Non-Invasive BPH Treatments I'm considering

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Please forgive the length of this but if you take the time to read it, I'm sure you will be able to relate.

60 years old.  Very fit, very active, very athletic.  I weigh 5 pounds more today than I did as a senior in High School.  I exercise, eat right, don't smoke, used to drink a glass of wine once every 3 days or so but can't even do that anymore without it causing urinary difficulties.  I've been dealing with BPH symptoms seemingly since time began.  I have not slept 8 hours a night for 30 years or more except for one night on February 23, 2010, from pure exhaustion, 3 days after my Mom died.  I don't know what it feels like to not feel like I don't have to urinate.  I have an enlarged prostate.  Who doesn't. I have tried Saw palmetto, Beta Sitosterol, Urolxitrol, Tamsulosin, Half a tab of Cialis daily, I've tried prostate magic pills, blended mixtures of the world's best of the best.  Swedish Flower, Rye Grass, this that, that, this. . .I still have BPH but the healthy food store owners are driving new cars thanks to me.  I'm done with pills, pills and more pills.  I'm done with side effects and lightheadedness, etc. I've become my grandparents with all the medications laying around.  I hate it.  I no longer know what it feels like to feel normal.

I have done endless research, I have been to multiple urologists, I have had ultrasounds, cystoscopies, rectal ultrasounds, uroflow tests, urodynamic tests, etc., etc.  Urologists tell you, "Hey, we'll just go in and clean you out, remove some tissue and you'll be like new."  The fact that they mention all of this so casually and nonchalantly is amazing to me.  We are men.  Men are visual, physical creatures.  We are used to a sexual experience where there is a result of our gun going off.  If you get a standard TURP, you will be shooting blanks forever.  This is insane.  Doctors act like this is no big deal, everything will feel the same.  No you won't.  It will NEVER be the same.  You're BROKEN.  You have lost a bodily function that if I am correct has (along with the help of a female partner) been creating the human race since a man first discovered his erection.  Having a ream job TURP is like going to a rock concert and not being able to hear anything.  They call the old fashioned TURP the ‘Gold Standard’?  You have to be kidding me.  It’s more like the kiss of sexual death to anybody that goes through it.  It butchers you.  I know men that have had to seek counseling they were so depressed after having a standard TURP.

I find it unimaginable and absolutely hard to believe that after endless decades of research, there is still not a reasonable and non life changing treatment for BPH, the most common problem that men face.  

Anyway, after years of my research, waiting and waiting for something wonderful to come along that will revolutionize how we treat this miserable part of a man’s life, I find that I can not wait any longer.  Constant UTIs (Urinary Tract Infections), long regimens of antibiotics, plus the daily Flomax, Cialis, etc.  I’m sick of the whole thing.  Now I have some thickening on my bladder wall and some trebeculations.

I am considering one of two or a possible combination of both to treat my BPH.  One is the A PKTM TURP which uses lower-voltage energy to vaporize and cut away the portion of the prostate that is enlarged and causing your symptoms.  The lower-voltage PKTM Technology, combined with the safety of operating in saline, results in a safer, faster and more effective procedure.  This procedure is also known as a ‘Gyrus, bipolar procedure.  No, not bipolar like my ex-wife, this is the good kind. 

Basically it is an Electrovaporization of the prostate with the Gyrus device.  The reason there tends to be less complications is that the surgeon can be more precise with what is removed and what is left alone.  There is also a saline solution that is used throughout the procedure.

I’ve been told and I’ve learned through my research that there is a 10-15% chance for retrograde ejaculation with this procedure, recover time is much shorter, less bleeding and very little chance, if any for ED.  Those are fairly good odds for a good outcome compared to Las Vegas where your chance for a bad outcome is about 99%.  It's still a chance but if I don't do something soon, I will be facing worse problems with my bladder, kidneys, etc.  I am still sexually active so would like to preserve that functionality.

If there is anyone out there that has had a Gyrus procedure, please reply to me with your comments.

The other procedure that everyone seems to be talking about is the UroLift.  Obviously this procedure is the least invasive one there is with eseentially no tissure being removed but there is simply not enough data yet with such a new treatment option.  The idea is great. Insert a device into the urethra, the insert and deposit some small anchors through and behind the prostate wall and tether some others on the inside urethra side and voila - you have an opening held open by stainless steel tabs and thread.  Sounds pretty darn good.  but. . . .I’m not sure anyone can convince me that you won’t be able to feel these foreign objects as you move around in (and around) such a sensitive gland.  The other thing I don’t get from a mechanical standpoint. . . .there are anchors on both ends of a surgical thread, what’s to keep the inner anchors from pulling the outer ones inward, thus closing off the urethra?  Am I missing something?  Then there’s the issue of the prostate which will continue to grow and grow over time.  How long will it take until it overwhelms the anchors or pulls through - or worse.  Is there anyway to remove something that resembles a spring-wing wall molly bolt that has been (essentially) blindly placed through your prostate wall?  The other question is that it is an implant situation so will the body reject it?

Hey.  I am all for doing something to relieve my BPH and see what it’s like to maybe sleep through the night and see what it feels like to urinate without having to pack a suitcase for the bathroom trip(s) but there’s a reason that there is a dozen (or more) different procedures for BPH on the market right now.  It’s because men are demanding better options.  All the the procedures claim to be the best invention since canned peas but the reality is that whether you scrape it, burn it, electrocute it, laser it, vaporize it, bake it, auger it, pulverize it, ream it, etc., it still destroys what it is to be a man.

If anyone has had the UroLift (or the Gyrus procedure) please reply and help me make a more informed decision and also to get the word out to our fellow BPH sufferers out there.  Maybe through our words and actions, we can some day create a vaccine or at least a completely non-invasive out patient solution.  Thank you for taking the time to read my long call for help.  I sincerely look forward to any thoughts you may have.

David

 

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  • Posted

    David,  Google Prostatic Arterial Embolization.  I just had it on November 21st and have been able to sleep between 5 to 7 hours without getting up. If you are in the U.S. it is now available in many states.  It's been available in Europe for several years.  My experience is that urologists know almost nothing about this minimally invasive procedure because it's not in their specialty.  It's dome by interventional radiologists.  The snake a catheter into the arteries that feed the prostate and partially block the blood supply.  It shrinks the prostate.
    • Posted

      Hi Bruce

      I am considering PAE- how are your results now? How much did it shrink your prostate. Mine is 190 gms and I am also considering Robotic Simple (haha) Prostateomy. 

      thanks for any feedback

    • Posted

      Ii have had two of them with improvement but not restoration of flow without Flomaz .8 mg.I can make it trough the night and maybe get up once to pee now.  During the day no problem.  It definitely helped and was a walk in the park compared to TURP and the othe invasive procedures.  I only know the shrinkage from the 1st PAE and it was ~ 37 %.  I am having a Cystoscopy in a couple of weeks to go down the tunnel and see if the prostate is still in the way.  It's really the only way to know if there is a blockage. 

    • Posted

      hi Bruce

      I know your post is old but am interested to know more about your experinces with PAE, and particulary why you have had 2 of them

      You say you are going for a Cytoscopy? What did that reveal?

      Have you slipped back into problems? Howare you now?

      I had a PAE in Feb this year with much initial improvement, however i had Acute Retention twice in October this year and am not sure why!

      (I was out drinking on each occasion, but Often go out and drink 6 pints or so with no problem!)

    • Posted

      Jezz said: "...I had a PAE in Feb this year with much initial improvement, however i had Acute Retention twice in October this year and am not sure why! (I was out drinking on each occasion, but Often go out and drink 6 pints or so with no problem!)

      -------------------------

      A few of us here, including myself, have perodic episodes of Acute retention (AUR) with fairly normal voiding behavior the rest of the time. The common denonminator seems to be the consumption of large amounts of fluid in a relatively short period of time such as you describe when out drinking. In my case, I've also noticed that this sometimes happens upon awakening from sleep or after a nap. Being horizontal  can accelerate urine production by the kidneys so again a full bladder is implicated.

      IMO, and from what I have been able to deduce from the literatured, what seems to be happening is that while our bladders function normally most of the time, they are still compromised with weakened detrussors that fail if the load is too great. 

      Over the summer I was averaging maybe one or two incidents of AUR per week but haven't had any for the past three months. Not sure if that means my detrussors have rehabilitated even more or perhaps because I haven't been drinking much beer, or there could be another factor.

      In your case, assuming your voiding is otherwise pretty normal, the PAE removed part of the obstruction easing the burden on your bladder. However, if your bladder was stretched and compromise from years of bph, that doesn't mean it can function like a fully normal bladder that would have no problem with the 6 pints of beer.

      It's possible that you could rehab your bladder even more through CIC like I have, but again assuming everything works well otherwise, the easier solution would be either to drink less beer or make sure to carry some catheters with you to the pub smile

      Why this prolem is intermittent I don't know, but there could also be other factors involved. FWIW I asked two urologists about this problem and they didn't have a clue why this was happening. 

      Jim

       

  • Posted

    Gyrus was around in in 2001 when I was researching treatments but I have not heard of it for some time.

    I cannot understand why you have let your life be disrupted for so long due to fear of Retro with today’s better alternatives to TURP. I refused TURP for ten years until I could have Green Light Laser PVP for my 75 gram prostate in 2005. Life was back to normal by day three and no retro. My prostate regrew over the years and Tamsulosin helped the flow but reduced ejaculation and was leading to retro. I then had a Thulium laser procedure (prostate then 125 grams) in 2013  that I was warned would most probably lead to retro... So what? It's no big deal it seems that it creates a physiological barrier in some minds.

  • Posted

    Hi Everyone;  Whats the difference between the "PKTM Turp-Gyrus" and a "Plasma Button Turp".  They both sound like they are pretty similar to one another.  I know that CS123 highly recommends the  Button Turp and is extremely happy with his results.  I had a "PAE" back on Sept. 10th of 2014.  Not really happy with my results.  I was getting up 4 times a night and now on a "good night" I only get up 3 times.  The Doctor says thats a success not a failure.  I guess beauty is in the eye of the beholder.  I fully agree with David about what some of these surgerys do to your sex life.  Iam no longer on  Tamsulosin or Avodart.  Those 2 drugs are what we call "castration drugs".  Its amazing to me with all the "technology" in the world that somebody hasn't invented a shot that could shrink that darn thing!!!!!!!
    • Posted

      Hi Chuck,  I was told by a Doc that the PAE can take six months to fully shrink the prostate.  Hopefully you will get some additional relief.
    • Posted

      Did you ever consider cryosurgery It has had some good reports in medical journals when compared to other treatments.
  • Posted

    Hi David and welcome to the forum.

    I understand your feelings. I'm 68, and like yourself have had bph for most of my adult life. I remember 20 years ago doing some research into procedures and it has struck me how little the field has seemed to advance with Turp the gold standard then, and Turp the gold standard now. Disappointing to say the least.

    I therefore read with interest your comments about the "Gyrus procedure" but when I did some online research last night I didn't find the "10-15%" numbers for retro ejaculation you stated. One study said 100% retro, another said about the same as regular Turp, and another I believe around 40%.

    Where did you come up with the 10-15% figure?

    As to Urolift and PAE, you will find folks here who have both, with different outcomes, but not sure enough of a sample to make a decision on these relatively new procedures.

    Have you ever thought about self-catherization? If you can keep an open mind and get by the "Oh my g*d not that " knee jerk reaction, it might actually be perfect for someone with your mindset.

    You will get 100% rid of all your symptons right away, meaning no frequency, no urgency and will sleep like a baby. You can ditch all the drugs and you won't need an operation, so no retro, etc.

    I've been self-cathing for almost 2 years now and to make a long story short wish I had started doing it before that as it would have greatly improved the quality of my life.

    In your case, until a better surgical procedure comes along,  you could look at self-cathing as the best way to get the results you want without the risks (retro) you don't want. 

    And back to your numbers (10-15%). Even if accurate, given your fierce resistance to the having retro, would you risk a 10-15% chance?

    You might want to see my post "Self Catherization. An alternative to Turp, Greenlight, Holep..." for mor information.

    Jim

     

    • Posted

      TURP is only the Gold Standard for closed mind Uro's who only do that procedure. They know how to do it and it it is the cheapest to do.

      There are hundreds of thousands of patients satisfied with the laser procedures they have had in the last fifteen years. They just don't post here as they are not looking for answers 

    • Posted

      Derek,

      You can debate whether some of the newer laser procedures are better than Turp, but I don't see them as a radically new approach, I see them more as arguably better techniques with less post operative side effects --  but they all leave you with retrograde ejaculation in the vast majority of cases.   I'm sure many people are happy with BOTH Turp and lasers, but that really wasn't my point. I, and the other poster was just hoping that in the last 20 years, more progress had been made in the direction of say PAE or Urolofit, but too soon to say if those procedures are there yet.

    • Posted

      I waited eleven years after being diagnosed for something better than TURP. PVP seemed the answer and I was satisfied with it. Probably about 50% of patients had their prostates regrow. Urologists admit that initially they thought it was a quick simple procedure but realised that it needed more time and care to avoid retro.

      From reports here I doubt that PAE is very effective and Urlolift will not stop your prostate from growing. Really BPH is like a cancer in that removal is the ultimate answer.     

  • Posted

    Sorry to hear that you have been suffereing for such a long time. I am 86 and had the Urolift procedure about a month ago. My initial reaction was of joy because I had a good nights sleep and my stream was much better. To my dismay, this reversal of symptoms gradually disappeard and now I am just about back where I was before the procedure. Instead of getting better over time, I had the reverse effect. I should have been suspicious when the Urologist said, "Yes this will relieve about 50% of your problems but if it doesn't work, we can always do the TURP."  I had told him that I will never agree to the TURP. But here is a suggestion to you. I have a 77 year old friend that is now doing self-catherization and he sleeps through the night without getting up. He said it takes a while to get the hang of it, but this relieves him of the medications and all these so-called surgery solutions that don't appear to work very well. It's worth checking out.
    • Posted

      @Albin: I have a 77 year old friend that is now doing self-catherization and he sleeps through the night without getting up. He said it takes a while to get the hang of it, but this relieves him of the medications and all these so-called surgery solutions that don't appear to work very well. It's worth checking out.

      --------------------------------------

      If so inclined, why don't you invite your friend over to this forum so he can personally share his experiences with self-catherization. Sometimes I feel like the lone voice here for this painless simple procedure that can solve a lot of people's problems without medications or surgery.

      Jim

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