How did you decide on a procedure?

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There are many different BPH surgical procedures and I believe most urologists are probably only comfortable with a few of them.  To those of you who have had a procedure, and especially if you traveled to another location or changed urologists to get a procedure your urologist could not do, how did you decide which one to get?  And how did your local urologist react when you told him you were going to someone else?

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    Lee were you offered anything by your urologist.  What is your problem.  Is the problem your prostate or is it your bladder.  Then you have to research each procedure.  9 out of the 10 top procedure cause retro.  And many other side effects.  Retro, dripping and some others.  Do you pros and cons.  My problem was my prostate so I had a urolift done.  That is the only procedure that does not cause retro.  You have to do your research because you are the only one that can pick for you.  Good luck  Ken
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    • Posted

      My BPH is currently controlled fairly well through medication.  Just increased my 2mg Doxazosin to 4mg and that resulted in symptom improvement.  I have a large median lobe which rules out Urolift.  I usually get up twice per night unless I drink too much after dinner.  Daytime frequency is more of a problem, especially when traveling.

      My uro thinks TURP is the best, he's been doing it for 30 years.  Seems like you can find anecdotal evidence in favor of or opposed to just about everything.  I prefer clinical studies.  I have recently developed retro (perhaps due to a couple bladder tumor surgeries) so that's not really a concern at this point.

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  • Posted

    Kenneth asked prostate or bladder? I think that's a very important question because it seems to me that many men get procedures done at the recommendation of their MD without knowing what the real problem is. As my urologist told me: if prostate drugs don't help much, it's probably more than a prostate issue. He told me my problem was prostate, bladder, and sleep and  that surgery probably wouldn't help much. Too many men get surgery without being aware of what the consequences might be and many of them don't get relief from the procedure (some are worse off). It's your body; you have to do what's best for you and don't worry about offending a doctor. 

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    • Posted

      " .. if prostate drugs don't help me much, it's probably more than a prostate issue..."

      Hi Reg, can we also say "if prostate drugs help, it's probably a prostate issue. " ? Hank

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    • Posted

      Here is another thing you have to be aware off.  This is what my urologist told me.  Most urologist will do many test to fine out what the problem is.  If they can't figure it out they assume it's the prostate and tell you this is the procedure you need.  That is when you get another doctor.  You have to stand up for your body.  Ken  

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    • Posted

      Reg and Hank,

      In general, the prostate, bladder and nervous system control voiding. The efficacy of prostate drugs can give indications in some cases but I would certainly not make that the basis of a diagnostic decision where something serious like surgery is involved. Not saying you're saying that but it could be read that way. Best indication would be urodynamic testing where all three factors are measured during under simulated voiding conditions.

      Jim

       

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    • Posted

      Jim:

      My urologist suggested that if the drugs don't work, then there may be other issues as well as BPH. It confirmed what I had been thinking for sometime. When I suggested that to my MD (other issues as well as prostate), he said "oh no, it's just your prostate." I don't have much faith in doctors but I respect my urologist. 

      As for testing, some of them are quite invasive and cause their own set of problems. Knowledge is important to make informed decisions about what's best in dealing with prostate issues and even then there is often uncertainty. 

      It seems like self-cathing  might be a good option for those guys with severe symptoms. It may provide them with time to decide what to do rather than get rushed into something they will later regret. Our symptoms may be similar but we all have our own unique situation.

      Reg

       

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    • Posted

      My urologist does all test,  But he told me that most urologist will test but if they can't find the problem that assume it the prostate.  But after it's cut out it to late.  Ken

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    • Posted

      The key word is "may". No sense guessing with something like surgery hanging over you. Urodynamic testing is nothing compared to the invasiveness and risks of a surgery. Yes, self cathing is an option, I'm a big advocae, but that's not really the discussion here.

      Jim

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  • Posted

    Like Reg said, don't put the cart (surgery) before the horse (proper diagnosis). Surgery is too often a reflex reaction by urologists. And the surgery they recommend is often the one they do, which may or may not help, or even be the best for you. Have to do your research. If unsure, or if you don't like what's out there today, there's self catherization. Does everything the best surgery can do without the risks and consequences of surgery. Probably not for everyone, but everyone should at least consider it. Bet 9 out of 10 docs don't even mention it as an option.

    Jim

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