My history is rather interesting:
After frequent urination in the evening and urine urgency at times during the day, my family Doctor did an ultrasound, which showed an enlarged prostate, 71m and several areas that appeared to be lesions obstructing the bladder. They referred me for an MRI, but unfortunately it was done on a 1.2 T MRI, which is not the appropriate method for an MRI of the prostate. 1.5 T is the minimum with 3.0 T the preferred. But because I had a linx procedure done 5 years ago for reflux, I was limited to a 1.5T
The results came back indicating granularity in the reading but still came up with a Pirad 4 finding on one of the lesions. My urologist at the time said that since it was done on a 1.2T , you can throw the results in the trash, in so many words:)

After doing quite a bit of research, I switched to a different urologist. Who also did not suggest I have a biopsy or a repeat MRI, but started me on Gemtesa, Flomax, and Dutasteride, which I have been on for about 3 months now. My symptoms have improved dramatically from 5 times a night to 1 or at most 2. Daytime urgency is almost non existent. Now as to Gemtesa, cost in the US is 550 a month and not covered under most insurance. But in Canada you can get it rather easily for 300 for a 3 month supply, which I did. My Dr had no problem with me doing it that way.

I also convinced my Dr to do a biopsy of the prostate. I was not prone to ignore the pirad 4 finding, and he did a saturation biopsy, that is very comprehensive that came up benign on all samples. But before that I was waiting the results of a MYPROSTATESCORE 2 test, and I got back after the biopsy results, that indicated I had a 98% chance of having prostate cancer.

Confusing to say the least. So, I have two issues to deal with, my bph, and the possibility of prostate cancer.

At 78, more then likely I will just do active surveillance if it is concluded I have it. But in the meantime I have decided to go with Dr. Meakins metobolic protocal under his supervision, as a prophylactic and general overall metobolic health approach. I just am starting that now.

As to BPH I have chosen PAE as the best solution. My urologist agreed with me, and said he was a big fan of PAE, he is the best urologist in the las vegas area, by far. So that is scheduled for 11/14.

The other options for controlling BPH seem to me to be rather crude, and fraught with potential complications. While PAE if done by an IR who does a substantial number of these a year, seemed to be the one with the least amount of complications. And had good results for many.

Dr Meakins protocol is a stretch, but I am one to try out things that are logic based. He has a substantial following and many have used his approach for many stages of cancer with success.