceedure, as I’ m sure Holep, Holap, PvP and other laser treatments will be in a few yrs time. As advances in the treatment of BPH seem to,be occurring very quickly. I’m just sorry that the Rezume proceedure was not available a few yrs back, before my prostrate increased in size above 80cc.

Reading one of your previous posts and also this one, I assume (wrong I know) that you have had some sort of treatment in India and that you have been very pleased with that which you have received.

 

Contrast that with the service that you have received from the hospitals here that you have contacted regarding laser surgery for the prostate, and I can see exactly where you're coming from, because I agree with you that the service that many hospitals here (and other organisations) offer is/can be well below expectations and doesn't give much in the way of hope for receiving good treatment.

 

I do know this because I mentioned it in another post of mine and one particular urologist basically told me to leave his office because he had been feeding me several different antibiotics over the months to cure a UTI/kidney infection, and the latest one had caused some sort of muscle/tendon problem and my calf was swollen to twice its normal size (apparently can happen with this particular antibiotic) so when I suggested that I would like to cease taking it and try another one, or at least perform a culture which he had not done in the past six visits to establish exactly what the bacteria was, he became stroppy and basically told me to leave his office, saying, I can't do anything more for you.

 

A few months later I was being treated for very dangerous E. coli bacteria and whether it was from a small operation I had at the hospital, or because I had been fed many, many months of inappropriate antibiotics, I will never know. What I do know is that the actions of this Dr were absolutely disgraceful.

 

It does not fill me with much hope when I read what you have posted, and also take into consideration my own experience, and that of other people I know, because this place is trying to convince people it can become "a medical hub", but before it can do that it needs to lift its act quite considerably.

 

As regards the TURP procedure, I remember looking at the original instrument, which a urologist in Auckland had in his office in a glass case and the bloody thing frightened me to death, because it was about the size of the thickness of my thumb and more than a foot long, and when I asked exactly what he did with it and he told me, I decided there and then that it was not for me.

 

However that was one of the first instruments and they have been refined quite markedly since then.

 

As for the Rezume procedure, well it is relatively new so therefore its long-term effects are not known and for me I would prefer the laser treatment if I had a choice these days, but as you say, in Thailand, well, therein lies the rub.

Edited December 14, 2017 by xylophone

[xylophone]

18 minutes ago, nontabury said:

 Sheryl, do you know of anyone who has had laser treatment for the Prostrate, here in Thailand, and if so where

I know I'm not Sheryl, but a few months ago I did speak to Dr Subepong (spelling) at the Eternity Clinic and he confirmed that he does do the laser surgery on the prostate.

 

Furthermore I believe he does it at his clinic in Hat Yai. He also travels to other hospitals to perform urological operations, so perhaps try speaking to him direct?

 

[JLCrab]

11 hours ago, xylophone said:

<snip>

It does not fill me with much hope when I read what you have posted, and also take into consideration my own experience, and that of other people I know, because this place is trying to convince people it can become "a medical hub", but before it can do that it needs to lift its act quite considerably.

<snip2>

OK I realize what the is the the topic heading here, but there have been several instances as above where someone wants to take a whack at the Thai medical system -- maybe deserved and maybe not.

This topic and many others are about elective or non-emergency conditions where one can contemplate whether to travel to India or elsewhere for treatment. However, if you become victim of a heart attack, or stroke, or aneurysm, or other condition where immediate life-saving emergency care is critical, you do not have the option to hop on a plane. If one is that suspect of medical service available here in Thailand, maybe you should go somewhere else.

[nontabury]

6 hours ago, JLCrab said:

OK I realize what the is the the topic heading here, but there have been several instances as above where someone wants to take a whack at the Thai medical system -- maybe deserved and maybe not.

This topic and many others are about elective or non-emergency conditions where one can contemplate whether to travel to India or elsewhere for treatment. However, if you become victim of a heart attack, or stroke, or aneurysm, or other condition where immediate life-saving emergency care is critical, you do not have the option to hop on a plane. If one is that suspect of medical service available here in Thailand, maybe you should go somewhere else.

I shall be moving back to the U.K. next month after 20+ yrs in Thailand. Persuaded by my family, as I love living here,however two factors finally made me agreeable to return. 

1/ Dangerous roads.

2/ Concerns regarding medical treatment here in Thailand.

 

 

[JLCrab]

3 hours ago, nontabury said:

I shall be moving back to the U.K. next month after 20+ yrs in Thailand. Persuaded by my family, as I love living here,however two factors finally made me agreeable to return. 

1/ Dangerous roads.

2/ Concerns regarding medical treatment here in Thailand.

So one way to no longer be concerned about the status of medical care in Thailand is to no longer be in Thailand. Reminds me of this vintage VW ad:

 

[nontabury]

After waiting Over 7 days for a reply,from numerous Thai hospitals, as to do they offer either the PVP or Holep procedure, I finally received a reply from Bumrumgrad. They Din’t mention Holep, but say they do the PVP proceedure, no additional information that I requested, regards experience of the Doctor. However they supplied a price of 300,000 Baht, including two days in the hospital, as opposed to just short of 100,000 Baht in India, Amazingly they then 

List what is not included in their costs.

  I have also obtained estimates for this proceedure from a Harley street clinic and also private treatment in a U.K. hospital. Their prices are much higher than in India, but lower than at Bumrungrad. In fact it’s possible to flu to the U.K. have the proceedure with either of these two, and save money rather than going to Bumrungrad.

 

[xylophone]

10 hours ago, nontabury said:

After waiting Over 7 days for a reply,from numerous Thai hospitals, as to do they offer either the PVP or Holep procedure, I finally received a reply from Bumrumgrad. They Din’t mention Holep, but say they do the PVP proceedure, no additional information that I requested, regards experience of the Doctor. However they supplied a price of 300,000 Baht, including two days in the hospital, as opposed to just short of 100,000 Baht in India, Amazingly they then 

List what is not included in their costs.

  I have also obtained estimates for this proceedure from a Harley street clinic and also private treatment in a U.K. hospital. Their prices are much higher than in India, but lower than at Bumrungrad. In fact it’s possible to flu to the U.K. have the proceedure with either of these two, and save money rather than going to Bumrungrad.

 

They want to be the "medical hub" of Asia, but I'm afraid they have a lot to learn about customer service and that the customer should be the centre of their universe, not them!! 

 

Have had similar poor service/response in my quest for medical services here...........

 

Good luck with whatever you decide to do.