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Hello. I would like some advice!
O have Bernal developing UTI problems in the last years, so I visited a urologist. I took some test: PSA 0,8 an urofloxometry with a score of 3 ml/min average an 4 ml/min max, and an echographs. At last a cystoscopy that showed that my urethra was perfect but there was an obstruction in the bladder neck: two lobules that seemed to bee from prostate enlargement. My prostate showed to be normal in the echo (about 20 ml) but someway, it’s pressing the bladder giving me UTI symptoms. The lobules are 2,5 cm more or less.
I have been on Tamsulosin for 3 weeks and I feel a little improvement, but if I think in taking medication for the rest of my life, I get depressed.
No side effects from Tamsulosin, just the infamous RE.
So I’m thinking in going ahead with TURP. In the country I live, the only options is standard TURP, but as I am young and the prostate is small, maybe the results will be good.
So guys, what would yo do, being just 43, with a small prostate pressing the bladder (diagnostic BHP)? Taking Tamsulosin for years, with RE and maybe more symptoms in the future, or just going ahead with the surgery? (TURP).
I know TURP gives RE too, but I am already suffering RE from Tamsulosin, so it wouldn’t be a big deal. ED possibility concerns me a bit more, but with my small prostate the surgery maybe would be easier. I’ll try to ask the uro for TUIP but I think they don’t do it here.
Thanks a lot for reading me and excuses for my poor English!
1 like, 37 replies
nick67069 fenran1
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Dont look at medication as "punishment" for life. Think of it as they are buying you time to research and not jump into drastic option , like TURP. As you know, prostate grows with age; since you are only 43, by the time you are 70 you may have to do some procedure again... Also with time, they may be more options available in Chile for you, or you may decide that it is worth traveling abroad to do the alternate procedure.
fenran1 nick67069
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fenran1
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stan98754 fenran1
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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
fenran1 stan98754
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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!
stan98754 fenran1
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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
fenran1 stan98754
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Could the standard TURP work for IPP? Thank you
hank1953 stan98754
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stan98754 hank1953
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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.
stan98754
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fenran1 stan98754
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hank1953 stan98754
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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
hank1953 fenran1
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stan98754 fenran1
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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 .
stan98754 hank1953
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No I havent yet. I will do it after 6 months after FLA - in October.
This dark "egg" is bone pubis.
hank1953 stan98754
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stan98754 hank1953
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nick67069 stan98754
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