Which is the best surgical treatment for benign prostatic hyperplasia?
Posted , 19 users are following.
I'm sixty two years old and have been catheterized (for now just over six weeks ) after being hospitalized for urosepsis following a cystoscopy. I'm waiting for the TURP procedure on the NHS although I believe there may be better surgical procedures and I am prepared to pay privately to get the best result. Any thoughts, information and/or weblinks would be most welcome. Thanks. P
0 likes, 103 replies
chuck68670 PetW
Posted
Miracles Brother....- are what we are All looking for....
And only a few guys on this site profess to have benefited from being a recipient of such.
I am 61 and have been dealing with issues associated with BPH for several years. I too, am on this site looking for the "Perfect" procedure/miracle. I am doing intermittent CIC to help lessen any bladder stretching and help get a little better flow, pending my long research and numerous visits to Health Care Professionals, during my lengthy search.
Good Luck Sir, and if you do find any Miracle, PLEASE let the rest of us know.
Decorously,
Chuck
derek76 chuck68670
Posted
If you wait for a miracle you will die waiting. When my BPH was first diagnosed in 1994 TURP was the only show in town apart from having it totally removed. I waited for a good laser procedure to arrive and GL took ten years to appear. In that time my prostate grew from 35 to 75 grms and my PSA went from 5.0 to 9.8 and I had two negative biopsies in that time.
PetW chuck68670
Posted
Thanks Chuck. Much appreciated! And if by a miracle I find one I will certainly not keep it to myself. 😃 Best. P
PetW derek76
Posted
Good points derek. I've never been told the my PSA apart from 'it's OK' and I have no idea what size my prostate is. Clearly I need a lot more information from clinicians!
derek76 PetW
Posted
I wonder what OK means for PSA in theory it should be zero,
Since my last procedure in 2013 it is 0.70. Prior to that one it was about 7.8 and before the 2004 GL it was 9.8 down to 5.0 after it.
I always engage them in conversation and ask questions.
There are two PSA tests the standard one and the Free PSA test that is much more expensive so the NHS tend not to do it.
I got my GP to take the blood and I paid for the test at a private lab. When the results came back my GP did not know how to interpret it so I explained. You know more about this than I do he said.
PetW derek76
Posted
Yes indeed - 'OK' is simply not good enough - though I guess had I the gumption to ask my GP for more information then he'd have probably filled me in. I've since found out - amazingly and scarily enough - that my neighbour who is the same age as me had a PSA that was considered normal though slightly on the high side and that his GP said his prostate felt normal too. He had no symptoms, peed normally and yet it turned out after further tests and a biopsy that his prostate was cancerous. He's since had a prostatectomy and apparently he is clear at the moment of cancer. He has since however had problems peeing and has had to have the neck of his bladder widened due to scar tissue constriction.
derek76 PetW
Posted
When first having a BPH diagnosis in 1995 a PSA of 5.0 was a trigger for a biopsy. I had two in the next two years they were so enthusiastic about them. As each caused infections and one a rather big bleed just as I was about to leave the hospital and needed an overnight stay I refused any more on the basis that a big prostate means a high PSA.
I had actually been told in 1983 after a cystoscopy for another problem that my prostate was slightly enlarged and to keep an eye on it !
dan25410 derek76
Posted
My doctor said that there is a much higher correlation with prostate cancer as PSA approaches 10. I'm glad to hear that is not always the case
derek76 PetW
Posted
There are several versions of TURP now but Uro's tend to generalise. I even had one call GL TURP and when challenged said they re all just boring a hole. Procedure availability can also vary depending where in the UK you are.
I had GL in Newcastle in 2004 and Thulium/Holmium laser in Sussex in 2013. Both were good and recovery trouble free and life back to normal in a couple of days though others have different tales to tell.
There is no doubt that procedures performed in British hospitals are superior to those done in Uro's 'Offices' in America.You are entitled to ask for the procedure you want to be done in the area of your choice. I lived in Scotland and had GL in Newcastle as it was new at the time and not widely available.
Best results with all come if your median lobe is not the problem area and your surgeon does a bladder neck sparing procedure to prevent retrograde ejaculation.
If you look for the NICE ( National Institute for Health and Care Excellence ) site all the procedures are detailed. We can't post direct links here.
PetW derek76
Posted
Thanks Derek - I've already looked at the NICE site but haven't found direct comparisons. I'll have a look again. Thanks again. Good to know that you've had no issues.
hank1953 PetW
Posted
Are you concerned with retro ejaculation ?
PetW hank1953
Posted
I'd love to keep everything working just fine but I accept that this is probably out of the question. My wish list starts with being able to pee normally with some sexual function preserved. Retro ejaculation I'd prefer to avoid but it isn't the priority. Considering this what would you suggest Hank?
hank1953 PetW
Posted
If RE is not your concern, hoLEp is by far the best procedure. Very high success rate. Very effective. Great longevity. Well documented and proven. Bipolar TURP (not regular TURP) is next. Followed by GL.
If RE is important to you, Rezum or FLA is your best shot. Not as effective but much lower risk of RE. Urolift has even lower risk of RE but much less effective, and there are more and more reports of problems with the clips used.
Then again, there is self cathing, which is not a procedure.
PetW hank1953
Posted
Excellent information hank. Many thanks for this. P
andrewcalgary PetW
Posted
in USA, maybe FLA
derek76 andrewcalgary
Posted
He told he is in the UK and has been treated by the NHS but will consider private treatment.
Usually the advice that holds good for one country does not for another. UK NHS patients are often given a take it or leave it choice and cannot easily see other Uro's for options or the newer or more expensive procedures. The NHS in the main want to use the cheapest option and to free up the bed for the next patient at the moment that is Rezum. Google will tell you that PAE is now approved but the system is in no way set up to offer it widely available.
PetW andrewcalgary
Posted
I'm in the UK but thanks for the info, andrew
PetW derek76
Posted
I take it that PAE is also included on the NICE site derek