BPH - natural treatments vs TURP, open surgery
Posted , 14 users are following.
I'm 59 with an enlarged prostate (120 cc), which is 4x normal size for my age. I had an MRI-fusion guided biopsy 18 mos. ago that showed no cancer. Another 3T-MP MRI a year later showed nothing of suspicion. However, following my Bx in 2015 my PSA has shot up (10) and bounced all over between 5 and 7. Before the Bx, my PSA was between 3.5 and 4.5. I have tried every natural supplement out there, including DIM, IC3, progesterone cream, beta sitosterol, pygeum, maca, etc. Things have gotten worse since the Bx. My prostate might be too big for TURP, TUIP, but I might be a candidate for GreenLight, and open prostatectomy is an option. Anyone have any success with alternative medicine or is surgery 100% a given for a man in my situation? PS - I bled for weeks after the biopsy and my symptoms have only worsened. I won't go thru that again.
0 likes, 98 replies
mark23925 MichaelVM7
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MichaelVM7 mark23925
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Sounds like retrograde ejaculation. Even meds like Flomax and Proscar can have that side effect.
I've been reading up on the PAE procedure you mention. Does not seem like it's widely offered so far. It does sound promising.
mark23925 MichaelVM7
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richp21 MichaelVM7
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PAE is offered in many places in the US, as well as in the UK, AUS, and Portugal. The two most experienced doctors in the US are Dr Bagla in VA and Dr Isaacson in NC. Have a lot of additional info if you are interested. I'm scheduled for PAE with Dr Bagla on March 27th.
kenneth1955 MichaelVM7
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Being you have no cancer and you are fine there are many reason for your PSA to up and down. Try a less evsaive procedure first before youstart cutting away at the prostate. There are to many side effects from them. Don't get me wrong that sometimes you have to but why take the chance of causeing more problem. There was a man on here that was talk into have a turp and all it did is give him more problem. He has been leaking for over a year and can't get any help for it. Research some of the others first Please for your own good Ken
MichaelVM7 kenneth1955
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Thanks Ken.
I think I have some time to think this thru. A negative biopsy and then a year later a completely negative MRI is good news. And my PSA density is about 0.06, which it should be under 0.1.
I'm looking at PAE and HoLEP. I'd do open surgery as a last resort if symptoms worsen. I found an amazing surgeon but really would prefer not to undergo major surgery if there's no cancer.
I am concerned about undergoing a procedure and having more health challenges afterward.
These are difficult decisions.
kenneth1955 MichaelVM7
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derek76 MichaelVM7
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Open prostatectomy is an option that you should not even consider for BPH.
I had an early version of GL PVP in 2005 for my 75grm prostate (when 71) It was a walk in the park. It was done far from home on a Friday afternoon and the catheter was out on the Saturday morning and I had expected to travel home by train that day. It took me until about noon to void a good amount and it was as red as it had been into the overnight bag. A scan showed that I was still retaining a large amount so they decided that I should stay for another night in case I needed help when at home.
It took me until the Sunday afternoon to void fully and be allowed to travel home. Really from the next day life was back to normal and I went to the races on the Monday.
Over time my prostate regrew to 135grms and I had a Thulium/Holmium laser procedure three years ago. It is rather similar to Holep in that they can obtain tissue for a histology report. In my case 37grms was sent off. This time I bled a I lot more after the procedure probably as I had been taking Warfarin and it was still in my system. The surgeon said that I could go home with a catheter and have it removed the next week. There were crossed wires on that and it was left in for two weeks and much of the time I was passing clots and debris. Once it was out my urine was completely clear. Volume was good and I had no retention but as after the GL I was not impressed with my flow that even now fluctuates and no reason has been found for it.
Frequency does not exist I can go hours without needing or thinking about going. No more going out with a toilets map in my head.
Gradually my night time needs went down from three to one
My PSA came down from around 9.0 to 0.74. Apart from the tissues sent to histology I don't know how much was taken away he just said 'A lot' When I last had my prostate checked two years ago it was 55 grams.
After GL where they did a bladder neck sparing version I had no RE. However after taking Tamsulosin prior to the Thulium laser procedure I was well on the way to it and the procedure did the rest.
MichaelVM7 derek76
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Derek,
What is GL PVP? Also, why did you choose the laser procedure, instead of say, TUIP or TURP. It sounds like HoLEP also involves cutting tissue, like TURP and flushing out clumps of tissue.
"No more going out with a toilet map in my head"....wow, how I can relate - needing to know where the closest bathroom is.
Your PSA went from 9 to 0.74?! I almost gasped reading that. Wow.
So then, your prostate has not regrown since the 2nd procedure? I had always wondered about that - if a man has a TURP or other procedure at 50, would he need to do the same thing again at 60 or 70?
Glad to know your prostate is down to 55 grams! (For the prostate measurements, is 55 grams the same as 55 cc?)
Wish you continued good health!
thanks!
Michael
j12080 MichaelVM7
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I am 65 years old and had a 125 cc prostate. I have dealt with it for over 8 years. I researched all options for almost 2 years. Tried many herbs and alternatives. Would not do the RX meds.
I would very highly recommend you look deep into Focal Laser Ablation. I had it done in the middle of December. I had a blockage of the urethra, nocturia, and a large median lobe that was causing retention. This was visible by the 3TMRI and a procedure was done in Houston that corrected all the symptoms in just over a month. It was safe, little to no blood at all. Would not preclude doing any thing else if it did not work. This procedure did not damage or enter the Urethra so no damage. There was no sexual side effects including no retrograde ejaculation.
If you have interest in hearing the specific details, you can personal message me or call me as I will send you my contact. The doctor I used was dr karamanian and you can look him up..
MichaelVM7 j12080
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Thank you so much for your reply and personal message. I will get in contact with you.
Thanks for sharing your personal story, it is encouraging.
Forums like this are great for men from various walks of life to interact and share helpful info. I appreciate all the help I've gotten in the last two days.
Michael
jimjames MichaelVM7
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Hi Michael,
It's not just about prostate size or even prostatic obstruction, as your garden variety urologist might make you believe. So before even considering any one of the prostate reduction surgeries you mentioned, make sure you and your doc have done the homework..
What symptons are you experiencing? Do you know your IPSS (International Prostate Sympton Score)? If not, google it and take the 5 minute test. What diagnostic tests has your doc done? Have you had imaging studies, do you know your PVR (post void residual), have you had a cystoscopy or urodynamic studies?
As to natural supplements, I think you have answered your own question. You've tried them all and things are getting worse.
-- Jim
MichaelVM7 jimjames
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My IPPS score is 26, and Quality of Life score is either 5 or 6 (somewhere between unhappy and terrible). W/out Flomax my stream is very weak and it takes a long time to void.
I think a lot of my problems the past 18 months is due to the biopsy. My PSA went up to 4.5 but came down to about 3.8 before the Bx. Six months after the Bx my PSA was 10 and my prostate volume had increased by 50%.
Of course, no MD is going to say the biopsy was the cause.
Flomax, as many men know, is a libido killer. Natural herbs, as many have found, just don't deliver as promised. Still, desperate men will spend thousands on snake oil promises in the hopes of regaining youth and ending misery.
I have not had the PVR or urodynamic studies. MRI said my bladder wall is thickened, due to urine retention.
Can I ask, Is the cytoscope bad? Are you sedated or drugged during it? Do you need a catheter afterward?
Aside from frequent urination, feeling like I haven't emptied my bladder, and waking up at night (1-3 times, on rare occasion, 4 times), I also have chronic low back pain and tightness, and my scr-tum is in pain if I sit for < 15-20 minutes.
I have zero libido, thanks in large part to Flomax, but probably mostly due to a large prostate.
I'm fairly lean, in decent shape (in terms of not having much fat, not in terms of aerobic shape), and most people don't think I look my age. A small gland can sure take a lot out of a man's life.
Thanks Jim.
Michael
MichaelVM7
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*I meant to say I have pain "down there" if I sit for more than 15-20 minutes. I can usually tolerate up to 20 minutes unless it's a hard chair or bench, in which case I am constantly moving and fidgeting or sitting on my hands. I contantly squirm in meetings at work or in church when my pastor is preaching.
jimjames MichaelVM7
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Hi Michael,
Given your IPSS and QOL score, sounds like it's time to take some sort of additional action.
As to Flomax, a good alternative is 5mg Daily Cialis. Studies show it works just as well but instead of impeding your sex life it can enhance it.
Also, while you're looking into surgeries and procedures, consider self catherization (CIC). It's a great fit for someone not quite ready for surgery but who wants to inhance quality of life. CIC is an easy and painless way to empty your bladder on demand. It will get rid of as many symptons as any surgery, protect your bladder and kidneys, and let you drop your Flomax. More on this in the self cath threads, or just ask me, as I've been on a CIC program for three years now.
Cystoscopy is not bad, no sedation necessary. Just make sure it's a FLEXIBLE cystoscope, not a rigid one. Rigid is a different game. You mentioned retention, did they give you a number? You want that. You should be gettting a bladder scan for retention with every office visit given your symptons.
-- Jim
MichaelVM7 jimjames
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Jim,
Have you heard of candida (yeast) infection causing prostate inflammation and prostatitis?
My uro has not done a urodynamic study and hasn't suggested it. Perhaps I should take the initiative and ask for it?
Is the cystoscopy done after the urodynamic study?
Have you had the cystoscope procedure? I hope they give valium or something that makes you loopy. I do think I have a pretty high pain tolerance - and I've lived thru a ton of sports injuries and basically live every day w/ chronic back pain - but a procedure like that scares me. I hate to admit being a baby (most guys don't want to do that) but that really scares me quite a bit.
thanks,
Michael
jimjames MichaelVM7
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Hi Michael,
Actually I hadn't, nor have any of my uro's mentioned it, but just googled it and came up with some interesting hits. If you're considering it, probably best to check out the side effects of any anti-fungals you might have to take. Thanks for the heads up I plan to research this a little more!
Regarding cystoscopy and urodyamics, the order would depend on what your uro thinks needs looking at first but I don't see how it matters much. Video urodynamics is preferred if you are going to do it. I understand that not all docs do both, and in some cases it may not be necessary, but if I were making a decision on a major surgery or procedure I think in general having both would be prudent. That said, if your doc rarely does urodynamics then he might not be the one to have it done with because it's not just the test but what the doc prescribing the test is looking for and how it's analyzed.
I've had a couple cystoscopies. You want the FLEXIBLE cystoscope, not the rigid one, unless your doc gives you very good reasons otherwise. The flexible is fairly painless, not much more than like inserting a catheter. They give you a numbing gel which is probably more than you need, but if you're totally petrified you could ask to be put to sleep. With the rigid, you want to be put under. Fifteen years ago, when I didn't know better, I had what I believe was a rigid cystoscopy with only a numbing gel. You know the expression "hitting the ceiling". I learned where it came from!
-- Jim
uncklefester MichaelVM7
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MichaelVM7 uncklefester
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Thank you, that does help put my mind to ease. 😊
Michael
MichaelVM7 jimjames
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Jim,
Have you had a urodynamic study? I read up on the procedure.
I don't know if I can go through that. Am also wondering if the information is really helpful. I know I have urine retention, frequent urination and am up a few times on bad nights.
Does a uro dynamic test show any damage to the bladder and does that inform the doctor to hurry up with surgery in that case?
I might ask for valium, if they'd even give it.
I don't have the stomach for this.