BPH Options

[bjorn2bwild]

I have been on .8 mg of tamsulosin for fours years (I had to go back and look it up). I am so ready for this ordeal to be done. Upon questioning, my urologist admitted that at my age, 61, i will have to have another prostate procedure in about 10-15 years.

HoLEP has been discussed here as probably the best option for a truly 'one and done' procedure.

 

[Koolau]

A high school classmate recently reported that his aquablation went well, and that his first post-widowhood sexual encounter (after the procedure) was satisfactory. Given that I just went to the higher dose of Tamsulosin, I appreciated his willingness to share the information.

Heh, heh, not much has changed since High School, has it?

 

[Qs Laptop]

I have been on .8 mg of tamsulosin for fours years (I had to go back and look it up). I am so ready for this ordeal to be done. Upon questioning, my urologist admitted that at my age, 61, i will have to have another prostate procedure in about 10-15 years.

My urologist said it was likely I would need to have the procedure done again within 20 years.

 

[erkevin]

"Humongous Prostate" guy here: size confirmed. MRI shows a prostate of 127 cc in volume, normal is 20-25 cc.

No cancer evident, but bladder is in rough shape. A little more than 3 weeks until aquablation.

 

[Trooper]

* I was puzzled by the measurement choice of weight rather than volume until I realized that it would be easier to weigh the removed tissue as opposed to a volume measurement.

I believe I read that the average density of the prostate is about 1gram/cc, so the two measurements are often interchanged.

 

[razztazz]

I believe I read that the average density of the prostate is about 1gram/cc, so the two measurements are often interchanged.

That is correct. I asked my own urologist the same question. Every article I read seems to play fast and loose with cc's vs grams. How can you compare information like that?

 

[Koolau]

That is correct. I asked my own urologist the same question. Every article I read seems to play fast and loose with cc's vs grams. How can you compare information like that?

My guess is that within the error limits of the measurement they are virtually the same. (Most non-bone, non fat tissue is "water" which is 1/gm/cc to a first approximation). I will say that it is typically easier to weigh something than to determine its volume. Having said all that, It would be good to pick a unit and stick with it - just so as not to confuse patients.

 

[grasshopper]

As noted before my prostate tissue removed by HoLEP was 55 gm measured by capture. MRI volume was measured 108.6 cc. pre procedure.

 

[Trooper]

Post surgery appointment with my surgeon 4 1/2 weeks after HoLEP. called me the posterboy of HoLEP with no complications, all the plumbing is working, and back to my white cotton boxers.

A bladder ultrasound was done and amazingly only 17 ml of retained urine equal to about 1/2 oz. for those that are math challenged. Most docs are very happy with less than 100.

Do you know what your retention was (ml) pre-HoLEP?

 

[grasshopper]

I self cathed and would still get 100-200ml after peeing. I was daily self cathing to take a load of my kidneys.

 

[Trooper]

"Humongous Prostate" guy here: size confirmed. MRI shows a prostate of 127 cc in volume, normal is 20-25 cc.

No cancer evident, but bladder is in rough shape. A little more than 3 weeks until aquablation.

Best of luck to you, erkevin. Do you happen to know if you are retaining urine? Have you had ultrasounds post-pee to see how empty/full your bladder is?

 

[erkevin]

Thank you for the well-wishes. Yes, on the bladder retaining urine. I believe I have had 3 ultrasounds that confirmed that. I do a lot of double-voiding during my nighttime excursions to the bathroom.

 

[Trooper]

Thanks. I'll be interested to hear whether the aquablation fixes your retention issue.

 

[Car-Guy]

Thank you for the well-wishes. Yes, on the bladder retaining urine. I believe I have had 3 ultrasounds that confirmed that. I do a lot of double-voiding during my nighttime excursions to the bathroom.

Seems to be a very common problem

 

[aja8888]

Seems to be a very common problem

It's going on with several of my friends too! But we are all past our expiration date. I'm guessing there's something in the water around here.

 

[Trooper]

Or the prostate/bladder/urethra architecture was designed poorly

 

[braumeister]

Or the prostate/bladder/urethra architecture was designed poorly

As many comedians have said, "Why would they run a sewer line through a recreation area?"

 

[Car-Guy]

It's going on with several of my friends too! But we are all past our expiration date. I'm guessing there's something in the water around here.

Or the prostate/bladder/urethra architecture was designed poorly

Well once your OEM warranty has expired, all bets are off. That's why you buy extended coverage. (e.g. health insurance)

 

[marko]

Or the prostate/bladder/urethra architecture was designed poorly

Whoever said "nature does perfect designs" never had prostate problems.

 

[MichaelB]

Whoever said "nature does perfect designs" never had prostate problems.

Either that or prostate issues are nature’s way of telling us we’re close to the product expiration date.

“Best used by …”

 

[aja8888]

Either that or prostate issues are nature’s way of telling us we’re close to the product expiration date.

“Best used by …”

+

 

[Koolau]

Whoever said "nature does perfect designs" never had prostate problems.

Nature doesn't care that your plumbing (etc.) wears out - as long as you've procrastinated and raised healthy offspring to maturity. After that, you are expendable. Who said Mother Nature was benevolent?

 

[erkevin]

So this morning I was scheduled to have my aquablation........

Yesterday morning, I received a call from my urologist's office that the hospital now says that they are not in my insurance (BCBS) network. A month earlier, they said that they were and apparently someone made a mistake.

Two days ago, the hospital called me 2x. Once to take advance payment for the procedure (my deductible share, $2500) and the surgical nurse also called me to walk me through the procedure, etc.

But yesterday, someone learned how to read?

Only that hospital has the robotic arm for aquablation, so that puts me in a really crappy position. I called the hospital to inquire about self-pay. Transfer back and forth, back and forth, told to look on the website for estimated cost (not there) and never received any answer.

I checked for urologists up in Phoenix to do aquablation; none in network.

This leaves me with very few options:
Appeal through BCBS to get the hospital approved since they are the only one that has aquablation.
Have my urologist do a TURP on me instead of aqua.
Wait until 2026 so I can find better insurance (not really an option).

There is no HoLEP in my area (anymore).

Pretty discouraged and disgusted right now.

 

[finnski1]

So this morning I was scheduled to have my aquablation........

Yesterday morning, I received a call from my urologist's office that the hospital now says that they are not in my insurance (BCBS) network. A month earlier, they said that they were and apparently someone made a mistake.

Two days ago, the hospital called me 2x. Once to take advance payment for the procedure (my deductible share, $2500) and the surgical nurse also called me to walk me through the procedure, etc.

But yesterday, someone learned how to read?

Only that hospital has the robotic arm for aquablation, so that puts me in a really crappy position. I called the hospital to inquire about self-pay. Transfer back and forth, back and forth, told to look on the website for estimated cost (not there) and never received any answer.

I checked for urologists up in Phoenix to do aquablation; none in network.

This leaves me with very few options:
Appeal through BCBS to get the hospital approved since they are the only one that has aquablation.
Have my urologist do a TURP on me instead of aqua.
Wait until 2026 so I can find better insurance (not really an option).

There is no HoLEP in my area (anymore).

Pretty discouraged and disgusted right now.

Sorry. That sucks. I'd hound them (the hospital)more for the estimated total cost if you 're willing to self pay. Also hound the insurance company. Good luck.

 

[Qs Laptop]

So this morning I was scheduled to have my aquablation........

Yesterday morning, I received a call from my urologist's office that the hospital now says that they are not in my insurance (BCBS) network. A month earlier, they said that they were and apparently someone made a mistake.

[..]

Pretty discouraged and disgusted right now.

This totally blows. Sorry to hear about this. You were mentally and physically ready for surgery and then this happens. I would appeal to your insurance company. You made the decision for aquablation and I'm sure you did your research. That's what you want; that's what you should get.