Looking for BPH options

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Much has already been discussed.  Like many other readers i am dreading TURP or Laser for the fear of retrograde symptoms.   I had my problem at 45 and I am 49 now living with the problem with varying degree discomfort including occasional blockage.   My size is approx 80-100gms.  I am considering options of TUMT or UROLIFT.  

I am currently in Delhi, India and I need a doctor recommendation for this either in UK or USA because i dont believe these procedures are performed in India.   I am taking Saw Palmettor with Flotral.    Symptoms are getting worse and cannot be wait much longer.   Appreciate your inputs.

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  • Posted

    There are indeed many hospitals in the UK that do these operations, but the waiting lists seem to be 18+ weeks (I am presently trying to find one that is shorter).

    Private treatment is supposedly quicker, and costs about £5,000.

    I believe such treatments are indeed available in India, and at a much cheaper price - I've been quote $3K - $5K. The surgeons say they have a good experience - one mentioned 15 per month. So I'd have no problem going there to have it done; but there's the visa problem (I understand it can take weeks).

    The two surgeons I had reply from are in Mumbai: DR N Anandan MS.,FRCS.,Dip Urol ( London)‏,  quoting $5K; and Dr Sanjay Pandey,  quoting $3K using holium laser (which seems to be the best treatment).

    Emis Moderator comment: I have removed the email addresses as we do not publish these. If users wish to exchange details such as this please use the message facility.

    http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

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  • Posted

    Dr. Marcus Loo in Manhattan, New York City, USA
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    • Posted

      Dr Naveen Kella, San Antonio, Tx. He has done at least two dozen procedures by now. Charges $2500 flat fee including anesthesiologist and all other fees. I have met him, a very nice man and accomplished urologist. 
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  • Posted

    I had a TURP 4 weeks ago tomorrow, and today I gave it a run to see if there were any complications like retrograde......and in my case I can confirm there is retrograde.  Very weird feeling but I can live with that as it's still better than the alternative, full retention or retrograde is an pretty easy decision to make!
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  • Posted

    Go to a Urologist and have the prostate scoped thru the urethra to determine if it has a third lobe. If none the uro will check size of the prostate vis ultrasound thru the anus. Neither procedure is painful. In a half hour you know if you qualify for urolift. If there is no third lobe and the prostate is less than 100mg you should qualify for urolift. Then look up an American-born Indian urologist in San Antonio, Texas by the name of Dr. Naveen Kella. He has done the Urolift procedure with great success. Good luck!. 
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    • Posted

      Sam, keep us posted on whatever method and timing you select. Someone of thousands who read these posts will benefit from your experience. Good luck!!
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  • Posted

    Dear Samdelhi:

    My case is somewhat similar to yours. However, size only 63 grams.  I am 56 years old and just had turp four weeks ago.  My urine stream improved drastically.  I was taking Jayln once a day, medication used in the US for enlarged prostate. I am recovering now and my post surgery symptoms has improved.   Don't be concern about the Turp procedure.  It is a one day thing with no pain.  If you need further info about the procedure in the US, please let me know.

    Good luck  

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  • Posted

    Read more about TUMT berfore opting for it, it is an old procedure that does not have a good outcome compared to TURP or the Laser versions.

    A lot of Laser surgery is done in India with health tourists from Europe and America coming to take advantage of lower costs. If the surgeon can do  a bladder neck sparing procedure you should not suffer from retro.  

    Google found a lot of Indian medical papers about Urolift but I did not search out surgeons doing it. Remember being a new procedure there is no long term data on its sucess.

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    • Posted

      There is plenty of data on urolift to indicate that after two years the positive effect is the same as at 60 days. To me this indicates that it will be effective for at least five years, probably longer. The unquestionable benefit is that it will keep you off the meds for years. Once you take the meds your libido declines, retrograde ejaculation sets in permanently and ed is your permanent condition. Buy yourself some time. If urolift is possible for you it will do exactly that. 
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    • Posted

      Thanks Ron.    Thats encouraging information.   I would be looking for doctors who have performed this procedure for some period of time. Also this procedure is limited to few countries in the west.
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    • Posted

      Something that I fail to understand!

      "The UroLift System relieves prostate obstruction and opens the urethra directly by retracting the obstructing prostatic lobes without cutting, heating, or removing prostate tissue. The Delivery Device transurethrally pushes aside the obstructive prostate lobes like opening window curtains. Small permanent UroLift Implants are deployed, holding the lobes in the retracted position, and thus opening the urethra while leaving the prostate intact"

       BUT that cannot prevent it from continuing to grow.

      moves the prostate to stop/reduce pressure on the bladder but surely it it does not prevent it from continuing to grow.

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    • Posted

      No, it will continue to grow just as it does with turp, tump, tuvp, GL or any other method that removes tissue opening up the urethra path. They are all temporary, five to ten years I believe and many times less than that. The beauty of urolift for those who qualify is that it is a very minimally invasive procedure that brings immediate painless relief without retrograde ejaculation or any of the possible side effects of the cutting or lasering procedures. No ED at all, no downside at all.  It's simple, the prostate has a strong membrane capsule surrounding it. The stitches pierce this membrane and the Doc tightens the stitches compressing the lobe away from the urethra. The procedure is being conducted around the world and is proven to be as effective after two years as after 90 days. This certainly indicates that it should still be effective for a number of years. To me it is an easy way to get immediate relief, buy some time to allow for more advances in BPH relief technology and above all in my mind, eliminate the need for the BPH meds which within a year or so turn you into a girly-man. Permanently. If you meet the qualifications for urolift and you are contemplating meds instead realize that the meds will emasculate you in short order. If you don't mind that then take the meds, they will work for a couple of years or so then they don't work anymore and you are again facing surgery, except now you are facing surgery and ED simultaneously.   
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    • Posted

      When I first found that I had an enlarged prostate in 1994 I waited for something better than TURP. First it was TUMT, cyrosurgery and then various laser procedures. So after twenty years there is still not a good answer.

      The only way to stop it regrowing is a radical prostatectomy  with all that ensues.

      To relieve the symptoms retro is a small price to pay.The feeling's the same and it's less messy.

      When you masturbated as a boy did it suddenly feel better when something spurted out and surprised you?

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    • Posted

      Now here is a switch I hadn't heard anywhere before. I have stated some of this on another forum so I may be repeating. I went to see my uro a few days ago with a new low PSA report in hand, good report on my kidney function so although I'm retaining 450 or so ml after voiding, so far at least I haven't hurt my kidneys by backing up from a too-full bladder. I went to a urolift uro a couple of months ago and he advised me that my third lobe and 114 mg prostate would disqualify me for urolift.  So I sat down with my uro fully expecting that he would state that tuvp would be necessary befor long. (he does tuvp rather than turp, says it makes a cleaner, quicker-healing job). But he surprised me saying that he has a colleague with the firm who I think you should go see. He does an entirely different sort of procedure. I saw him in four days and he agreed that his procedure would work better. He makes an incision beneath the navel, another into the bladder and cores out the prostate through the bladder neck from the inside leaving the outer capsule with all of the nerves untouched. He said the upside is that it is a permanent fix as there will be no more growth and adverse side effects are less likely than turp, tuvp, tumt, GL etc. It's a one-shot lifetime solution. The downside is that it is a more radical surgery and since it is done through the bladder neck there is some stretching and recovery of the bladder sphincter with some amount of incontinence until the bladder neck recovers. He noticed that I have a navel hernia (an outie in laymen's terms) and said he could fix it while was at it. I asked if he could also graft on four 4 or five inches of tallywacker from a donor but he stated that there is a limit to the advance of urology although it has been dramatic. I told him I would get back to him.     
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    • Posted

      Hmm, 450 ml left after voiding sounds like a lot to me, I think I was leaving about 300 ml after voiding and that was enough to push me up the priority list for either the GL or TURP.  

      Once they got in they decided TURP was the go for me.

       I have been wondering if they would ever be able to do keyhole surgery on the prostate. I automatically just thought that going in through the bladder could possibly have it's own set of complications later...but of course I dont know!

      However being able to get your hernia done at the same time sounds excellent, this guy sounds like he's a bit of a 'one stop shop'! wink  

      Good luck mate.

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    • Posted

      Well, you know I have had the hernia for 76 years and it has been no problem other than girls saying ooooo,  what in the world is that? OK it's gross but fixing it is not any kind of a priority. 450 ml is a lot according to everyone but it isn't bothering me and all my signs are ok. I'm just floating along in a lot better condition than I deserve. I guess I'll just stop up one of these days but not to worry (as you would say) as I have a catheter in my ball cap. Piece of cake.  
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    • Posted

      I dont know what to say! 76 years (is that a mistake) with a hernia doesnt sound too entertaining!

      I know very little about the prostate problems we can develope and the way they are dealt with, but I am almost sure if I were to be still holding 450ml after voiding I would of been regarded as urgent here (Australia) and probably rushed into surgery. For example,  when it was time to take my catheter out after having full retention, they said I was going nowhere unless there was 100 ml or less after voiding. That had to be done 3 times and if that couldnt be achieved then I was going to have surgery next day!

      As I said I'm no expert on which way is best or who is better,just passing on my experiences.

      Please keep us informed on what you decide on doing as who knows whats around the corner for any of us.

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    • Posted

      Seems that in OZ you have Tough Love!.

      My retention was mostly 350/400 ml for a long time as I refused to have a TURP and did not want to self catheterise.

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    • Posted

      Going by what others from around the globe have experienced it does look that way. I have an appointment with my ero next month so I'll ask him why the difference.
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    • Posted

      In 1995 when my prostate was 35 grams and my retention was 250mls I was told that I needed a TURP as a matter of some urgency.

      I refused. It was ten years later when it was 75grms that I finally persuaded them to send me to another part of the country for a GL Laser PVP.

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    • Posted

      Well, you know I have not been in any pain, so no urgency to fix things. This morning after not getting up at all in the night I could go very little and it looked like I was going to be in full retention and I decided, dang, I had best get a hold on this thing so I got out out the catheters that Bob on this forum uses and had recommended and decided I would try to use these things just in case I couldn't go at all. Well i couldn't get it past the prostate it just came to a painful blockage. I didn't force it and just quit. Later on l went normally but not as much as usual. I don't know how I could pass so little urine while drinking so much water. I don't know, I'm not in any discomfort, I must be retaining a lot. I know that I must somehow get a handle on this thing. I'm not going to the emergency room and asking for a catheter. I've started taking the Jalyn again today so goodbye sex life. Crap, what a piss-poor way to run a lifetime.      
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    • Posted

      That was in 2005 and practically instant recovery but not the expected hosepipe flow. By 2009 my prostate was growing again and by 2012 was 125grm and I was getting repeated UTI's. When I went for heart surgery they could not get a catheter in and had to use a suprapubic one.  I then had Thulium Laser surgery last year. Recovery from that was slower as in their rush to get me out of hospital I was sent home with a catheter in for two weeks and that caused an infection. No retro after GL but there is after Thulium Laser. It took a long time for the flow to improve but still not any better than after GL. As long as urgency and retention have gone that does not matter.

      One thing that has not changed seems to be my tendency to prostatitis. I was given an antibiotic about five weeks ago that cleared the infection but not the symptoms.     

        

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    • Posted

      I know that the bladder does stretch and therefor you dont feel the urgency although the bladder might be quite full.

      That happened to me, after a few days of almost full retention I got use to the pain/urgency.

      My son demanded I go and get it looked at even though I was practically pain free at that stage, I knew there had to be holding a lot of fluid but the thought of a catheter being rammed in there didnt appeal to me at all. Eventually that night I did go to hospital and the fluid that shot out into the bag did suprise me, even though I knew there had to be a lot.

      Same as you Ron, fluid going in but very little coming out. The thought of self catherting scares the daylights out of me.

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    • Posted

      It seems catheters bring their own set of problems , I had one in for two weeks as well I got Sepsis from that one.
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      The surgeon said that mine had been left in for too long!

      He had said for a week but when I was discharged from the ward the junior doctor gave me an appointment to come back in two weeks.

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    • Posted

      Well, self-cathing may not work for me. I tried it three days ago, standing, sitting, about every position. I would go in fairly easily for about eight inches and stop. Pushing farther was painful and obviously not going farthur. So, I stopped that day, watched some youtube videos about relaxing, breathing, etc  and yesterday tried again. Hit the same spot, maybe an inch farthur, still painful and when i pulled it out it had a bit of blood on the end. That catheter is not going in. Maybe another one will. I thought sure I would have an infection from that but all is ok today.I got back on the Jalyn because I was afraid of full retention and Jalyn works almost immediately. Yesterday I was passing urine better than I have in weeks. So, I've had to make a choice between my sex life and being able to urinate. The surgical choice of open prostectomy thru the bladder neck sounds like a damn poor option as well but that's what my uro recommends.I think a difference between my symptoms and most others I read on these threads is that although I must be carrying around about 500 ml at all times I'm not getting the urge to go. I got up only once last night after five hours of sleep. I'm not sure this is a good thing. I know one thing, befor I do an open prostectomy thru the bladder neck (OMG!!) I'll get some more opinions. Fortunately, I can get an appointment with a half dozen different uros in a week or so. This is the health care system that Obama wants to control with federal bureaucrats! I better get my problem fixed while I can.   
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    • Posted

      I dont think I could do the 'do it yourself' style of catheting. I wouldnt know wether to try to push the thing through regardless or stop but I guess pain would be the deciding factor. I do know it's was not a joy when the nurse first put it in during full retention. After all she couldnt feel my pain, she said 'this could hurt' and she was right on the money!

      It's a good thing that you have the choice of who you want to perform the surgery and which way your going to tackle your problem.  I would be confused as buggery by now, all the eros you have seen all say their way is best...man what a decision!

      I had mine done in our public health care system we call Medicare. We pay a levy through our taxes to fund it. 

      I believe It is a very good system but it does have it's disadvantages, like a long waiting time to be done although if it is urgent then it's usually done very quickly.  

      If we choose the public system, we dont have a choice of which surgeon is going to do the procedure/operation, that is left to the Hospital that specialises in whatever your problem is. But the head surgeon is always there to oversee everything.

      Also it is up to the surgeon as to which is the best way...I really didnt have a choice but he did say that after they get in and have a look around, they will decide then if it's GL or TURP! I simply said...'lets go'!

      And now nearly 5 weeks down the track, I am very happy with the result.

      I do have a problem with permanent retrograde and slight incontinence which they say will improve.... but hey, I can fully urinate again! 

       But I am realistic and taking it one day at a time.

       

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    • Posted

      THe catheter just stopped moving. It was so tight that I tried to twist it thinking that might help but it was too tight to twist. It just stopped with a sharp pain, not severe but enough to tell me to stop and it did have a bit of blood on the end. You can see why the damn meds are accepted so readily. Within hours of taking Jalyn I'm peeing like a racehorse. Two months ago when I saw a uro about the urolift method his PA used a scope of some sort with a camera to look aroung at the prostate and up inside the bladder. I watched all of this movement up and around on a monitor. His whole staff came in to look. No pain, no blood, no after-effect. I think he said something about a deadener like novocaine. He had probably done that thousands of times. Amazing, I thought I could do it but certainly not with that catheter.   
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    • Posted

      I can only imagine what all that twisting etc would be like and frankly, it makes my eyes water!

      Just checked out what Jalyn is, it looks a pretty wild drug.  The uro told me that pills would not be a long term option for me because after a time they will stop working.

      They had me on tamsulosin, and while it didn't have me peeing like a racehorse, it still did the trick. 

      I had Lignocaine before the catheter was inserted a few times, and that stuff only just took the edge off my discomfort...in my case it's certainly not a deadener! 

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    • Posted

      I began using Jalyn in January 2013 and it kept me open enough, the problem was just the opposite, when I needed to go I had to find a bathroom right now.  About two months ago I read about  Cialis for daily use and tried that. Worked great to stop the urgency but I was retaining more and eventually came to almost full retention.  Hence back to Jalyn with all the side effects. One side effect is that the hair falls off your legs. When i got off Jalyn the hair returned. So now i guess I'll have bare legs again. Look it up, it's a known side affect. I'll stay on the sorry stuff until I finish my building project then have some sort of surgery. Can't be incapacitated now. Actually, the last uro I saw gave me a prescription for tamsulosin but I haven't filled it as i have plenty of Jalyn. What are the side effects of Tamsulosin and why this drug instead of others?   
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    • Posted

      I've looked it up and there are many side effects with Jalyn. I think if your only losing hair on your legs, then your probably doing ok from what I've read!

      Tamsulosin (Flomaxtra) was the third lot of medication they tried me on. The first two were actually for high blood pressure (cant remember their names) but were also known to help with retention. I had reactions to those first two like really bad nausea, headaches and diarrhea.

      I think they tried the blood pressure pills first because they are on the 'Pharmaceutical Benefits Scheme' which means they are heavily subsidised by the government and Tamsulosin is not!

      The only side effect that I noticed from Tamsulosin was a stuffy nose at night...oh yes and it stoped the urgency, which as you are well aware of is a real nuisance when out and about!

      You mentioned Cialis, I was taking that but for a totally different reason while travelling through the Orient a few years back. I'm thinking that stuff could of caused my eventual full retention.......just a thought!

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    • Posted

      I said that they were one and the same as Google semed to lump them together but it seems that they are prescribed together.

       

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    • Posted

      No, JALYN is a combination of Tamsulosin, and Dutasteride, a BPH med which works in an entirely different way to open up your prostate so you can pee better while reducing your libido by 50% or so, giving you permanent retrograde ejaculation and ED. Super! 
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