anyone had prostate surgery? how did it go?

[schnytzal]

I am destined for some sort of prostate treatment in the near future. this is largely because after a night out and around 7 ciders, i was clearing zero piss. went to the ER in the morning and got catheterized. attempts to remove catheter resulted in retaining piss and getting recatheterized. so i'll keep the straw in my dick til i do something. assuming the MRI goes ok and nothing suggests i need a biopsy, i'll most likely do Rezum. at 85 grams i'm on the large end of what most docs would consider a good candidate for minimally invasive approaches like Resum or Urolift. not even considering medication involving hormones, i don't want moobs or a soft dick.

some docs around here are still doing TURP, but the long recovery time and possibillity of a lot of bleeding doesn't appeal to me LOL. for an all-in permanent solution, the  best thing currently going IMO is HoLEP enucleation, but seeing as this usually results in retrograde ejaculation (in other words you can O but you won't be shooting ropes). this does not appeal to me LOL. Urolift inserts clamps to open the urethra and doesn't remove any prostate tissue. it also can interfere with an MRI. so i chose Rezum, it doesn't remove as much tissue as a laser enucleation, but is not likely to cause retrograde ejaculation. worst case scenario (aside from rare stuff) appears to  be that i might need another treatment down the road.

anyone had prostate issues? if yes what did you go for and how did it work out?

[1tooth]

Thank you for reassuring me. I'm at 35 grams and those doctors have been stringing me along. I'll relax and leave it be.

[udontony]

I had prostate surgery here in Thailand and it went very well.  Basically I can not give you any advice, that can only come from a doctor that has all the facts in front of him.  Prostate problems vary from the most benign to serious and very aggressive cancers, all need to be taken very seriously until you know exactly what you are dealing with.  Only after that is it possible to recommend a treatment regime.  Regular prostate antigen testing via a blood test every year will help to give advanced warning if there is a problem, it saved my life.

[duke main]

@schnytzal have you scheduled the procedure? Where will you do it? Thanks for opening this topic. I hope you'll update periodically. I only have to get up once per night but sometimes it takes a couple of minutes for the flow to commence. Best wishes.

[Pumpuynarak]

I had the Turp procedure in January 2022 here in Korat, Korat hospitals only do the Turp procedure but as a mate had the Turp and it was a great success i thought that will be ok for me. How i got it wrong, here i am today with basically the same problems i had back before the Turp op.

Its been said before and i'll say it again, your choice of urologist is the most important aspect NOT the choice of hospital.

I've never had a satisfactory explanation as to why my Turp procedure failed despite my repeated questioning. I now have a back up plan for when i redo some type of procedure, for the time being i'm coping ok.

 

[Pumpuynarak]

1 hour ago, Pumpuynarak said:

I had the Turp procedure in January 2022 here in Korat, Korat hospitals only do the Turp procedure but as a mate had the Turp and it was a great success i thought that will be ok for me. How i got it wrong, here i am today with basically the same problems i had back before the Turp op.

Its been said before and i'll say it again, your choice of urologist is the most important aspect NOT the choice of hospital.

I've never had a satisfactory explanation as to why my Turp procedure failed despite my repeated questioning. I now have a back up plan for when i redo some type of procedure, for the time being i'm coping ok.

 

Something i should add is that i now suffer with retrograde ejaculation due to the Turp procedure. Its no big deal really i still O but don't get the opportunity to decorate wifey's beautiful face lol

[Snowbird99]

My prostate has gradually increased in size over the years. Non cancerous. 
 

First treatment was Urolift. Uncomfortable for a few days after the procedure but everything healed and all functions ( urination , erection, ejaculation )back to normal. 

Prostate continued to grow and after a few years the Urolift wasn’t really working any more.  Looked around for the next treatment and found ‘Aquablation’ This uses a water jet to remove excess tissue. The jet is guided by a computer following a map defined by the surgeon using an ultrasound scan. Unwanted side effects such as erectile dysfunction  and retrograde ejaculation are significantly reduced compared to TURP and other procedures. The main advantages of this process are accuracy and no heat. Heat can cause unwanted damage in some procedures. 
 

Had an Aquablation. Anaesthetised for the procedure with a one night stay in hospital. Total recovery about six weeks. Not pleasant but entirely bearable. 
 

Outcome pretty good. ‘Pissing like an eighteen year old’ to quote my urologist. Erection same as before the procedure, which was fine. Ejaculation reduced, some goes forward as normal and goes back into bladder. Sensation just the same as before. 
 

I’m happy with it. 
 

This all happened in UK. Fairly new procedure and possibly not yet available in Thailand. 
 

Just use Google to search ‘Aquablation’ for details. 

Edited August 19 by Snowbird99
Typos

[Encora]

17 hours ago, Snowbird99 said:

My prostate has gradually increased in size over the years. Non cancerous. 
 

First treatment was Urolift. Uncomfortable for a few days after the procedure but everything healed and all functions ( urination , erection, ejaculation )back to normal. 

Prostate continued to grow and after a few years the Urolift wasn’t really working any more.  Looked around for the next treatment and found ‘Aquablation’ This uses a water jet to remove excess tissue. The jet is guided by a computer following a map defined by the surgeon using an ultrasound scan. Unwanted side effects such as erectile dysfunction  and retrograde ejaculation are significantly reduced compared to TURP and other procedures. The main advantages of this process are accuracy and no heat. Heat can cause unwanted damage in some procedures. 
 

Had an Aquablation. Anaesthetised for the procedure with a one night stay in hospital. Total recovery about six weeks. Not pleasant but entirely bearable. 
 

Outcome pretty good. ‘Pissing like an eighteen year old’ to quote my urologist. Erection same as before the procedure, which was fine. Ejaculation reduced, some goes forward as normal and goes back into bladder. Sensation just the same as before. 
 

I’m happy with it. 
 

This all happened in UK. Fairly new procedure and possibly not yet available in Thailand. 
 

Just use Google to search ‘Aquablation’ for details. 

I think they are advertising it now, saw ads in the lift both in Bumrungrad as well as in BPH.

[udontony]

23 hours ago, Pumpuynarak said:

 

Its been said before and i'll say it again, your choice of urologist is the most important aspect NOT the choice of hospital.

 

I agree with that 100%, the doctor is the most important part of the treatment, unfortunately good urologists are not easy to find in Thailand, but there are some.

[Phoenix Dave]

I had excellent service, and results, with cancer treatment from my urologist. Dr Isares Saisorn at Samitivej Sukhumvit in Bangkok. Had 40% ablation via HIFU in 2018, 2 nights in hospital, had normal urinary function before I left the hospital, just a little leakage. I traveled home (20+ hours travel) a week after the procedure, with zero issues. Waited the recommended 8 weeks, then sex as usual, with reduced output, not retrograde. ED was already an issue, no change there.

Monitoring ever since, but now it's come back. I wouldn't change a thing about what we did, I spent the last 5 years making the best 5 years of my life.

[duke main]

9 hours ago, Phoenix Dave said:

I had excellent service, and results, with cancer treatment from my urologist. Dr Isares Saisorn at Samitivej Sukhumvit in Bangkok. Had 40% ablation via HIFU in 2018, 2 nights in hospital, had normal urinary function before I left the hospital, just a little leakage. I traveled home (20+ hours travel) a week after the procedure, with zero issues. Waited the recommended 8 weeks, then sex as usual, with reduced output, not retrograde. ED was already an issue, no change there.

Monitoring ever since, but now it's come back. I wouldn't change a thing about what we did, I spent the last 5 years making the best 5 years of my life.

The cancer returned, or just BPH? Either way I'm sorry to hear that.

What treatment are you considering now?

[Phoenix Dave]

36 minutes ago, duke main said:

The cancer returned, or just BPH? Either way I'm sorry to hear that.

What treatment are you considering now?

Cancer is back, Stage 4 by the time I worked through all the tests required for insurance, now on hormone therapy. My next trip will be an experiment in capability.

[schnytzal]

On 19/08/2024 at 10:58, Pumpuynarak said:

I had the Turp procedure in January 2022 here in Korat, Korat hospitals only do the Turp procedure but as a mate had the Turp and it was a great success i thought that will be ok for me. How i got it wrong, here i am today with basically the same problems i had back before the Turp op.

Its been said before and i'll say it again, your choice of urologist is the most important aspect NOT the choice of hospital.

I've never had a satisfactory explanation as to why my Turp procedure failed despite my repeated questioning. I now have a back up plan for when i redo some type of procedure, for the time being i'm coping ok.

 

as i understand it, TURP, Rezum etc can all fail, in that your prostate may continue to grow and block your urethra.

i've been to 3 urologists, one of whom is too 'cowboy surgeon' for me (no MRI, not even an ultrasound, just 'yeah it's big you should do something.' the other 2 are good, and say basically the same thing, including the risk that, if i do anytihng other than a HoLEP enucleation i might be right back there soon-ish for a repeat.

the advantage of enucleation is what it says on the tin: the entire inner core of the prostate is removed. disadvantage, this is done buy shoving the core up into the bladder then breaking it up. it it by far the best thing going according to most urologists i've talked to or read as far as solving the problem. but for me the price (pretty much guaranteed retrograde ejaculation at 70 percent plus odds) is too high for now.

[schnytzal]

On 19/08/2024 at 14:58, Snowbird99 said:

My prostate has gradually increased in size over the years. Non cancerous. 
 

First treatment was Urolift. Uncomfortable for a few days after the procedure but everything healed and all functions ( urination , erection, ejaculation )back to normal. 

Prostate continued to grow and after a few years the Urolift wasn’t really working any more.  Looked around for the next treatment and found ‘Aquablation’ This uses a water jet to remove excess tissue. The jet is guided by a computer following a map defined by the surgeon using an ultrasound scan. Unwanted side effects such as erectile dysfunction  and retrograde ejaculation are significantly reduced compared to TURP and other procedures. The main advantages of this process are accuracy and no heat. Heat can cause unwanted damage in some procedures. 
 

Had an Aquablation. Anaesthetised for the procedure with a one night stay in hospital. Total recovery about six weeks. Not pleasant but entirely bearable. 
 

Outcome pretty good. ‘Pissing like an eighteen year old’ to quote my urologist. Erection same as before the procedure, which was fine. Ejaculation reduced, some goes forward as normal and goes back into bladder. Sensation just the same as before. 
 

I’m happy with it. 
 

This all happened in UK. Fairly new procedure and possibly not yet available in Thailand. 
 

Just use Google to search ‘Aquablation’ for details. 

Aquablation sounds basically the same as Rezum, using water to take off tissue. at 85 grams i'm on the large side for this, but it's what i'm going to try. reduced odds of retrograde ejaculation. i'm not quite ready to accept that as my new normal yet. i've had retrograde ejaculation on Harnal and i didn't find the orgasms to be as strong regardless of where the sperm lands.

[schnytzal]

On 20/08/2024 at 08:26, Encora said:

I think they are advertising it now, saw ads in the lift both in Bumrungrad as well as in BPH.

i've decided against urolift, mainly because it interferes with getting a clear MRI image. i'll have my first MRI soon (insurance company is due to stop dicking around and sort their shit out tmr) and, if there are suspicious lesions, a biopsy. the better urologists i've visited think odds of cancer are very low but an MRI is still recommended. as an added bonus it will tell them (and me) whether the median lobe is an issue.

[schnytzal]

On 20/08/2024 at 10:02, udontony said:

I agree with that 100%, the doctor is the most important part of the treatment, unfortunately good urologists are not easy to find in Thailand, but there are some.

a key tell is if they test stuff or they just stick a finger in your ass and tell you you need medication, surgery, etc (the latter option, shows the doc is as shit as the stank on his rubber glove).

[Snowbird99]

Rezum use water vapour to reduce the prostate. I.e. water at a temperature of about 100 degrees C. Aquablation uses a cold water jet. Heat is an enemy of a good outcome in terms of sexual function. 

Aquablation uses ultrasound in real time to control the ablation.

The absence of heat and greater accuracy tend to produce better outcomes in terms of maintaining sexual function.

Aquablation is not so size constrained as Rezum. 85 gms is not at the limit for Aquablation.

My urologist says that Aquablation is taking over from TURP as the gold standard treatment. 

85 gms is, from memory , towards the top end of size for Urolift.

Urolift is compatible with MRI up to three Teslas. 
 

Agree with previous poster who said choice of doctor is key. At the minimum look for someone who has carried out the procedure multiple times. There is a learning curve and experience matters. 

Edited August 28 by Snowbird99

[Pumpuynarak]

On 19/08/2024 at 10:58, Pumpuynarak said:

Its been said before and i'll say it again, your choice of urologist is the most important aspect NOT the choice of hospital.

So have we identified a top performing urologist ? if not is there anyway we can get concrete info to determine a urologists success rate ?

My back up plan is to go to BNH hospital in Bangers and see Dr Suntchai as they do 4 procedures so at least he/you have different options according to the most suitable procedure for your problem.

[udontony]

On 29/08/2024 at 01:04, schnytzal said:

a key tell is if they test stuff or they just stick a finger in your ass and tell you you need medication, surgery, etc (the latter option, shows the doc is as shit as the stank on his rubber glove).

Tuesday this week I went for a check up with my urologist, approx 30 blood tests and a urine analysis, even from the start he never stuck his finger up my bum, all tests and scans.

[udontony]

18 hours ago, Pumpuynarak said:

So have we identified a top performing urologist ? if not is there anyway we can get concrete info to determine a urologists success rate ?

My back up plan is to go to BNH hospital in Bangers and see Dr Suntchai as they do 4 procedures so at least he/you have different options according to the most suitable procedure for your problem.

I found my surgeon by recommendation from another urologist, they did not have the equipment there, so I asked for the name of the very best he knew.  He refered me to the surgeon in Bangkok Siriraj hospital which is a government hospital, but about as good as it gets for first class treatment.  Siriraj is the largest hospital in Thailand and can be a bit daunting when you first go there, but worth the effort.

[thainet]

5 minutes ago, udontony said:

Tuesday this week I went for a check up with my urologist, approx 30 blood tests and a urine analysis, even from the start he never stuck his finger up my bum, all tests and scans.

You seem sad that he didn't stick it up there..haha..  oh well next time you can request it specifically😀

[udontony]

4 minutes ago, thainet said:

You seem sad that he didn't stick it up there..haha..  oh well next time you can request it specifically😀

Quite an unpleasant proceedure even when a glamourous lady doctor did it in the UK.  Even worse when I had the three biopsies done that way here in Thailand.  The one that found the tumour was done through my abdomen, much more civilised!  No prostate at all now, so never need that done as there is nothing there for them to find!

[schnytzal]

3 hours ago, udontony said:

Tuesday this week I went for a check up with my urologist, approx 30 blood tests and a urine analysis, even from the start he never stuck his finger up my bum, all tests and scans.

neither of the docs i think are good did a butt finger. actual tests instead.

if you need a urologist and you're paying out of pocket the guy at Siriraj impressed me favorably, and the prices, even with a 'foreigner surcharge' are about 1/3 Bumrungrad. i'll probably go to the guy at Bumrungrad, now that Pacific Cross are finishing their long, tedious5 years' worth of record collecting (including collecting records from Vejthani, last time i was there was more than 5 years ago, and only ever went there for WP health certificate LOL).

all of that said, it's easy to spot a "bad"doctor, they don't run tests before just jumping on to prognosis. also note that this sloppiness looks like  overconfidence to me, not lack of intelligence or training.

i think the guy at Bangkok Hospital Pattaya wasn't THAT bad, he may have skipped the tests because i told him i would ultimately go somehwere closer to home (Patts is a 2 hour drive one way, and not where i want to be when i can't use my dick LOL)

[schnytzal]

4 hours ago, udontony said:

Siriraj is the largest hospital in Thailand and can be a bit daunting when you first go there, but worth the effort.

first quuestion a taxi driver will have... "which Siriraj?"

 

there are a LOT of buildings.

[schnytzal]

4 hours ago, udontony said:

No prostate at all now

WOW.

cancer-free now?

can you um... still get a stiffy? don't think you can 'make stuff' with no prostate...