BPH (enlarged prostate) Diagnosis

[frayne]

Yup, as an almost 73 year old male, the old BPH (enlarged prostate) diagnosis via a cat scan has raised its ugly head. Probably has been creeping up on me for the better part of the last three years but I wrote it off to just getting older and one of the things us guys have to deal with. Well after total blockage and a weekend in the hospital, two weeks on a foly catheter, failed voiding test and now self cathing, I'm in line to be scoped to see just how bad the problem may be. In doing some research about treatments, Turp, Steam and Laser, I was just curious if anyone here might have had similar problems and what treatment avenue did you take. Good outcome or not and if you had to do over, what might have you done differently or suggest to someone looking at some sort of intervention to resolve the problem. Appreciate any and all responses in advance.

 

[aja8888]

Yup, as an almost 73 year old male, the old BPH (enlarged prostate) diagnosis via a cat scan has raised its ugly head. Probably has been creeping up on me for the better part of the last three years but I wrote it off to just getting older and one of the things us guys have to deal with. Well after total blockage and a weekend in the hospital, two weeks on a foly catheter, failed voiding test and now self cathing, I'm in line to be scoped to see just how bad the problem may be. In doing some research about treatments, Turp, Steam and Laser, I was just curious if anyone here might have had similar problems and what treatment avenue did you take. Good outcome or not and if you had to do over, what might have you done differently or suggest to someone looking at some sort of intervention to resolve the problem. Appreciate any and all responses in advance.

Get ready for a lot of responses.

I'm one of the lucky ones, so far, just on Tamsulosin (Flowmax generic) and things are still good at 80. Maybe I shouldn't talk....

 

[Car-Guy]

Have you tried Flomax for at least a few weeks?

 

[frayne]

Have you tried Flomax for at least a few weeks?

Yes, currently taking it and have been since Feb. 16th.

 

[Car-Guy]

^^^^^
You might ask your doctor if you can double the dosage for a few weeks then if it works, back off to just one. (Don't ask me how I know about this.)

And while doing your research for an invasive solution, if needed, you might want to read up on Aquablation.

 

[tfudtuckerpucker]

I was on Flomax for some years, then it slowly stopped working and had negative side effects. I switched to Tadalfil years ago, and it works very well. FWIW.

 

[marko]

We had quite a discussion on the subject last summer here:
https://www.google.com/url?sa=t&sou...YQFnoECB4QAQ&usg=AOvVaw2_VEPidnUTZzCT2ecq9ieK

Mostly about surgeries and other options. I had a prostatectomy last July and it was the best thing I ever did. I never knew how miserable I had been for 20 years. Hoping that your situation is still manageable but if you're already at the self- cath stage, it might be time for other approaches.

DM me any time.

 

[braumeister]

A TURP worked quite well for me and I would definitely do it again. Four years ago.

 

[donheff]

I used Flomax for a while, but it dropped my BP, and I passed out a couple of times. That turned out to be a heart arrythmia (SVT) exacerbated by Flomax. Other meds were not as effective for the BPH. When my urologist had to go in after a bladder stone I had him do a TURP (laser I think). That was 2016. So far, so good. The plumbing still works although I have retrograde emissions which is a deficit although not a deal stopper (TMI?).

 

[frayne]

We had quite a discussion on the subject last summer here:
https://www.google.com/url?sa=t&sou...YQFnoECB4QAQ&usg=AOvVaw2_VEPidnUTZzCT2ecq9ieK

Mostly about surgeries and other options. I had a prostatectomy last July and it was the best thing I ever did. I never knew how miserable I had been for 20 years. Hoping that your situation is still manageable but if you're already at the self- cath stage, it might be time for other approaches.

DM me any time.

Marko, thanks for sharing the link. After reading through all the comments, I feel reassured that I'm not alone in this journey, a path many of us "old farts" must traverse. Looking back, I probably should have seen a urologist two years ago, but that ship has sailed. Right now, it's a waiting game of appointments and procedures, and unfortunately, patience isn't my strong suit. However, it is what it is.

What I've discovered so far is that having a catheter in, or even self-cathing, isn't the nightmare I always imagined it to be. In fact, there are some definite pros. With a Foley catheter, I never had to get up at night to pee, and I slept better than ever. Through the self-cath routine, I've learned a lot about my bladder capacity and how frequently I actually need to urinate. I even started a spreadsheet to track time, input/output amount, moving average, and a comment section to note any unusual conditions.

Realizing that I'm fully voided is a major relief too. Knowing I don't have to scout out the location of every restroom within a twenty-mile radius of my home is a plus as well. Lastly, I can't thank everyone in this FIRE community enough for sharing their experiences in this area. It's been invaluable.

 

[marko]

What I've discovered so far is that having a catheter in, or even self-cathing, isn't the nightmare I always imagined it to be. In fact, there are some definite pros. With a Foley catheter, I never had to get up at night to pee, and I slept better than ever.

Good. For me. while the catheter had it's pluses as you note, I found it a huge aggravation as I had to have it for 2 full months.

Hang in there!

 

[bjorn2bwild]

What does your urologist recommend?
TURP is the most commonly available of the natural orifice procedures, followed by Aquablation and HoLEP.
HoLEP removes the most tissue, giving the longest lasting relief and is best for men with large prostates and bleeding issues - the laser cauterizes as it cuts. But this surgery is not for the impatient.
Most of the men here will recommend the treatment they received, it’s unlikely anyone has experienced all three.

 

[monte1022]

The plumbing still works although I have retrograde emissions which is a deficit although not a deal stopper (TMI?).

Not TMI. I'm getting older and these threads are definitely informative. A procedures effectiveness as well as adverse effects are important topics.

 

[rk911]

Yup, as an almost 73 year old male, the old BPH (enlarged prostate) diagnosis via a cat scan has raised its ugly head. Probably has been creeping up on me for the better part of the last three years but I wrote it off to just getting older and one of the things us guys have to deal with. Well after total blockage and a weekend in the hospital, two weeks on a foly catheter, failed voiding test and now self cathing, I'm in line to be scoped to see just how bad the problem may be. In doing some research about treatments, Turp, Steam and Laser, I was just curious if anyone here might have had similar problems and what treatment avenue did you take. Good outcome or not and if you had to do over, what might have you done differently or suggest to someone looking at some sort of intervention to resolve the problem. Appreciate any and all responses in advance.

I just went thru this at age 72 back in July. My posts should be searchable.

I began bleeding heavily during urination on June 1st. (Actually, this was the second time this happened, the first in 2021 while we were in CA closing out my late BIL's estate. I ended up with a catheter for a week with advice to "get this taken care of...soon".)

Anywzy, an initial trip to the ER and came home with a catheter. I was back in the ER 12-hrs later with a blocked catheter. Went into surgery to remove all blood clots from bladder and to examine the prostate. The surgeon cauterized all bleeders but because the prostate had grown so large, 300-400 grams as I recall (but it may have been larger) additional bleeders were bound to happen. Two more ER visits were necessary to replace a blocked catheter.

I had two surgical options...RASP (Robotic Assisted Simple Prostectomy) and
the HoLEP (Holmium laser enucleation of the prostate). The HoLEP was new-er, performed at hospitals not close to us but minimally invasive with a shorter post-surgical recovery. The RASP was also minimally invasive but more invasive than the other requiring three incisions across the abdomen. My urologist would perform that surgery in a nearby hospital. I chose the RASP primarily because the waiting time for the HoLEP was measured in months vs weeks for the RASP.

I had the RASP surgery on July 31st...9-weeks after the first ER visit. I had been wearing a catheter 24/7 for those 9-weeks. After my first surgery back in July the doc gave me a choice...keep the catheter or not. He was certain I would be back in the ER within hours if the catheter was removed.

Post-surgery I was supposed to stay in the hosp. overnight but ended up staying nearly 2-weeks because part of my small intestine did not wake up from the anesthesia. I was discharged two-days past my 73rd birthday.

Once I was discharged it was about 6-weeks before I felt really well. Today, 9-mos post surgery, I feel really fine. I don't dwell on coulda-woulda-shoulda regarding my surgical choice as there were other factors that drove me to my decision and I am at peace with my choice.

Best advice: Do your research as every case is different. In terms of post-op assume something will go bump in the night and plan accordingly. My wife needs daily help and support and we have no kids. My nephew was going to be staying with her for a day or two so I had to scramble from my hospital bed to find friends to fill in. If you end up staying in the hospital longer than planned be kind to your nurses. Those angels got me thru the hospital stay.

Good luck.

 

[rodi]

Following this thread. My husband has his MRI tomorrow because his PSA numbers are moving up. Urologist is in 2 weeks.

My dad did very well with the TURP. 10 yearsater he got prostate cancer, and had radiation, which effectively treated his prostate cancer.

 

[bmcgonig]

This is a good Peter Attia video worth watching starting at minute 28. They talk about different approaches to your problem. He really likes HOLEP. You go home with no catheter. Seems to depend on the talent of the surgeon.

https://youtu.be/poTcAm_rknw?si=HfCnpSrzl2C-EuJN

 

[rk911]

Had it not taken months to get on the surgical calendar I likely would've chosen HoLEP.

 

[Montecfo]

Did anyone get prescribed Finasteride and find that to be effective?

Or not. Meantime going with the flo...

 

[rk911]

I had been taking that for a few years but it did not, apparently, have any significant effect.

 

[aldo]

I didn't do well on meds for BPH; tamsulosin caused BP to drop dramatically, finasteride discontinued due to gas. Had a TURP 16 weeks ago and am much improved. The worst part for me was wearing a catheter for 2 weeks after the procedure. Should have had it done years ago

 

[grasshopper]

I have had an excellent out come from my June 2023 HoLEP surgery. Blow by blow case summary near the end post.

https://www.google.com/url?sa=t&sour...UTZzCT2ecq9ieK

 

[bjorn2bwild]

Two videos with expert surgeon Dr Amy Krambeck explaining HoLEP and comparing it to TURP.
The second video is a live surgery and not for the faint of heart. Viewing the video requires logging in with a Google account.

 

[grasshopper]

These two videos of Dr Amy Krambeck made me think that HoLEP was the way to go. I had two choices for surgeons my Urologist said the first doc would have me off the table in one hour. The second would take 3 hours, but taught the first one the procedure. Yea I went with door number two.

 

[camfused]

Been taking Tamsulosin for years, now on double dose and it does not work well any more. Going to have a PAE procedure done this summer, after I get on Medicare (current insurance does not cover it, and it would be $13K now).

From what I have read, the PAE procedure has the least side effects, and is the least invasive. It only lasts 5-6 years though, so will have to have it done again then.

 

[gianmatt]

Yup, as an almost 73 year old male, the old BPH (enlarged prostate) diagnosis via a cat scan has raised its ugly head. Probably has been creeping up on me for the better part of the last three years but I wrote it off to just getting older and one of the things us guys have to deal with. Well after total blockage and a weekend in the hospital, two weeks on a foly catheter, failed voiding test and now self cathing, I'm in line to be scoped to see just how bad the problem may be. In doing some research about treatments, Turp, Steam and Laser, I was just curious if anyone here might have had similar problems and what treatment avenue did you take. Good outcome or not and if you had to do over, what might have you done differently or suggest to someone looking at some sort of intervention to resolve the problem. Appreciate any and all responses in advance.

I am 65 and was using a self cath for months. A cytoscopy showed that I had a blockage (one part of the prostate had grown upward and was blocking the entrance to the bladder.) My surgeon gave me some choices, and the least invasive one was Aquablation. I highly recommend looking into it. I am now a month post-surgery. No more catheters, no sexual side effects as with TURP, no Flomax.


The key is to find a good doctor/surgeon who does this. I had been to two other urologists who misdiagnosed me. One said "I've been doing this a long time - you will need to self-cath for the rest of your life." A medical degree hanging on the wall doesn't mean the doctor knows what he is doing.