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Non-Invasive BPH Treatments I'm considering

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david92007
david92007

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

 

4 likes, 133 replies

133 Replies

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  • tomcat715
    tomcat715 david92007

    Posted

    Call Dr Isaackson at UNC Hospital Chapel HIll NC Interventional Vascular Radiology. I just had my PAE on tuesday and i highly recommend him and his success and i had no pain or problems.  Waiting for the results though over next 2-4 mos.  I am already peeing normal.  not even getting up at night but wont see true results till later on.  Tom CHicago
  • ramblin
    ramblin david92007

    Posted

    I had a PAE on July 2, 2015 at St. Louis Un Hospital in St. Louis, MO by Kirubara Haveesan.  My GEHA insurance paid 80%. Prior to the procedure (I'm 60) I was getting up about hourly at night. I now sleep at least one three hour period every night.  During the recovery period, for about the first month, I had retrograde ejaculation, but that went away. I am looking forward to my follow up flow test in January. You should do this procedure before you do anything else.  My cost was $2000 - the best money I've ever spent.  By the way, my prostate was 80cc prior to the procedure. I'm planning on a rescan at one year.
  • SalinTexas
    SalinTexas david92007

    Posted

    If you're out on the West Coast or anywhere near Texas, I suggest talking to Dr Rao in El Paso.

    Its been 5 months since my prostate artery embolization with good results. Hopefully it will hold up. He told me that even if I'm among the 10-20% of people who don't get a good result after PAE, I can still get the TURP if needed. I think PAE is a good non-invasive treatment to start off with and try.

  • ScottFree
    ScottFree david92007

    Posted

    Hi Guys,

    I had not explored PAE, probably because it is relatively new and like one of you said, Urologists do not do it.  This thread popped up on a BHP search as I am exploring my options.  From the on line reading, there appears to be few side effects.  I also see it works with very enlarged prostates which is my issue.  One of you referenced this patient info forum having a site devoted to PAE. I wanted to link to this thread in case I cannot find it.  For you that have had the proceedure, can you outline the actual experience for us?  Such as do they knock you out as they do in a heart cath so you feel nothing?  Is it out patient? And once the proceedure is completed, you do not wear a cath as long as you were peeing before the proceedure?  Any pain, bleeding etc. Or do you just go home and wait for time to shink your prostate? In googling it, I see it is offered in Tampa General Hospital which is constistantly ranked as one of the country's best and I agree with that as a former patient.  It sounds like a great alternative to the other methods and I am just wondering the catch?  Thanks in advance for any personal feedback from patients that have had the PAE proceedure.

    Scott

    • ramblin
      ramblin ScottFree

      Posted

      The "catch" is that you must approve the procedure through your insurance before starting. Medicare only covers if it is part of a clinical trial. My insurance (GEHA) covered the prodedure, but my cost was still over $5000. It improved my condition, but did not cure it. In my case, the IR was only able to do the right side, and I've put off going back in, due to the cost. Without insurance, you are looking at $50,000.
    • ScottFree
      ScottFree ramblin

      Posted

      Ramblin, Thanks for the reply.  As far as the proceedure, it appears they knock you out, like with a heart cath, so obviously painless during the proceedure, how about after?  Any pain?.  After the proceedure, did you have to wear a cath?  Any issues with peeing if you did not have a cath. Any  afterwards and and how long does it take before you start seeing improvement from the prostate shrinking?

       If I understand the proceedure, they block the blood flow to the prostate and then I'm not clear on why it shrinks.  Are the cells dieing off or what causes it to shrink?  My main issue is bleeding associated with a  large prostate, so I really like the idea of this seemingly far less risky proceedure than some of the others.  

    • ramblin
      ramblin ScottFree

      Posted

      I had it done at St. Louis University Hospital by Dr. Haveesan. You are mostly concious but immobilized for about 2 hours during the procedure and 2 hours after the procedure.  The most painful part is the groin puncture. You will be too sore to drive for at least 24 hours.  Urination was painful for the first week, and then I developed a UTI.  Make sure your doctor prescribes antibiotics before you check out! I slowly improved for about six months, then stabilized.  
  • jimjames
    jimjames david92007

    Posted

    I realize this is an old thread, but given the title "non-invasive bph treatments" and the fact that others may be reading this thread since it has now been updated -- anyone who is considering a "non-evasive" approach should consider CIC (self catherization). No operation, no recovery, no side effects. The absolute most 100% reversible solution there is because all you have to do is stop doing it. CIC will empty your bladder completely any time you want. It prevents all associated symptons of a large PVR (post residual volume) and it protects your kidneys. After a few weeks, most find it easily and pain free. After a few months the process becomes as easy as brushing your teeth but takes less time. CIC can be a permanent solution or just a way to extend your "watch n' wait" period until something else comes along that you can truly live in without crossing your fingers that it will work.

    Jim

    • nealpros
      nealpros jimjames

      Posted

      Do you think it's possible that so many insertions into your sensitive urethra could change it?

      Neal

    • jimjames
      jimjames nealpros

      Posted

      Good question, Neal. You can create something called a "false passage" but it's easily reversible, not permanent. Never happened to me. There also is a higher incidence of UTI's but I think that can be partly attributed to the patient population and technique. I haven't had a symptomatic UTI in over two years and had two a year previous to CIC. There is also lifetimes of data from the SCI (spinal chord injury) community and nothing I've heard about regarding changes to the urethra. Of course there may be changes we don't know about but I'll chance it over the changes we do know and hear about here and in other forums about the side effects of many of the surgical procedures.

      Jim

    • jimjames
      jimjames nealpros

      Posted

      Neal,

      You can probably google "self catherization and side effects or damage" and come up with a more complete answer than I have given but most of the issues with self catherization seem temporary and solveable with proper technique and the newer hydrophillic (very slippery) catheters. Still, the more we know what to expect the better in any of this. 

      Jim

  • spr
    spr david92007

    Posted

     By the way I found another doctor who does PAE- Dr, Nutting in Denver- he accepts insurance. He claims to have done over 100 and is a seasoned physician

    I realize a good number of you are from the UK, I put this in for my American compatriots.

    thanks

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