BHP 43 years old

Thank you! Wise words, I hadn’t think in that way of drugs for some years, getting time to have more options. I had different surgeries in the past (not prostate related) and I’m not afraid of getting one (or two more). Greetings. 

Hadn’t though sorry

Hi Fenran,

You are  from  Chile.  Im from  Central Europe  and  did  FLA procedure in Texas  ( April  2018)  so in current  open  Globe is the distance no big problem.   Avoid TURP as drastic method and  rarely successfull with your problem  with serious side effects.  

You have normal size prostate but  big median lobe acting like "pressure valve "  in your bladder neck.  Similar to me.  Exact term for this is  IPP -  Intravesical Protrusion of Prostate. Avoid  Urolift and  PAE  - they are poor methods for your diagnosis  IPP.  The only 2 methods with good results  for IPP are REZUM and FLA.  ( I selected FLA). Probably for your problem is better REZUM  where will be neccessary maybe 2 shots  to  median  lobe. And Rezum is not so costly as FLA.   I have plenty materials and information  with details .  if you have interest, just PM me.  Have a nice day, 

Stan

Thank you very much for the info.

Sadly I’ve no resources of time to take a surgery abroad, so it’s not an option for me. I’ve two babies (2 and 3 years old) and they are the priority for me.

To get treatment in Chile is what I can expect, and it’s or medication or TURP, it looks.

Sadly it looks that TURP with median lobe protrusion hasn’t got a good pronostic, but what else can I do? I think I’ll stay on tamsulosin for a long time, waiting what to decide, but the effects have been really limited (it’s easier to star to pee, but the flow is almost a bad as without taking it).

 I just want a solution for at least 10 -  15 years of peace of mind and body. Greetings!

Hi Fenran ,

most important is correct diagnosis .  You need  good cystoscopy,  TRUS ( trans rectal ultrasound )  but the best is MRI  ( magnetic  resonance  ) .If the  reason is really   big and long median lobe  blocking bladder neck - IPP ( like  was my problem ) no Tamsulosin  will help  you, or any other  alpha blocker  .  These meds  relax  smooth  muscles in urethra , but  if you have IPP your urethra is  not blocked -due to your prostate  is of normal size  20 ml.  Even  I think  no  5-alpha reductase inhibitors ( Finasteride ,e.t.c. )  meds    to shrink prostate size  will  help you due to your prostate is of normal size. Of course you can try both  and see results  in time.  .

    Can you imagine  median  lobe acting like  " pressure valve " or  cap of sink ?   It  blocks your  bladder neck  and situation will be no better in time.  The reason  is not big prostate  and standart BPH , but IPP blockade.  This is  hydrodynamic  reason  not  hyperplasia of  prostate along  prostate urethra.  I can send you some pictures to understand clearly  what I mean .   And  you must be afraid of serious damage of your bladder and kindney.   REZUM is not very costly.Its   mini invasive procedure -will take just  about 10 minutes.  BUT is very important  to find in US or South America  good experienced doctor to not "sting"  you  prostate urethra , but just  median  lobe. .       Happy decision , Stan 

Thank you very much for the info. I’ll try a MRI done. Unfortunately, no rezum here in Chile, and as I said I can’t afford to travel outside, to a different country. Mi medical insurance only covers TURP (80% of the value) but anyway I haven’t any more options here

Could the standard TURP work for IPP? Thank you 

Hi Stan, just curious. Do you know what your IPP was before your successful FLA ? Hank

yes folks please see this "Beast"  IPP  of median  lobe. - fully blocking  bladder neck.  And see   trabecular bladder and  its damage by  diverticules on  upper wall as effect of  several years retention. 

This is  MRI scan  . No other method will describe so clearly  real anatomy  of any human internal organ.  It cannot be visible in such resolution by TRUS or  Cystoscopy. This is  3T  MRI.   But  be aware,  urologists dont like to prescribe  MRI scan  ( its out of their pocket).

OMG!! That was your prostate???

Thanks Stan, great image ! Couple of questions if you don't mind.

1. Do you have the image after FLA ?

2. What is the dark egg-shaped thing just below the bladder ?

Hank

See if you can get an MRI image like this for your median lobe. Hank

unfortunatelly  yes.    So  if you have something similar  ist neccessary to  solve it.  

Meds are not  efficient.    I tried nearly all .   My prostate was not so big just 45 ml  but with this  lobe "beast" .  I tried even  PAE .  Without any  effect.  Now  experienced urologist and IR ( intervent. radiology )  Drs.  know that in case of such  IPP  is  PAE not effective.

So firstly  you need 3 T MRI  - surely in Chile is a lot of these  devices. But uro Dr.  dont like  to prescribe it, so probably you need to pay it for. In my country it was about 550 USD .     

No  I havent yet.  I will do it after 6 months after FLA  - in  October.  

This dark "egg"  is bone pubis.  

Thanks Stan. Was it you that did a meticulous compilation of all FLA patients ? I am very interested in that compilation. Hank

pls PM me. thank you  Stan

I am also interested in info on FLA.. sent you a PM