BPH Problems - Questions to ask yourself (and your Doctor) regarding procedure options
Posted , 13 users are following.
Hello Everyone - I posted this in another thread and thought I would start a new discussion with it. If you are a BPH sufferer, and you are overwhelmed by all the procedures being offered for your condition, here are some questions I used for myself as I pursued (and obtained) a solution for my BPH problem:
Will my bladder neck be touched/disturbed?
Will my urethra be touched/disturbed?
Will my sphincters (internal or external) be touched/disturbed?
Will my nerve bundles be touched/disturbed?
Will I get a short-term fix or a long-term solution?
Next, determine if the following are goals you want to achieve after the procedure is performed:
A. Pee freely like you did when you were a young man.
B. Continue being sexually active.
C. Not have any urgency.
D. Not have incontinence issues.
E. Not get up multiple times per night.
F. Not have to insert catheters up your penis.
G. Have the ability to normally hold your bladder.
H. Never worry about where the next bathroom is.
I. Travel freely, whether to town or around the world.
J. Not have to control your fluid intake regardless of the time of day or night.
K. Not have to take any medication/herbs/vitamins to control anything to do with your BPH.
Finally - "Is all the above simply a fantasy/wish list, or is this really achievable?"
What I have shared above is about me, my experience 7-months ago, and the outcome I was able to achieve and the goals I was able to meet (yes, I met every one of the goals you see listed). You notice none of above ever mentions the terms non-invasive, minimally-invasive, invasive, or radically invasive. These terms scare us first before we ever get a chance to be honest with ourselves about what we really want for our BPH problem. As a result, we could be running away from the very procedure that gives us everything we want.
Again, only food for thought. If the above is not where you are mentally or physically with your BPH problems, please disregard. To each his own.
Dave
P.S. My BPH problem was acute full retention with a MRI measured prostate of 265g (no cancer). I had a simple robotic prostatectomy (NOT radical), which is a shelling out of the prostate lobes like an avocado, leaving the prostate lobes intact. Access was gained through the abdomen (small robotic incisions), the bladder, and then into the prostate. Released from the hospital 24 hours after procedure and wore a foley for the next 10-days to allow bladder to heal. I do not take (or require) any medication for my now ex-BPH problem. If you would like further information, just private message me and I would be glad to share.
1 like, 27 replies
j12080 DaveCanPee
Posted
Sounds like f l a . Not invasive. Real-time Vision with an MRI during the procedure sure activity, nothing gets damaged. Shorter recovery. But no Invasion on the urethra no Invasion on the bladder neck controlled removal of tissue wit accuracy up to 1mm.. Excellent procedure to consider. But please understand. Neither Your solution nor FLA or any other treatment will stop The cellular multiplication that happens with BPH. Do not let a doctor fail to tell you that because it is the truth. BPH is treatable not curable.
DaveCanPee j12080
Posted
Hi J1208p:
You are right. "Cure" is a strong word. I like "best" answers to the questions I shared above.
I do not have experience with FLA, but I wonder which route they take to get to the prostate? Also, when the prostate mass is lasered, where does the removed mass go? Do they suck it out during the procedure or is it expected to be absorbed by the body? I have pictures that show my mass removed and it measures 4"x4".
Dave
j12080 DaveCanPee
Posted
, yes, here is a strong word. Fact is BPH is a cellular reproduction issue. No one understands why no one understands what causes it no one has any idea how to stop it. It is far too lucrative Define to cure and much more profitable to treat it.
, with regard to the two questions you ask about focal laser ablation, it is done through the rectum under Twilight anesthetic it is not painful and was not even uncomfortable for me I felt nothing. With regard to your question about what happens to the tissue, once the treatment is complete and the tissue has been lasered, it is removed by the white blood cells of the body this takes a couple of months to four months to be complete and yes symptoms improve over that time. This is a natural course and reaction of the body and as it is completed the prostate reforms its new shape.
The most important thing about f l a is the selection of the doctor doing the procedure. I have said many times and fully believe this is as much art as it is science. I am sure that is the same with the doctor that performs the procedure you chose. Removal of prostate tissue in any way without analysis, detailed study and the time it takes to determine what a good job is a foolhardy treatment. That is why Dr selection is most. My doctor had a secondary degree in biomedical engineering which I believe helped a great deal. What I like the most in my procedure is that it is done while in an MRI with real-time eyes on the tissue being removed. That, along with the accuracy detail level of a laser assured me in my choice that I would not lose sexual functions which was my number one priority. My prostate was 125 CC and I have suffered for 9 years. I had this treatment over 2 years ago. And still have the benefits that I wanted to achieve though I do realize the prostate continues to grow and cellularly reproduce itself.
derek76 DaveCanPee
Posted
The laser burns the tissue away. It also if properly done leaves a smooth surface within the prostate. A Uro once said to me that some early badly done ones were left looking like hanging curtains.
You should look at some of the GL and HoLep procedures on Youtube by Fernando Gómez Sancha . There are also some by Graham Watson who did my Thulium/Holmium procedure. In one where he did a demonstration in Germany he complains that the one they gave him was too small.
DaveCanPee j12080
Posted
Hi J12080 - You and I are on the same page- Remove the mass and preserve the nerve bundles, urethra, sphincters, and bladder neck. I agree asking the right questions is a must. At 62 years old, we will have to see how much of mine grows back before I die (procedure done last year at 61). In the meantime, I need nothing for anything and I do not consider myself having BPH.
Dave
derek76
Posted
I should have said vaporises not burns away.
Lookngforoption DaveCanPee
Posted
Dave, we have talked before and I agree with the way that you got to your decision. I joined this board in December. I have had BPH sysmptons for at least 5 years and really have been disappointed with the way that the medical community approaches symtoms and solutions.
62 yo had not been to see a Uro until just last month for BPH.
I have been on Flowmax for about 2 years and became concerned with my urine retention after joining this board. I was afraid that I was going to have to start taking 2 a day as the effects were not as good as when I first started taking it.
I decided on my own to start CIC in January because I didn't want to be "Locked up" with no options except the ER. I now use CIC 2 times a day, before bed and first thing in the morning and have them with me at work and have been known before a long meeting to also self cath. I am retaining about 200-250 cc.
My Uro is Mayo Clinic trained and during the first visit was surprised that I was using CIC and he wanted to know who had prescribed the catheters. I told him that I get catheters by mail without a prescription and it was a lifestyle decision. I also told him that I wanted a resolution to my BPH problems. He recommended Rezum. I told him that I was investigating a simple prostate removal, he immediately said that he would not recommend that procedure because of the high likely outcome would be incontinence. I told him that I am looking at surgeons all over the country, and he said that he had done hundreds of the procedures. He scheduled a Cysto, for later this month.
I told the doctor that I wanted a T3 MRI and he said my insurance would not pay for it, and I reminded him that I did not have insurance and was prepared to pay for it myself. He begrudgling wrote the order, saying that it was not medically warranted.
The results were 115gr prostate with extensive evidence of prostitis. I agree with Dave's decision and I am now on the hunt for doctors to speak to, and yes, Daves Doctor is on the list.
DaveCanPee Lookngforoption
Posted
Hello - Good to see you again. As for me, no incontinence. Not sure where that comes from. I can say that for about a month after the procedure, I had to be careful coughing hard or farting because you tighten up and strain the middle section of your body and a little pee might slip by as you get use to your new "garden hose." If your internal and external sphincters are working, then you have control. This goes away soon thereafter and then there is no issue.
I cannot over emphasize the benefit of removing the mass that is pushing up into your bladder and closing in on your urethra and bladder neck. I have shared this before, but I do not know how I made it from normal to a 265g prostate without any major symptoms over the years (I never took any medication). Yes, my stream was weak and peeing took a while at the toilet, but I was not plagued with getting up multiple times at night, etc. Then all of a sudden, I locked up. That is when your freedom and normalcy goes away. And for me, that was unacceptable. Removing the mass was key to getting back my normal. That was clear as rain.
While I respect every man here, and the decision they make regarding their condition, but BPH is about a larger than normal prostate wrecking havoc and taking our freedom away. Shrinking it mathematically did not make sense, squeezing it with bands was not going to work for me, and roto rootering my urethra area was not going to take care of the rest of the iceberg below the surface. My mass had to be removed. That mindset took me to a short list and the rest is history. No regrets. I would definitely do it again,
Dave
alanatcroydon DaveCanPee
Posted
I agree that if you pay yourself, you can take charge of what happens. As I have said before here, the cost of an operation can be less than the price of a car or of a good holiday. Which is the most important to you? In your locality, the price may be high. If so, think about going somewhere where costs are lower. Last June, I went to Poland for my PAE. If anyone wants details, DM me
j12080 DaveCanPee
Posted
I agree the $20,000 I paid for focal laser ablation was the best money I ever spent. Now 2 years later I still feel that way. Life has been good and continues to be that way. I feel it will last and if/when my prostate grows back I will do it again with even more confidence because I have the knowledge that it works. I feel with this BPH condition taking control and paying your own way is really the only way to go. I feel bad for the people that cannot afford it. When our system goes to single-payer it will be that way for everyone.
j12080 DaveCanPee
Posted
I agree the $20,000 I paid for focal laser ablation was the best money I ever spent. Now 2 years later I still feel that way. Life has been good and continues to be that way. I feel it will last and if/when my prostate grows back I will do it again with even more confidence because I have the knowledge that it works. I feel with this BPH condition taking control and paying your own way is really the only way to go. I feel bad for the people that cannot afford it. When our system goes to single-payer it will be that way for everyone.
j12080 DaveCanPee
Posted
I agree the $20,000 I paid for focal laser ablation was the best money I ever spent. Now 2 years later I still feel that way. Life has been good and continues to be that way. I feel it will last and if/when my prostate grows back I will do it again with even more confidence because I have the knowledge that it works. I feel with this BPH condition taking control and paying your own way is really the only way to go. I feel bad for the people that cannot afford it. When our system goes to single-payer it will be that way for everyone.