New to the forum, trying to manage BPH

Hi Bob,

If you've been reading the forum for years, then you probably know that there have been successes and failures with all the current procedures, as well as varying side effect profiles, many of them sexual including permanent retrograde (dry) orgasm. 

If you're still not sure and/or want to see what's on the horizon, you might consider self catheterization (CIC). It's a non drug, non surgical approach that can potentially empty your bladder, protect your kidneys and alleviate your bph symptons as well, if not better, than any surgery available while preserving full sexual function. It also has the potential to rehab your bladder could mean better surgical outcomes in the future, if you so choose, or even the ability to void normally without the catheter most of the time, as in my case. 

Jim

You do sound like you have pretty standard BPH symptoms. Before you have any procedure, I would get a full workup. I presented a lot like you but had bladder issues too, which surgery can't address. A urologist should do at least a scope to confirm that your urethra is indeed restricted, where and how much. The answers to those questions will help guide the doc/you as to what procedures would offer the best outcomes. Also, have a urodynamics test for bladder function. Years of BPH often take their toll on bladders.

As for procedures, if any doc you see recommends a full out surgery as a first line of treatment (TURP, Holep, Button TURP) find another doctor. Under the best of circumstances, they are full out surgeries with the associated risks, have a long recovery and will almost surely leave you with RE (dry orgasms) and can leave you incontinent or impotent. For someone young and fit like you, those would be borderline malpractice.

There are procedures that can be performed in a docs office without putting you under with fewer side effects, quicker recoveries and less risk. They are Rezum, Urolift, iTind, PAE and FLA. PAE and Urolift won't help if you have an enlarged median lobe. FLA isn't covered by insurance. RE is unlikely with all of them, most (maybe all) will require days to weeks with a catheter (I recommend a self cath rather than an indwelling one - don't do any procedure with any doc who won't set you up for that).

First, get a diagnosis (you have trouble peeing so I recommend a TURP isn't a diagnosis), then see what your doc suggests and make a decision from there. There are lots of threads on each procedure in this forum. Good Luck!

I concur with Old Buzzard, that full testing, including urodynamics should be done prior to any decisions. I also suggest a simple void log can give plenty of information and is often overlooked by uros because I guess it's too low tech and can't be charged for Just write down the time and volume of each void for 24 hours. Not a bad idea also to include an column for fluid intake, again write down how much was taken in and when. You also might want to google "IPSS Score" and take the simple test to see where you relatively fit into things sympton wise. BTW do you know your post void residual (PVR)? It's measured with a simple ultrasound scan in your urologist's office. 

Jim

Good morning Bob.  First of all I am sorry for what your going through.  You need to listen to what the other guy's are saying.  Do you really need a procedure.  You have to find out if your prostate is the problem it could be your bladder.  Yes if the urologist first thing out of his mouth is you need a TURP or LASER surgery.  Say thank you and go right out the door.....get a another opinion.  At your age or any age a man has to see what side effects he can deal with retro ejaculation, erection problem or some others.  Just because your sex life is good now once they start cutting away at the prostate you just add to your problem.  Don't let you problems pick your procedure.  Take care and good luck  Ken      

I have had the ultrasound done, and doc says emptying is good, even though I have high frequency.  I did do a test where I urinated into a funnel type of device that measured rate of flow and starting/stopping.  The report was that I have a weak stream and start and stop a lot.  

Doc wants me on medication, does not want to do surgery.  Is medication my only choice? Which meds are best?   And what about the Beer/alcohol thing? 

Hello  Bob, and welcome to the forum. You sound almsot identical to my situation, only I am 54, but also very active, work out, lift etc.

I also have had a real battle with prostatitis and also BPH. 

I had a PAE procedure back in Jan 2016, that did nothing for me, except cause the worst case of prostatitis I have ever had. My Doc almost put me in the hospital for IV antibiotics. And the Doc who done my procedure actually suggested I may need to have my prostate removed. That was my last conversation with him!

Then I read here on the forum about a new procedure called FLA, which you can search for here on the forum, and read about. The Doc who done mine 2 weeks ago is in Houston TX and he not only done the FLA procedure, but he also done a rigorous, detailed regimen to attempt to cure the prostatitis hopefully forever.

There is a new DNA test where they can test to see exactly whst bacteria you have, and what antibiotics to treat it with.

You can do a search here on the forum, where I went into the details of exactly what he done, and the meds used. 

Or if you have any questions feel free to pm me.

It has been just over 2 weeks, and I can already see a difference in my urination, and ejaculation. And for the first time in years I do not constantly feel my prostate. That probably sounds funny, but when you have prostatitis it feels like you are sitting on a golf ball all of the time.

The procedure is very expensive, and the Dr does not take insurance, however he will give you the documentation to submit it yourself. My insurance gave me a pre approval, but it remains to be seen if they send me any money back. But either way it is totally worth it.

Do you know how large your prostate is?

Joe