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

    I am a 69 year old in  good health overall, non-drinker, non-smoker who will be going for a Turp in Richmond Hospital, outside Vancouver BC,  in  4 days time. I was originally going to have a Plasma Button but it was suggested that I have a Turp done, and was told it is still the best option to use. I was going to pay to have this procedure done and he still suggested i have the TURP done by a collegue, which is paid for by the Provincal Health Plan. The size of the prostate is approx 50g. I  have read almost everything about what to expect, and believe that the horror stories are real. One has to live thru these things in order to be able to elaborate on them. All I want is the same as everyone else, a speedy recovery and good health. Wishing and hoping simply doesn't cut it anymore with me, I need something done and its going to be. I should also add that this lastest round of wearing a catheter (  50 days ) is getting really 'wearing', as you well know if you have had a catheter in for any length of time. This is the closest I have ever felt to being totally, isolated in my whole life. It could be worse, there could be cancer involved and all that comes with it, but looks like that is not in the picture.

    I look at life usually positively, and will do the same with this procedure. I was on Proscar and Flomax, and a couple of years ago I stopped taking the Flomax and was doing great with just the Proscar, "UNTIL" I had my gall bladder removed on July the 14th and had the anathestic, that drug blew my prostate up. Inability to urinate and constipation. I lay that or it was simply a considence that it happened but what ever it was, I was go to go before that gall bladder was remvoed.

    I would bet my life that the anathestic had alot to do with it. But it is what it is and I'm very hopefully that the TURP will do the job its intended to do.

    Family is planning a cruise on Oct 4th, I hope I am well enough to go. 10 Days from Vancouver down the California Coast and back, if I"m well enough I plan to go, if not then they go and I sit home and recuperate. I just want my health back, the sooner the better. Thanks for all your input on this site, its been helpful.

    Mike

    • Posted

      I don't think your "prostate blew up" from the anathestic, more likely you had POUR (post-operative urinary retention) which is very common after surgery with general anesthesia, especially if you're older. POUR has to do with your bladder stretching, not with your prostate. And POUR is often reversible after the bladder has time to recuperate.

      Since you were doing so well before the operation, I guess the question is have your doctors removed the catheter recently and given your bladder an opportunity to work on it's own, now that it's been given a month or so of rest? If not, you might want to discuss this as it's very possible that by now your bladder has returned to its pre-operative functionality which you seemed happy with. 

      Another option, if it turns out the bladder is still not back to business, is to transition from wearing a Foley to self-catherization (CIC) for another month or two and see if that can bring some of the elasticity your bladder probably lost. I personally do CIC and it appears to have brought back a significant amount of bladder elasticity that I had lost with years of retention. I also think you will find CIC much less troublesome and disrupting of your life than wearing a FOLEY 24/7.

      For anyone else with BPH contemplating any non-BPH type of surgery involving general anesthesia, make sure the surgeons are aware of your BPH, and take precautions (such as bladder emptying before the operation) to minimize stretching of the badder during the operation, and read up about POUR. 

      Jim

    • Posted

      Hi and thanks for the post, your probably right, and I was told that if I did "spontaneous' being to void after the 2nd time of catheter removal, there was an 80% that I would have to have surgery done  anyway, I'm biting the bullet and getting this 'fixed'. I've had enough of having to deal with it and want at least some relief in knowning that I have been proactive. My surgeon is also an instructor at UBC in the Urology Dept. I just hope that he gets the job done and done right. He has a string of credentials.

      Mike

    • Posted

      I certainly understand there comes a point where "biting the bullet" is the best choice over trying to just patch things up with this and that.

      I'm sure you've done your research, but just keep in mind that TURP, like all these procedures, is not always the total fix and there is a very high incidence of sexual side effects such as retrograde ejaculation, which may or may not concern any individual person.

      As to the "80%" figure, my urologist (also a professor) told me there was a 100% chance I would need surgery in order to be able to void completely without a catheter and he was wrong. Sometimes the figures the docs throw out are self-fufilling, as most people follow their advice and therefore they have very sketchy data and follow through on the ones that don't who usually end up going elsewhere, as was my case.  

      Not trying to convince you to "wait and see" what your void function will be like without the catheter, but wanted to share my thoughts at least for others reading this who may be in the same situation. 

      I personally, have a strong "watch and wait" personality when it comes to these sorts of interventions, but I certainly understand and respect those who just want to get more immediate fix, as long as they have done their research in terms of outcomes and side effects. 

      Jim

    • Posted

      Hi Jim

      You made some good and valid points and after 3 attempts of voiding without a catherer, it became pretty clear that I had to do something and yes the "self-fulling" aspect is also true, but i was willing to pay for a Plasma Button, and after examination, he said, that for me, the best solution was a TURP, he said that he just saved me $7000, because our Medical system will pay for it. There was no greed on his part because he could have done the procedure and I would be no wiser, that a TURP could have sufficed.  

      So based on that and my research, I decided to go ahead and have the TURP done this Thursday. I have had a catherer in me since July 14th, so I'm ready for what ever comes my way now. This has been a very long haul. 

      The sex issue, I know can make men think twice, but I know lots of guys who had the prostate removed and they are very glad they did. Good thing I have "alot" of very fond memories as well.LOL I'll keep you posted and good luck with the "wait and see". I twill probably work out for you and if not then you can go ahead with whatever type surgery fits your needs. Thanks again for the input, its much appreciated.One thing is very certain we are not alone with this problem. 

      Mike

    • Posted

      Glad you thought this through, and good luck with the TURP on Thursday. And do please do keep us posted on how things went. 

      Jim

    • Posted

      Hello Mike,

      I hope it went well for you. Are you able to give us an update? I am booked in for Green Laser on 6th October and have been wearing a catheter for the last month or so. But I am going to a clinic for self cath next Tuesday which will give me an ableit brief chance of trying to see how well I can void. Its going to be a bit of a quandry for me, so any feedback from yourself would be very valuable,

      Thanks

      Jeremy

    • Posted

      Hello Jeremy

      Its been 5 days since the TURP but am feeling much better now, unfortunately I ended up in recovery  for 9 hours instead of the usual 2, because of TUR syndrome, you can look that up on Google, its not pleasant but I got thru it OK. I was a bit hesitant after I went in to the clinic and had a Dr remove the catherer removed yesterday at noon. Once I got home it started and I peeded like a teenager, with a bit of pain as expected. None the less , I was voiding on my own. Some blood and small clots and that is on going. I bought some Tena guards for Men and will use them as long as necessary, I have to keep doing the exercises to gain more control over the bladder.  I suppose my first impression is that I am glad it was done, of course I will have more to say once I have some more time "on my own" voiding. My prostate was about 100 grams, I have to say now that I'm glad I had the TURP done. The other surgeries never seem to be mentioned when you have prostate issues here, and that could be, because of the cost factor, I don't know. I was willing to pay for the Plasma Button but the surgeon there suggested that I have the TURP.

      For now I'm taking the antibiotics and resting, and walking. Very little pain medication is involved at all. I am also taking a mild laxative, so as not to strain, and have more blood issues. It will take time for the insides to heal and I'm well aware of that.

      Keep in mind that voiding in our situation is also psychological, Do your best to relax, and all the best to you. Please let me know how your making out, and as a friend of mine, with a sense of humor  said to me

      " May the flow be with you", obviously a Star Trek fan.

      Mike

    • Posted

      Hello Mike

      I have looked up TURP Syndrome and it looks horrendous, I am glad you are ok now. Were you not offered any of the Laser options? ie Green Light or HoLep? I believe these are "safer". 

      Keep us posted and best of luck.

      Jeremy

    • Posted

      I was surprised that his hospital was still using that particular fluid.
    • Posted

      Hi Jeremy

      It was horrific, that's the only way I can describe it. Man was I sick, but I had a nurse who stayed with me for 9 hours. She must have been an angel, because I have never recevied such incredible care. I wrote to the hospital and wanted to acknowledge her service to me. Keep in mind that 2 in 100 men will have TUR syndrome, and unfortunately I was on the receiving end of it. It really is rare.

      I had initally wanted to have the Plasma Button, but on exam, he said No, you need a TURP, and called a fellow surgeon and it was set up to be done. I was all set to pay $7000 to have it done and ended up paying nothing and having the TURP done. I have to tell you that right now, 6 days later, I'm peeing like a teenager and its "clear". I'm doing exactly what I'm told to do and that is,  take it easy, drink 12 to 14 glasses of water and no straining on a BM. I'm walking and just doing my best to get back to my old routine. At the moment, I couldn't be happier.

      I also woke up this morning with a "woodie", so I know that is working also. :-)

      I'm looking forward to more progress and will be sure to keep you updated. I hope that all goes well for you.

      "May the flow be with you"

      Mike

       

    • Posted

      Reading some of the horror stories I think one realises the NHS as a postcode lottery in terms of regional care levels!
    • Posted

      Hi Derek

      I suppose they haven't had any issues with it. Trust me, no one wants to go thru it. But I came out the other side and I'm fine now.

      All the best

      Mike

       

    • Posted

      I am really glad to hear you are receovering and that it has been a successful outcome. Great news! I guess you must feel the end result justified it all in the end. So 12 to 14 glasses of water is gallons!" HOw much did you drink whilst you had the catheter in before the op as a matter of interest. I have had one in since 28th July, no fun at all!
    • Posted

      I have guarded optimism and will continue to do so. Your right to, about the end justifing the means. In may case it certainly has been the case. Yes i'm driniking more now than at any time in my life, I was not a water drinker at all. Its important to keep the bladder flushed as much as possible now more than ever for me. I did also drink alot when I had the catheter in as well. I recall the 3 times that I had to go to emergency to get the foley installed and trust me I was glad it was in, because the pain was unbearable as you probably already know.

      It also pays to be clean freak as well, the reason for that is infection, and that can be real nightmare. I have never washed my hands as much as i did when I had that catheter in me, in my life. However, its very, very important.

      I certainly hope that you see some light at the end of this tunnel,and you get the relief you deserve. Keep us posted

      Best

      Mike

    • Posted

      Hi Mike,

      Sorry about the TUR syndrome but glad you are otherwise happy with things  and starting to get back to routine. Good luck ahead and keep us informed about your progress.

      Jim

    • Posted

      Thanks for response.

      I had had 2 visits to A&E to get catheter in and will never forget the second one when i had to wait 4 hours!!! Never have had to endure such pain! I was infected and with complete rention! I have an appt on Tuesday for self catheterization but am paranoid about infection so any tips appreciated. I am being as clean as poss. Appt for Gl Laser as I have mentioned is on 6th Oct, but I am keen to see if I can void on my own. 

      Jeremy

    • Posted

      I have successfully done self-cath (CIC) for two years without a single UTI or other problem.  If you just follow the protocols, which are common sense, you should not have a CIC-caused problem.  I am circumsized, and it is easier for us to keep clean as nothing gets trapped, but even for those who are not circumsized, just following the hand-washing and penis cleaning instructions, and using an anti-bacterial wipe (these come in individual packets as well as in plastic containers of 40 or 48 for home use), should keep you free of any CIC-created UTIs. 
    • Posted

      Hi again and sorry to hear, anyone knows what waiting for some relief in this situation is , its not pleasant. I forgot to mention that I would put some Polysporin on the tip of the penis and a bit around the tubing going in, Polysporin has 3 antibiotics in its makeup, so that can't hurt at all.

      So far so good after my Turp and aside from a bit of blood everything is returning to normal. I don't even wear the Tena  Guards anymore, I did for 3 days after the surgery but that was it. I'm heading in the right direction, that's for sure.

      M

    • Posted

      If I had to do it all over again I would have asked the doctor for prophylactic antibiotics prio to my first self-catherization because it takes the body a little time to get used to the process.

      Other than that, wash your hands, penis and meatus, and optionally you could use gloves. Also best to do it yourself even the first time -- as opposed to the doctor or nurse -- because you dont want anyone else's bacteria involved.

      There are a number of different ways to wash/disinfect but I found soap and water and/or those hand alcohol solutions for the hands and providone iodine swabs for the head of the penis and meatus. Providone iodine can be slightly messy if you're not careful, so away from home  I sometimes used BZK wipes instead. I did once try the hand alcohol on the meatus but it burns. 

      Later, if you're using a hydrophillic catheter like I do, you can try a "no touch" technique where you only touch the plastic funnel and not the catheter itself, but I think if you start out that way it may be too many things in the beginning. 

      Keep in mind that for many people -- not everyone -- the first couple of weeks of self catherization can be trying with some discomfort, bleeding and urgency but all that will go away completely. Also, don't be surprised if future urine cultures come back postiive. As long as you are not symptomatic, you do not want to treat that culture with antibiotics as "colonization" is considered normal with self catherization as opposed to a symptomatic UTI. 

      JIm

    • Posted

      Is Polysporin water soluble? If it isn't, not sure I'd use it on the tubing going in. Also, if you're using a hydrophillic catheter (which comes with it's own slick coating) I would check with the manufacturer before adding any other lubricant, cream or ointment. If you are not given a hydrophillic catheter, they will give you either a tube or individual packs of a water soluble lube. Use it generously and there will be less irritation. They say it's only necessary on the first few inches but it can be used much further down.

      Jim

    • Posted

      Hi there

      Sounds like you got it covered already, good. Yes the lube would really help out alot and cause less irritation, I noticed that right away, and it was a relief.

      Lots of good advice on here ...

      Mike

    • Posted

      Yes, if you're going to use lube, use a lot of it. However, better than lube in my opinion (and per some studies) is the hydrophillic catheter that doesn't use lube because of it's very slippery coating. I started with a red rubber catheter that used lube, but switched to a hydrophllic. I found the hydrophillic much easier to insert and less irritating.

      Jim

    • Posted

      Hi Jim

      Thanks for the reponses and for the others that have given advice.

      Its all invaluable.  I note you talk about colonization but still advise propholactic antibiotics. I will ask the Nurse, but when I asked the GP he refused, making a big song and dance about the recent news headlines on over subscribing AB's.  I bet he would have some himself though were he in my position!

      Jeremy

    • Posted

      Hi Mike

      Hope you are felling better.

      Have a look at my post to Jimjames re my recent removal of catheter and CIC today in fact.

      Fingers crossed I dont regress!

      But i do have some single use caths in a bag!! 

      regards

      Jeremy

    • Posted

      Hi Jeremy

      Yes i'm on the mend and so far so good.  I hope that your making progress and getting things under  control, sending good Karma your way, good luck and all you can do,  is what your doing.

      Best

      Mike

       

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