Therapies that balance sexual function with relief from pain and discomfort...

With the number of maturing as well as emerging technologies and solutions it is, as you know, difficult to know what to do. A  good plan for any man is to start research early, before you're in 'crisis mode'.  I dinked around taking medicine and managing my lifestyle around the issues for years till I had an acute retention issue early this year and ended up in an ER getting 'cathed'. It got me off dead center and into action mode but I should have known more much earlier.

Anyway, I opted for Urolift in July and am very happy so far. I thing a central focus of someone heading for an eventual procedure is to study the options and become aware of  one's particular situation from prostate size, configuration, bladder condition, and probably several other things that must be taken into account when settling on a solution.  Always know what the conditions are for candidacy for a procedure and push back if someone wants to do something outside the medical recommendations of standard procedure.  

Right now Rezume, P.A.E., Urolift and soon I-Tind are alternatives to the harsh tissue removal procedures.  My opinion is that one might better see which of these might be best given their personal situation.  As I've noted elsewhere, even if one of these turned out to not be 'permanent' and something else was required in 5-7 years, at least you're still intact. 

Best wishes...

 

Hi. You need to define what you mean by sexual function? I've had a HoLep in which the only downside is the RE. As I'm in my 70s it doesn't matter but apart from that the sexual aspect is just as good i.e.erection and orgasm

Agree! I had the pae by DR Bagla. Whole experience was great at Vascular Institute of Virginia and have dove great. My sexual function is great and there shouldn't be any risk of losing it if done by experienced doc.

Alan, I have been in study of most of the procedures for BPH for almost a year now. I have visited with 9 different doctors in six different procedures. Not to bore you with the details. I am now of the opinion that I am going with a procedure called Focal Laser Ablation. Ablations have been preformed for decades and are very successfully used in many procedures. This prostate Ablation process is as the name implies, Focused. It uses the 3TMRI to guide the Radiologist who is train in prostae Ablation of cancer. The best benefit of the proceedure is that there is not any sexual side effects unless the Doctor makes a mistake and does not know what he is doing. I have found 3 very good Doctors that do FLA for PCa ( Prostate Cancer) and BPH. They have found that ,in the process of Ablation of the prostate for PCa, the BPH symptoms were dramatically improved in the patients. The procedure is not approved for BPH but it is for Cancer removal. I also love the PAE procedure and have visited two of the top Doctors in that procedure. The PAE is more of a shotgun treatment of shrinking the total volume of the gland. The FLA is a direct treatment which is the debunking of the tissue where the blockage or promble areas actually are. The FLA uses a hair size laser. There is no cutting and little to know blood involved. The proceedure taked about one hour. Local pain meds and casual sedation. You go home immediately. Full results is in one to two weeks. Dr. Karamanian has opened a clinic called the Prostate Laser Clinic in Houston TX. I will be in Houston to visit him tomorrow for a consultation. With FLA there is no chance of iscaemia with the beads going to any unwanted organs as there could be in PAE. Also, no radiation. Also no damage to the urethra as the procedure is not done through the urethra and does not touch it. No damage to the sexual nerves in the peripheral zone of the prostate or to the seminal vesicles so no retro ejaculation issues. And, less waiting on results. 

I like the whole idea of the FLA, and if I do not get the results I want, as my prostate is 122 grams in size, I would then shrink the whole prostate by approximately 30 to 35 percent by getting a PAE procedure after the lasered debunked FLA has healed with full blood flow, then do the PAE.

This would be the best of both worlds in a treatment with FLA and a direct removal of tissue and an overall reduction in size with a PAE. Now a lot of people say that this would be too expensive an approach. I guess that is true but I want over these symptoms so bad that I am willing and plan on borrowing the money even if it is a second lein on my home. The way I see it is I am only going to live for maybe 20 to 25 more years at the most and I have worked my as--- off for 44 years. It is now time to enjoy my life. BPH keeps that from being possible. So let those kids inherit the debt of the mortage. I have to get well and I am going to do just that. Hell, a new car cost more than both these procedures cost together. I don't need a new car, can't drive one far enough without stopping for a bathroom now. 

If you or anyone else wants more direct information, then personal message me on this link and I will provide.

Good luck in your searching. 

Guys!  Thank goodness for this site!  I've read every response - TWICE.  As usual, I learned something.  The comment from bill76612 was especially resonant:  "As I've noted elsewhere, even if one of these [procedures] turned out to not be 'permanent' and something else was required in 5-7 years, at least you're still intact."  I truly did not think about that. 

As scot1424 and ross43299 have pointed out, Rezum seems to be a viable alternative.  And scott, I appreciate the stats you supplied.  I'm going to educate myself more on this procedure. 

Right now, my "therapy" is Avodart and Cialis (5mg daily).  The analogy someone made last week scares - essentially saying that Avodart is the analog of chemical castration.  About the ONLY thing it's done for me over the past eight years is to keep the prostate's growth under relative control.  As for nocturia, urgency, and frequency - not so much. 

While the Urolift has been FDA-approved (and is now covered by Medicare), PAE has not, but according to Dr. Ari Isaacson, it should be forthcoming.  I think that, as a demographic (1930 - 1965), our numbers should bode well for us, since so many of us are (or will be) in need of these kinds of technological advances.  Thanks again, gentlemen.  The takeaway from these posts, at least as far as I'm concerned, is to go with the most conservative, least intrusive procedure(s) for starters.

 

Let me add intermittent self catherization (CIC) to the list. Can do as good a job as surgery -- often better -- with zero sexual side effects. And unlike the common misperception, CIC is not just a maintenance procedure but can in at least some cases rehabilitate the bladder as well as an operation. I can personally attest to that.

Jim