prostate question

@ Gene,

Please refrain from Diagnosing someone else's Health issues.

I had a 38 gram prostrate and according to the 4 Urologists and one IR Doctors I spoke with, all agreed that a normal prostate size is on average between 14-28 grams. And that some prostates grow outward, while others grow inward. Mine grew inward and constricted my urethra to the point where I was trying to urinate about 16 - 18 times a day (24 hour period) and still had significant bladder/urine retention. CIC / Self Cath ing were a main stay and helped me tremendously (*recommend Everyone check into that blessing of an option).

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After trying for many months to get a PAE, I acquiesced and under went a Bi-polar TURP at Stanford University. *About $5,500.oo Out-Of-Pocket expenses; after PPO Insurance payments. The past couple of months since the TURP, I have regained much more control of my Life. My flow has improved by about 80-90% and I only get up once (sometimes not at all) at night. And I have not had to CIC / Self Cath since a day after the Foley cath was removed (and it was only in after the procedure from about 4 pm to 8 am the next morning).

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I would not try to diagnose anyone else's medical condition. This Site is a Blessing and great place to start, and it has a lot of Good, Caring People here. It was an invaluable resource for me. And I am grateful to all those who post their experiences, so others can learn. Please watch out for "opinions" and realize that many people who have Successful Procedures do not post here. So don't try to analyze the "Percentages" of each Procedure; it most likely will not be representative or an accurate sample. Do you own Research; and this Site is one of those Good Research Sources.

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Best of Luck to all who are suffering from BPH / LUTS and any associated conditions. I pray you each find Relief and Success in dealing with them.

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Chuck

ty for replying you gave me some relief with your comment!

Chuck,

I'm not trying to diagnose anybody. Prostate doesn't grow inwards our outwards, it's just growing with adenomatose tissue, and you are correct some have enormous prostate without much restriction of flow, some, some have obstruction with relatively small prostate. Your urologist is right: in most men 25 cc is the upper limit for normal size. Mine was 40 at 35 without any symptoms. 30 cc vs 25 cc is only 20% increase with results in only 6% increase in radius according to the laws of geometry. Common sense tell me that 6% increase can't cause obstruction. Yours was 38 g, a bit more. Effects are possible. at 30 cc unlikely.

Definitely in your case PAE was obsolete.

Chuck,

Who did your bi-Polar TURP at Stanford ? I live near there, it is an option for me. Did you have an enlarged median lobe ? Did the bi-Polar TURP cause Retrograde Ejaculation (RE), or any other side effects ? Do you have medicare ?

Thomas

You didn't ask me but I'll answer for myself anyway! I had an enlarged median lobe and I have retro (which I had before from the alpha-blocker I was on). No other side effects. I am on Medicare with a $1500 out-of-pocket max on my supplemental plan. I think bi-polar TURP is pretty standard these days and many doctors are either doing the entire procedure with a button electrode or (as my guy did), using a loop to start with (because it's faster) then finishing up with the button to cauterize any bleeders and smooth the surface. I also left the hospital without a catheter after 17 hours of continuous bladder irrigation. Resumed all normal activity after 3 weeks.

Interesting tidbit. The hospital is only 5 minutes from my house so when I got the bill for $750 (they billed Medicare $22,000!) I drove over to pay with my credit card and get the points. The billing gal says that will be $675. I say I thought it was $750. She says we give a 10% discount if paid within 45 days. I said the bill didn't mention that so if I had sent in a check for $750 that's what I would have paid. She says that's right.

why would PSA be obsolete in his case?

I didn't say PSA, I wrote PAE (prostate artery embolzation) which is effective only for prostate s larger than 60-70 cc and works best for prostate volumes >100 cc. It can shrink the total volume by 30-35% if successful.

Thomas,

Forgot to mention...

Yes & No on the Retro.

I still have ejaculent come out, but I think the TURP affected the Urethra lining or muscles, because it no longer shoots out, it just oozes. I was told that "may" improve as time passes (*even though I had the Bladder Neck Sparring Technique) .

Lee,

this forum exists for patients with PC and BPH who are willing to exchange their experiences, opinions and advices. I don't think anybody should refrain from expressing their opinions. In the end it will be you and your doctor who will perform the chosen procedure. A good advice from a fellow patient could be more valuable than an opinion of of a paid (heftily ) urologist, who can be biased in the world of fee for service medicine.

Strongly disagree that "doctor know better" Only the educated patient knows the best treatment in case of not ER service. My medical experience verified that many times. I was strongly advised and denied PAE by my insurance, PCP and Urologist. It turned out the lifesaver and changed my life entirely as in case of many peers with successful PAE.

Don't discourage people from freely expressing their opinion and even advise.

God bless.

When discussing prostates my previous GP used to say " You know more about this than I do"

You hit the nail on the head. People need to realize what a forum like this is and isn't. I use it as one of many sources to educate and inform myself about my condition and methods of improving it. I've gained a wealth of valid info here in addition to reading many relevant medical journal papers, studying the anatomy of the prostate, and watching narrated videos of actual procedures being performed. This is in addition to consulting with half a dozen uros and an IR (who BTW asked me if I was a physician...lol). While there is a risk of someone drawing an incorrect conclusion from reading someone else's opinion here and taking it as fact, I think the alternate risk is more harmful on average -- people not reading here because they're afraid they'll get incorrect info.

I'd pay attention to a persons personal experiences but too many quote rumour and third party fable.

I'd pay attention to a persons personal experiences but too many quote rumour and third party fable.

Exactly! If you were to believe the anti-TURP crowd, you'd think incontinence and ED were common TURP side-effects. Clinical studies show that is not the case (it may have been 30-40 years ago but techniques have evolved and improved.) The only person (other than a doctor) who can speak authoritatively on a given procedure is someone who has had that procedure. Coming from anyone else it's "rumor and third party fable."

As you say the newer TURP procedures are much better that what I was offered in

the U.K. in 1995. I refused one then and on the advice of American urologist Dr. Hernando Salcedo author of The Prostate: Facts and Misconceptions who I had corresponded with waited for laser procedures to become available.

Two friends and I had GL procedures in 2004 at different British hospitals during initial trials. We all had good results and the 64 year old with a much younger partner became a father. He needed another procedure about four tears later and mine lasted ( I was 70 then ) for nine years before it regrew and I had a Thulium/Holmium procedure as GL was not available where I now live. I'd have either or Holmium Laser now if needed rather that any of the newer procedures.

My last surgeon suggested that I take Avodart to prevent future growth . I asked if it had time to grow enough to be a problem at my age . He glanced at his screen and said perhaps not.