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TURP or a less invasive treatment for my prostate problem

Posted , 5 users are following.

vick124105
vick124105

Dear All

I am 48 a year old from Sydney, Australia, who has suffered for the past 15 years from frequent urination at night (about 2 to 3 times), prostate pain especially after ejaculation, and weak urine flow (average flow of 5.2ml/s & peak flow at 8ml/s). My prostate size is only slightly enlarged at 31ml. After having a Cystoscopy, my urologist believes I have a bladder neck obstruction and would need a TURP. I have resisted doing the procedure.

I was wondering from the symptoms I have described above whether another less invasive treatment such as PAE, Holep or Rezum would be a better alternative as my prostate size is not that large and my symptoms are not that extreme. However, my prostate issue does affect my quality of life including my sleep and sex life.

Any advice, experience or suggestions will be highly appreciated.

0 likes, 5 replies

5 Replies

  • Allondon
    Allondon vick124105

    Posted

    Hi Vick,

    I'm not sure what healthcare services are available in Australia, so these are thoughts based on my experience.

    You don't say if you had tests for UTI and prostate inflammation already.

    If you had and they came back negative, the next best step would be an MRI, that will show the details of your prostate and around. Or, if you don't have extra fat around your waist, a transabdominal ultrasound performed by a good radiologist can tell a lot.

    After that you can discuss your options, probably asking for a second opinion.

    My guess is you may need more specialised procedures to remove the obstruction (depending on its nature), but Rezum and PAE will not help as your prostate is normal size.

    • vick124105
      vick124105 Allondon

      Posted

      Dear Allondon. Thanks for your advice. I have been tested several times for UTI's and the results have always been negative. In regards to the prostate, my Urologist did say that he noticed that my Prostate had inflammation during cystoscopy. He reckons that my underlying issue was a bladder neck obstruction that was causing issues with prostate etc.

    • Allondon
      Allondon vick124105

      Posted

      Hi Vick,

      I am not a urologist, therefore I only share my opinion.

      I strongly believe that surgery is the last option after all alternatives failed.

      Prostate inflammation is tested by sampling a liquid exuded during prostate massage, it is different from UTI test. May be worth doing to exclude prostatitis.

      I really think you need to get a second (and maybe a third etc.) opinion as your prostate is not large enough to cause the obstruction.

  • WilliamUSA
    WilliamUSA vick124105

    Posted

    "... and my symptoms are not that extreme. However, my prostate issue does affect my quality of life including my sleep and sex life."

    Another non-urologist here, just a fellow urine restriction suffer.

    As Allondon pointed out, your prostate is about normal size. Thus, I would not expect that the typical prostate removal methods (Rezum (which I had), PAE, some sort of laser, etc.) would not help you much.

    If bladder neck instruction obstruction is the issue, your resistance to a TURP is well founded. Ask your urologist how much of the prostate would be removed if he does a TURP and if you would be likely to experience retrograde ejaculation (my guess is 100% likelihood). If you have prostate pain now after sex, could you image how you'd feel if you had retrograde ejaculation, too? At 48, it's not something I'd like. (I'm 65 and still normal after the Rezum.)

    Since your symptoms are not that extreme, I suggest the following. Learn to self-catheterize. Doing CIC before bedtime may help you sleep. Note that prostate issues have been getting me up at least twice a night since I was 50. As you know, this is annoying, but doable. (I don't CIC myself, but the folks on this site seem to love it!)

    Negative things can happen any time you cut and remove material from the body. I agree with Allondon that surgery is the last option. Hold out as long as your "symptoms are not that extreme."

    And multiple professional opinions would be a good idea, too. That Allondon has some good advice.

    Best wishes,

    Bill

  • TKM
    TKM vick124105

    Edited

    Vick,

    My best guess is that you may have a prostate infection (prostatitus). If they check your urine for bacteria, that only shows an infection of the blabber, kidneys or urethra. To check for infection of the prostate they need to check the semen. When I was 22 a Urologist checked my semen by massaging the prostate and collecting discharge on a microscope slide. I think it can also be collected by masturbation.

    Good luck,

    Thomas

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