Trying to decide on HOLEP, not 100% sure I need an operation

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Hello everyone, I have been diagnosed with BPH about 3 months ago and still wearing a catherter since that time waiting for an HOLEP operation. I have tried CIC and failed, actually passed out in the nurse washroom fell on the concrete floor bangging my head and noze pretty bad. 

I'm not even sure I need an operation, it all started 3 months ago when I felt ill, went to the ER and had my creatine level at 230, at first they didn't know why, then they did a bladder scan and had about 800ml of urine after void, I never had problem urinating, the flow was normal but I was going often and couldn't hold it in longer. After also an echo of the prostate, they told me it was very large and needed an operation. They prescribed me Flowmax (tamsulosin) but it did not do much. 

I don't understand why they did not prescribe me the combo med, Flowmax is considered a a1 Alpha-blocker (helps relax the muscle around the urethra) and another popular drug a 5 alpha reductase inhibitor like Avadart (a dutasteride) that shrinks the prostate, there is also another drug called bethanechol chloride for detrusor muscle contraction for urinary retention, not sure if some of you men are aware of these drugs or tried it as a combo. It seems to me that urologist just wants to operate, they signed me up and make me wait but in the mean time we did not try these things. 

In any case, this coming Monday, I'm going again for another prostate echo and tuesday I have another appointment with a second urologist for green light surgery.

Another thing I wanted to ask your men of BPH suffering, have you tried CTM ( chinese traditional medicine for BPH) according to them, they say that Urologist in our countries dont' understand the prostate and just want to destroy it, apparently they say that the prostate is calcinated and need to remove the heat and restore normal blood flow to shrink the prostate naturally, even ncbi gov sites did some research, herbs such as: Rou Gui (Cortex Cinnamomi) Huang Qi (Radix Astragali) and Chuan Shan Jia (Manis pentadactyla L.) (41.9%), Shu Di Huang (Radix Rehmanniae Perparata) (38.7%), Shan Zhu Yu (Fructus Corni) and Fu Ling (Poria) (32.3%), E Shu (Rhizoma Curcumae), Huang Bo (Cortex Phellodendri), Ze Xie (Rhizoma Alismatis) and Wang Bu Liu Xing (Semen Vaccariae) . Wondering if anyone ever tried these

I appreciate feedback from you all including my friends Ken and Jim

John 

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  • Posted

    Hey John.  How are you doing.  Have you tryed any of the chinese herbs yet.  I went to my urologist today and he ask me about you.  I told him about wnat happen to you when you got to see your doctor.  He does not like talking about another doctor.  But let me tell you he was not to happen.  I told him that you were going to see another doctor and will be considering a diffrent procedure.  He said that he wishes you the best and make sure the doctor help you without waiting 6 month's.  You were just saying maybe you don't need the surgery and you were just someone to put on his belt.  I hope this urologist can be trusted to do the right thing and not just operate just to operate.  If you had no problem before you went to see this doctor he may have done something wrong.  My doctor just put me on a new pill to help relax the bladder.  I'm not emptying all the way but he said it is not bad for my age.  I'm going to be going through alot of procedure for my heart and he just want to keep my bladder and kidney's in good shape.  Will start them Friday.  It's called Myrbetriq 25mg.  Please let me know how it goes and maybe he can try you on some of the diffrent bill and take that dame catheter out so you can have some fun.  Take care  Ken     
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    • Posted

      Hi Ken, great to hear from you, thanks for your kind message.

      Thank you also for talking about my case to your urologist, I will try to see my urologist to ask him about medication when I go for my echo on Monday, I'll have a better idea on the size of my prostate, I also have another appointment with another urologist on Tuesday this one is a green light expert so I'll see what he says, they both have info of what was done from the very first urologist who wanted to do a TURP on me, so really the one from HOLEP and Green Light have only data from the first TURP urologist so they haven't really did any more testing so I'm preparing some questions for both of them, if you can think of some question that I can ask them, I'd appreciate your feedback on that too. Myrbetriq sounds like a good medication according to Urology Times. 

      I'll keep you posted and sure hope you are doing ok with your heart issues. 

      Take care and enjoy your weekend

      John

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    • Posted

      Sorry I forget to tell you about he chinese herbs, I'm trying KAI KIT WAN you can type it on Google, here are more info:

      INGREDIENTS: Vaccaria Seqetalis, Paeonia Suffruticosa, Paeonia Veitchii lynch, Astragalus membranaceus, Patrinia Villoea juss, Peucedanum praeruptorum, Glycyrrhiza Glabra L., Saussurea lappa clarke, Akebia trifoliata 

      FUNCTIONS: Conditioning Prostate Gland functions, promoting glands activities, helping the recycle of blood and stop pains and inflammation. 

      Just starting on it today so I'll keep you posted

      John

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    • Posted

      Before I had my PAE at St. Louis University hospital last July, a urologist put me on myrbetriq. She gave me a month for free, and I bought a month.  That was more than enough! My blood pressure shot up, and I got no change in nocturia. It is an expensive drug, and useless, at least for me!  The PAE was partially successful, as the IR was only able to fully treat the right side, but my condition did improve in a significant way.
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    • Posted

      It is suppose to be something new. I will try it. If it don't help I will stop. The last few weeks I been going to the pee alot I can go 3 times in 20 minutes. Everything else is great Take care Ken
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    • Posted

      John just be up front with them both. You said you did not have a problem until he got a hold of you I would try meds first to see if then help and if you don't did surgery. Ask them if you readly did it and what would be best for you. You have to get yourself well so you can do more things. Im in GA with my family but still let me know what is going on please Also see which one you trust the most and does not give you the run around. Ask all the questions you need..Ken GOOD LUCK
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    • Posted

      Hi Ken thanks for the message, always well appreciated, yes I will try to meet with the HOLEP one on Monday, usually for an echo, you don't see the urologist, in any case I'll know more once I have the echo to see if the prostate shrunk from the rest and diet change and natural herbs, I think the best way is to remove the cath and see but the problem is if I remove the cath I'm on my own because they won't monitro me all day, you know checking if I empty my bladder, in any case if the prostate is still big I will ask for medication combination and cath removal on the next catheter change giving time to the med to work. 

      I'll keep you posted

      Enjoy your family weekend

      John

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    • Posted

      Ken I also ordered beta-sitosterol apparently it's helping BPH, not sure if you ever tried that, I'm also taking saw palmetto, zinc, vitamin D, D3, E and some Chinese herb tea and also still waiting for KAI KIT WAN
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  • Posted

    John,

    Sorry to hear you are having these difficulties. You say you have been wearing a catheter for several months. There is a high probability of an infection with prolonged catheter use - I had to do this for 5 weeks, got used to it, but it can be tiresome. 

    About the CIC: it can really help you, but you have to gradually learn to do it. The first time I tried it was impossible. I then studied all about CIC and the various catheters used, and sent for samples of hydrophilic catheters - self lubricating. I tried CIC again with one of these, and was successful. It gets easier each time you do it. 

    There are many possible procedures that can help your BPH. The easiest, with fewest side effects, would be PAE, performed by an interventional radiologist, not a urologist. Second, would be Urolift - the prostate Is moved away from the bladder and urethra with implants - no cutting or destroying prostate tissue. Next would be Rezum - parts of the prostate are steamed and eventually die. Next would be laser ablation. Revolix (Thulium laser) is the best, followed by Greenlight. HOLEP (using the Holmium Laser) is extremely effective, but the prostate tissue is morcillated in the bladder, and that means it must be performed by experts, such as the Mayo Clinic. Then, there are other treatments - TURP being the most common. There are different types of TURP using either a cutting loop, or a plasma button that vaporizes and cauterizes the tissue - much better than the loop. Bipolar loop is better than monopolar loop. Anyway, you have a lot of research ahead of you. 

    You can take the pills, like Flomax or Avodart (Finesteride/Proscar researches better), but there are side effects. Other drugs for overactive bladder - also have side effects. 

    I don't know about the Chinese herbs - maybe they will work.

    Before you make any decisions you need to know the size of your prostate and whether there is a median lobe protruding into the bladder. The HOLEP procedure is very effective dealing with enlarged median lobes. Urolift is working on a clinical trial involving the median lobe. Note, that HOLEP scoops out a lot of prostate tissue, so it is highly likely you will have retrograde ejaculation. This is not the case with Urolift. 

    Back to my original point - once you know what you're dealing with consider the procedure that has the fewest side effects and can be performed close to where you live and is covered by your insurance. 

    In the meantime, don't give up on the CIC - you can get used to it, but you will have to use a hydrophilic catheter. Most companies that sell/make them will send you free samples. Use the smallest one that will work - 14 fr (French) size might work. 12 fr is too small. 16 is "normal". The curved tip (coude tip) is painful for a first time user, but some like it. It didn't work for me and was what my urologist gave me for my first try. 

    Tom

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    • Posted

      Hi Tom nice to hear back from you, hope all is well with you

      I know wearing a catheter for so long brings more problems but for now I have no choice, I'm trying to mind myself to try CIC again, it seems that my brain won't accept it, not sure what it is I guess just looking at the lenght of these succers gives me the creep. I'll start by ordering some self-cath samples and see, hydrophillic coloplast speedy cath, are those the best one to start. I guess 14 fr is a good size to start with, I have a 16 fr cath now. 

      I know that HOLEP is a great choice for me, I have some worries about bleeding, retro, erections, etc. 

      In any case I have my echo on Monday to see the size of the prostate so I'll know more and will keep you posted.

      Thanks again

      John

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    • Posted

      John You have to get it out of your mind I had to. even a 12fr is good to start with just make sure you use alot of lube. I know you will get better but don't let the doctors talk you in to anything You have waited a long time whats a few more weeks to make sure what will work for you Relax PLEASE Ken
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