anyone had prostate surgery? how did it go?

[udontony]

2 hours ago, schnytzal said:

it ends up being not that different to most private hospitals, the savings is slight. however, for BPH and, possibly, prostate cancer, i'm interested in 2 doctors, and the other one's at Bumrungrad which is not as overpriced as people assume but still probably the most expensive hospital.
 

When I had my operation to remove the prostate, there were only two hospitals in Thailand that had the facilities to do it robotically according to my surgeon.  Siriraj where I was and Bumrungrad, no where else with the expertise and the equipment for this operation.  It could well have changed over the last four years, I have no idea.

 

[kingofsurf]

1 hour ago, roseram88 said:

So the canter was detected in BH Pattaya but they intervention (surgery so to speak of) was done in the main hospital in BKK?

Is this the standard procedure? They have the better surgeons and oncologists in BKK or was it just that they used a highly advanced MRI operation theatre?

Yes, the doctor treating me is based in BH Pattaya, but the high-intensity radiation machine is located at the main Bangkok Cancer hospital. 

The reason is that the machine is so expensive, BKK Hospital only has one. 

This is what the machine looks like (photo from internet).

The thing revolves around the body in a semi-circle, beaming radiation from various angles.

Apparently it is precise to an extremely tiny fraction of a millimeter.

The radiation session is not that long, maybe 20 minutes, and is painless, during and after the procedure.

My biggest fear was that I would involuntarily twitch, cough for sneeze, causing the radiation to zap other areas of my body.

So I focused on trying to lie as still as a corpse. 

It wasn't easy.

But here I am -- still alive to fuck another day.

Edited October 15, 2024 by kingofsurf

[Encora]

3 hours ago, Scuba+ said:

what side effects did you get from the biopsy? it's something they don't usually talk about

Piles!  Didn't enjoy that but they more or less went after a couple of weeks

[Encora]

1 hour ago, roseram88 said:

So the canter was detected in BH Pattaya but they intervention (surgery so to speak of) was done in the main hospital in BKK?

Is this the standard procedure? They have the better surgeons and oncologists in BKK or was it just that they used a highly advanced MRI operation theatre?

The insertion of the shield and markers was done at BPH, the radiation sessions at BKK, I dont think they have that equipment in BPH

The radiation Oncologist who supervises the radiation id BKK based, but is at BPH one day a week

[Scuba+]

7 hours ago, Encora said:

Piles!  Didn't enjoy that but they more or less went after a couple of weeks

That's good only piles, I've heard reports of ED issues

[schnytzal]

16 hours ago, udontony said:

When I had my operation to remove the prostate, there were only two hospitals in Thailand that had the facilities to do it robotically according to my surgeon.  Siriraj where I was and Bumrungrad, no where else with the expertise and the equipment for this operation.  It could well have changed over the last four years, I have no idea.

 

probably still the case, they're the only ones with HoLEP.

[schnytzal]

18 hours ago, Scuba+ said:

what side effects did you get from the biopsy? it's something they don't usually talk about

biopsy through the perineum is generally safer than through the rectum with very little chance of infection.

it's actually "the old way," the rectal route came about because it worked well with the best available imaging at the time. now, with very detailed, very high resolution MRI with contrast, they basically have a 3d model of that area of your body, and besides being safter, the perineum gives them better access to more areas of the prostate.

if they've no reason to mess around with anything beyond the prostate, then it's a pretty minor outpatient procedure.

for me, i think the side effects were due to having been on a catheter since July 7. the Foley catheter is held in place by a balloon inflated in the bladder. prostate makes a lot of fluid, and since you can't fuck or jack off, and it can't go into the bladder, it leaks around the catheter. that ranges from unpleasant to excruciating.

don't know if it's a universal thing but for me it happens when i shit. it was happening before the biopsy but the biopsy made it worse for a few days. first few days, it was every hour or so except when i was asleep. i think it was aggravated by my having to shit frequently. wasn't the runs (a common side effect from antibiotics) it was, i think, a type of mild constipation. not shitting everything out when you shit.

without the buildup of prostate fluid the biopsy would have been a walk in the park.

on the 28th i will ask if it's worth trying to remove the catheter. even if i get a few days catheterless and have to run to an ER in the middle of the night to have it reinserted

[schnytzal]

8 hours ago, Scuba+ said:

That's good only piles, I've heard reports of ED issues

i can't imagine how a biopsy would cause ED, unless there are suspicious lesion on the outer surface of the prostate where the nerves are located. i'd expect if they had to poke that area and sample tissue, the ED would be temporary *IF* the biopsy is the cause.

that said i doubt the ED had anything to do with the biopsy and these guys most likely had, or were well on their way to, ED issues already

[schnytzal]

based on what i know or have experienced, anyone's first choice for prostate issues should be Siriraj P or Bumrungrad.

these are the only places i know of in Thailand that have the latest toys (HoLEP, Da Vinci robot for radical prostatectomy). also the docs i went to at these 2 were the only ones of the 5 that i came away confident that i'd want them diagnosing and treating the problem. they collected the most evidence, and were the most meticulous about not leaping to conclusions.

a guy at one of hte Phaythai hospitals (on the Thonburi side of the river) was really shit, avoid.

the guy at BHP was ok, and probably better than i rate him because i made it clear that i'd follow up in Bangkok since it's a 2 hour drive to Patts. he probably would collect more evidence if i'd been planning on treatment there beyond the catheter.
 

[schnytzal]

a reminder, for guys who may be reading this post and do not (yet) have any prostate issues. get your total PSA, free PSA to total PSA ratio, and PSA density checked if you're over 40.

NONE of my symptoms are from the potentially cancerous lesions, and if you want to catch it early you won't have any symptoms. later on it may well still be treatable but there will be a LOT more collateral damage if it spreads beyond the prostate.

[Phoenix Dave]

22 minutes ago, schnytzal said:

i can't imagine how a biopsy would cause ED, unless there are suspicious lesion on the outer surface of the prostate where the nerves are located. i'd expect if they had to poke that area and sample tissue, the ED would be temporary *IF* the biopsy is the cause.

that said i doubt the ED had anything to do with the biopsy and these guys most likely had, or were well on their way to, ED issues already

The ED reaction, as I understand it, results more commonly from the American practice (insurance cost driven decision) to take 12 cores in one sitting all over the prostate to avoid the need for an MRI first. They did that to me twice now, first time did result in ED issues for about 6 months, second time ED was already a forgone conclusion.

[schnytzal]

13 minutes ago, Phoenix Dave said:

The ED reaction, as I understand it, results more commonly from the American practice (insurance cost driven decision) to take 12 cores in one sitting all over the prostate to avoid the need for an MRI first. They did that to me twice now, first time did result in ED issues for about 6 months, second time ED was already a forgone conclusion.

i don't know how many cores they took but i think it was a fair few. Prostate cancer is usually multifocal, i know they sampled more than just the lesion.

did they go through the rectum or the perineum? also, they went in blind? yikes. the fuckedupness of the US healtcare system (well, the doctors and many hospitals are great, but good luck finding a way to pay for the great ones)

[Phoenix Dave]

3 minutes ago, schnytzal said:

i don't know how many cores they took but i think it was a fair few. Prostate cancer is usually multifocal, i know they sampled more than just the lesion.

did they go through the rectum or the perineum? also, they went in blind? yikes. the fuckedupness of the US healtcare system (well, the doctors and many hospitals are great, but good luck finding a way to pay for the great ones)

Through the rectum, and all by feel with no imaging first. And don't be too sure about the 'great ones', being in Phoenix made it easy to go to one of the super-high-reputation joints, The Mayo Clinic. They don't get good referrals from me.

[schnytzal]

6 minutes ago, Phoenix Dave said:

Through the rectum, and all by feel with no imaging first. And don't be too sure about the 'great ones', being in Phoenix made it easy to go to one of the super-high-reputation joints, The Mayo Clinic. They don't get good referrals from me.

Ted Shaeffer may not have written the book but he edited the latest edition of it. there are great ones, but you'd have to find the right doc. they certainly exist there, but shit doctors also exist there.

i'm not a fan of any US hospital i've been to. my impression is if you find the right doctor over here, they're as good as anywhere. but finding the right doctor anywhere on Earth is friggin difficult.

[Gone-east]

On 03/10/2024 at 14:42, schnytzal said:

for the guys who've had the (MRI-guided) transperineal biopsy...

how rough was it? i've already decided i'm not driving, so that's not an issue. Pacific Cross have already decided to reject the doctor's request for 1 day observation in hospital. should i stay near the hospital for a night just in case?

I had one in January of this year in the UK. 24 samples taken and fortunately, no cancer found.

It was done by a Nurse in training under the supervision of a Doctor so it took longer than it might usually do, about an hour.

TBH, I found it a breeze. It was a little uncomfortable and not something you would volunteer for, but it really wasn't that bad.

I was advised that I wouldn't be allowed to drive home after the procedure so a son took me. I was out driving later that day.

I had some bruising and my urine had blood in it for a few days. My semen also had blood but that cleared up after about 1 week.

I found one of the best sources of info was Prostate Cancer UK, especially their community: https://community.prostatecanceruk.org/

Beware of rabbit holes though .....

Edited October 16, 2024 by Gone-east

[Harry Brown]

Early days for me, mine jumped a fair bit but still lowish. I will have another test done this month and they will see if it's continuing to grow.

I was looking at the radiation procedure where they seed the prostate. Has anyone had any experience with that

It is supposed to be less invasive and more chance of getting an erection

[Scuba+]

4 hours ago, schnytzal said:

i can't imagine how a biopsy would cause ED, unless there are suspicious lesion on the outer surface of the prostate where the nerves are located. i'd expect if they had to poke that area and sample tissue, the ED would be temporary *IF* the biopsy is the cause.

that said i doubt the ED had anything to do with the biopsy and these guys most likely had, or were well on their way to, ED issues already

Not sure, i heard reported that they take 17+ samples not just 1

[Yogi007]

I have just turned 50 and starting my journey on this path. Frequent peeing, not feeling empty. Have PSA test on Friday. Will take it from there. 

[kingofsurf]

3 hours ago, Harry Brown said:

. . . .

I was looking at the radiation procedure where they seed the prostate. Has anyone had any experience with that

It is supposed to be less invasive and more chance of getting an erection

I went through the "gold seed" implants.

I could still get boners and fuck in the aftermath, after waiting a bit. (with my daily dose of 5 mg Cialis I been doing for a long time now.)

This miraculous dick power endures even after the radiation treatments, and going into my fourth month of hormone injection follow-up therapy, meant to bring my testosterone count to nearly zero.

But this could change any time, who knows.

The silver lining of ED:  Every Thai chick will be able to deep-throat your flaccid dick.

I read that even without an erection, the penile tissue is still sensitive to stimulation -- so it's possible to have an orgasm even with a wet noodle dick.

I hope I don't end up having to test this.

Edited October 16, 2024 by kingofsurf

[Harry Brown]

27 minutes ago, kingofsurf said:

I went through the "gold seed" implants.

I could still get boners and fuck in the aftermath, after waiting a bit. (with my daily dose of 5 mg Cialis I been doing for a long time now.)

This miraculous dick power endures even after the radiation treatments, and going into my fourth month of hormone injection follow-up therapy, meant to bring my testosterone count to nearly zero.

But this could change any time, who knows.

The silver lining of ED:  Every Thai chick will be able to deep-throat your flaccid dick.

I read that even without an erection, the penile tissue is still sensitive to stimulation -- so it's possible to have an orgasm even with a wet noodle dick.

I hope I don't end up having to test this.

You say you've been down the "Gold seed" mode, so I think you have mentioned that you are now being reviewed with the Doc again but naw going with some other procedure, or are you all good?

[schnytzal]

1 hour ago, Scuba+ said:

Not sure, i heard reported that they take 17+ samples not just 1

they need to take multiple samples, most prostate cancers are multifocal. so even if they have a clear and obvious suspicious lesion (like mine) they want to sample more tissue. i don't know how many samples they took of mine, but i'll ask on the 28th.

[schnytzal]

a note for anyone dealing with a catheter for an extended period of time:

with a catheter inserted you might wish for ED. if it's there long enough you may get stiffies in the night while you sleep and have zero control. this happened to me after a couple of months. there's that word again: excruciating LOL. the pain woke me out of a coma-like sleep.

another thing in the plus column for Siriraj P..., the Urology dept has catheters that are more elastic. this seems to have solved the problem. prostate fluid leaking around the outside is still an issue though.

 

[udontony]

5 hours ago, Harry Brown said:

Early days for me, mine jumped a fair bit but still lowish. I will have another test done this month and they will see if it's continuing to grow.

I was looking at the radiation procedure where they seed the prostate. Has anyone had any experience with that

It is supposed to be less invasive and more chance of getting an erection

If you do need treatment you have to be advised by the doctor as to which treatment is best.  Some prostate cancers can only be treated with the complete removal of the prostate as they are so aggressive, as was the case with me.  Some are very mild and need no treatment and others maybe the radiation treatment.  In my opinion, the most important thing is to find a doctor that you are happy with and completely trust to help you make the right decision.  

[kingofsurf]

2 hours ago, Harry Brown said:

You say you've been down the "Gold seed" mode, so I think you have mentioned that you are now being reviewed with the Doc again but naw going with some other procedure, or are you all good?

I had my one-month follow-up meeting with the doc at BPH about two weeks ago.

My PSA level dropped from 33.261 to 0.072.

However, the doc said ideally the PSA level should be lower, to near zero, which apparently happens gradually.

He then injected the 2nd of my hormone shots that will be administered every three months for the next two years -- to try and reduce my testosterone level to near zero, so any undetected cancer cells have nothing to feed on.

My biggest problem is my prostate is still too large, and causes extremely inconvenient urinary problems.

I have to piss often, as soon as I feel the urge. The flow is weak, but not too bad. 

Nights are the worst, because while I'm sleeping, the urine builds up.

So every night, I wake up after only about 2 hours sleep, with my bladder feeling painfully full.

Sometimes I cannot even piss, until several minutes pass while I'm standing over the toilet. Then a weak, painful trickle of piss comes out. I only can drain about 1/3 or less maybe of my bladder.

But I learned from reading about BPH a technique to use.

After the first painful piss, I wait about 10-20 minutes and piss again. Then the flow is much easier and stronger. I guess it's because maybe the bladder muscle is more relaxed. I'm able to empty more of my bladder, but not completely. 

So I have to get up every two hours to rinse-and-repeat over the night.

I no longer am able to get continuous sleep, like the dragonrider dude.

I also try not to drink any liquids after 7 or 8 pm.

Good thing I am retired, so disrupted sleep really doesn't affect me badly. I just take daytime naps whenever I want.

I did tell the doc about the urine problem.

He said that generally the radiation shrinks the prostate due to the dead cancer cells, and that my condition should improve over time.

But I feel like this can't continue indefinitely.

Eventually, maybe some kind of laser/heated water therapy, or even surgery will be needed to remove prostate tissue, so I can piss normally and get a good night's sleep.

Still, it could be worse, like poor Jerry who does not have a bladder any more.

[Phoenix Dave]

My urinary problems matched @kingofsurf. I ended up on a foley catheter for 4 months. It took that long, but the hormone therapy did shrink the prostate enough to be able to mostly empty the bladder, but I was still stuck in the every-2-hour loop of waking up to piss. Now 6 months later it's more like every 4 hours.