New to all this. Where to start?
Posted , 14 users are following.
Good afternoon, all,
I am fairly new to this world. I'm about 50. I've been reading through this forum about all the different interventions available to treat BPH. I had no idea there were so many options out there.
The last couple of years, I've slowly experienced worsening symptoms. I went from sleeping through the night up until a couple of years ago to waking up to use the bathroom once or twice a night a few times a week...and have had an uptick in that recently. I am looking for a urologist so I can get a start can figure out a proper diagnosis. Are there any specific questions I should ask from the start? Is there a standard treatment hierarchy that most urologists go through? Are most of the options like PAE, HoLEP, FLA, and others usually reserved for those who have tried several different medications first?
Mainly...what advice would you give to someone who is just starting this journey? What do you wish you knew when you first started?
Thanks so much.
1 like, 43 replies
lester19220 sasquatch
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bob31550 lester19220
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silver bullet??
Just found something very, very interesting, in the big online bookstore. There's a review of Dr. Thomas Levy's book, Curing the Incurables. The top review is by the handle of skeptic turned believer, Brian. He has numbered his "astounding" health changes, and his first item is that his prostate health has been restored.
glenn77 sasquatch
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kenneth1955 sasquatch
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Well. For a start I want to welcome you to this forum. We have all gone through these problem. Now with your getting up at night you may have to watch what you drink. Do not drink anything after 7PM. When you are looking for a Urologist you need to find one that care about you not rushing you into a surgery. You will have to have a lot of test to make sure what is going on. He may start you on pills first. But try to stay away from Flomax & Rapaflo. Some men do not like the side effects. It can give you retro ejaculation. Which the sperm goes backwards instead of out. What every meds he give you before you start check out the side effects and tell the doctor you have a problem. With all the procedure there are 9 out of the 10 top procedure cause retro ejaculation. Urolift is the only one that does not cause retro. Because it does no cutting of the prostate. It is done with clips. You are going to have to sit down and do your pros and cons of everything. You will know if they are a good doctor when they listen you you and your concerns. I wish you well. Ken
Truthmatters kenneth1955
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"With all the procedure there are 9 out of the 10 top procedure cause retro ejaculation. Urolift is the only one that does not cause retro."
Are you including PAE in that? My experience, similar to almost everyone else, is that retro is not a side effect of the procedure.
kenneth1955 Truthmatters
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richp21 kenneth1955
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“ PAE decrease in volume”
Do you have a source for this?
Thanks.
Rich
TKM kenneth1955
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Kenneth,I don't think we know that a person would have more volume of semen with an enlarged prostate. I have never heard of any studies showing that. It is a deseased condition so I doubt that it would put out more volume and probably works less efficiently. This is a good question for Urologists or researchers, although I doubt there is much interest in studying it.
Thomas
kenneth1955 richp21
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richp21 kenneth1955
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kenneth1955 richp21
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tom6446 sasquatch
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bob31550 tom6446
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I am also a newbie. Was in ER several times and got ultrasound and CT scan but no one at this major hospital said that the bladder scanner (which was used twice on me) could "size" my prostate.
The uro didn't mention this either. Your post sounds very logical. Could you, or others, expand on this subject and your experience with prostate sonograms?
TKM sasquatch
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Sasquatch,
The first step is to find a Urologist, probably recommended by your GP, or a friend. You will probably first try lifestyle changes, like not drinking liquids in the evening. Do not take cold medicines, like antihistamines, they can make BPH problems worse.
If those don't help your Urologist may want you to try some drugs. The first is usually an Alpha blocker like Flomax or Alfuzosin. These are not bad . The side effects can be low blood pressure, dizziness, and retrograde ejaculation. All the effects are temporary and go away within one day when you stop taking the drug. For me the retro lasted about 8 hours so by timing when you take it, problems can be avoided. Some people take Cialis, to increase flow, and of course it does not cause retro, and can be a benefit to sexual function because it is like Viagra. Cialis can be expensive and insurance may not cover it.
A Urologist may suggest Avodart or Finisteride. Be careful of these drugs because they can cause loss of libido and erectile disfunction which may last for years after you stop taking the drug. The effects may even be permanent.
If the drugs don't help or lose their effect you can try Self Catheterization, CIC. There are some good discussions on this web site about this. If you don't want to CIC the next options are PAE, Urolift, or Rezum, in the order of least invasive to more invasive. Before you do any of these procedures you should get tests from your Urologist like DRE, Flow rate, Cystoscopy, Trus to determine prostate size, and possibly a Urodynamics test for bladder function.
Be aware that Urolift even though one of the least invasive procedures leaves metal clips in your prostate that cause distortions in MRI images and may interfere with the use of MRI for biopsy and FLA (Focal Laser Ablation) later.
Hope this helps,
Thomas
sasquatch TKM
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TKM sasquatch
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According to Dr Karmaranian in Texas that would make an MRI biopsy or a FLA more difficult but not necessarily impossible. However he said he has never done FLA on a patient with Urolift so did not know for sure.
Of course the old method of biopsy using 12 to 18 needles could still be done as far as I know.
Thomas
kenneth1955 TKM
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sasquatch TKM
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TKM sasquatch
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