Median Lobe Prostate Bladder Blockage Options?!?

Hi Chip,

I've got the same problem as you, the median third lobe. I had Prostate Arterial Embolization (PAE) in Nov 2013. at that time they didnt realise I had the median lobe issue. PAE doesnt work anything like so well with a median lobe although it did reduce the prostate size down from 53g to 38g which is actually pretty good if you've got just the normal two lobes. I'm pretty much back to where I was before I had the PAE. I'm due to see the Urologist quite soon to discuss other options which may include Urolift, he's not ruled it out at this stage although he is also talking about a "limited Turp" of just the median lobe as an alternative. Like you I'm avoiding Turp - seems to me the large majority of sexually active men who have had it done seriously regret it afterwards. Fortunately I found what it was like in advance as I took Tamsulosin (Flomax) for a while and that caused retrograde ejaculation until I stopped taking it. I've certainly had some Urologists in the past "playing down"  the seriousness of that particular side effect. They should take Tamsulosin for a while to see what's it feels like! I had one idiot Urologist tell me to "just switch the lights off" I never went to him again after that. I've just had another cystoscopy done to determine the exact size of the median lobe, it's that result I will be discussing with my Urologist shortly. So will see what the recommendation is then...

Hi Chip,  I am resending this post without the link to a video of the Urolift procedure since this site has blocked it.

I also have a medium lobe pressing on my bladder.  My brother’s urologist Dr. Claus Roehrborn in Dallas Texas pioneered the FDA study in the US for this procedure.  He is also the head professor and chairman of the Department of Urology at the University of Texas (South Western).  I have a Urolift scheduled with him in November.  He can do a Urolift  and fix the middle lobe to one of the lateral lobes if the middle lobes does not protrude into the lumen of the the bladder too much.  Or if it does, he can resect (remove) the middle lobe preserving the bladder neck and then do the Urolift, thus preserving  ejaculation.  No sure where you live. 

There is also a Urologist Dr. Peter Chin near Sydney Australia started doing the Urolift procedure in 2005. He is probably the most experienced in the world.  He has successfully done the Urolift to fix the middle lobe to the lateral lobe.  You can google him and go to his website and see a video of the procedure.

 Ufrolift will only work on prostates of 80gm or smaller.  To avoid retrograde ejaculation you need to make sure that your urologist can preserve the bladder neck when doing the Urolift.

Hope this is helpful,   Terry

I'm planning to have the PAE: prostate arterial embolization.  I think it's our best bet.  No sexual side effects.  The 2 docs who've done the most i the US are Dr. Sandeep Bagla in Alexandria, VA and Dr. Ari Isaacson in Chapel Hill, NC.  The 2 pioneers who have done several hundred are Dr. Pisco in Lisbon, Portugal and Dr. Cardinale in Sao Paulo, Brazil.  Good luck!   

Check out the PAE on this site, and others.

Neal

My dear, I am not sure, but one option could be PTE--Prostrate Arterial Emboliztion.

You have to take Trans Rectal USG, and take the report to both, to an Urologist, and an Intervention Radiologist, who has done PTE.

Then you can discuss, and decide.

Never think of TURP, or LASER, if you want to enjoy SEX and have more KIDS. Both of the PROCESSES can go WRONG--has gone wrong for many patitents.

And--- Good LUCK.

Chip I was wondering what tests help you define which part of the prostate is effecting you..like what type of test do doctors do....?

Amazing that many "hot-shot" docs in Los Angeles have NEVER heard of UROLIFT! I have been giivng them brochures.   Fascinating to me that new, upcoming and possibly improved urological info is not shared with other urologists in a uniform way.  

Hi Chip,

Hope you are well. Do you have anymore info or heard about anyone having the EP Turp from Germany? I am considering it. I'm in the US. My prostate is 120 and have large median lobe.

Thank you.

With my first Urolift procedure, the Urologist did not address the median lobe so I went to a different Urologist who did another Urolift, but only to put a clip to fix the median lobe problem. He atucally took a picture of inside my urethra and it showed that it was clear. I would recommend finding a Urologist who can perform the Urolift just to fix your median lobe.

Albin