Prostate and Bladder Issues: What to do?

Posted by ch665296f @ch665296f, Apr 19, 2016

I am a 68, nearly 69, year old man that has had bladder issues for years. I had green light prostate surgery 8 yrs. ago which helped for a while. Now, my prostate has had some regrowth and I have developed several bladder diverticulum. I have had just about every bladder test possible. I also have some incontinence issues, and manage by wearing diapers when necessary. I'm ok with that. My urologist had me on a combination of tamsulosin and finastride, but have not realized much of a difference. I'm a bit afraid of some of those drugs because I have read that they could mask the development of a more serious prostate cancer.

My urologist suggests that I may be a candidate for surgery, but what kind? Turp or total removal of the prostate? I have also read that turp sometimes needs to be repeated. Don't want that to happen either. What to do?

Interested in more discussions like this? Go to the Men's Health Support Group.

I also have investigated the PAE. It’s been around for a few years now and more and more interventional radiologists are doing it around the country. The main negatives that I can see are you need someone who has done a number of these because sealing up the wrong artery could result in rectum issues. Also there’s no long term track record as prostate could grow back as it may get blood from other vessels nearby. Then I guess you would do it again. All in all I am seriously considering it when I finally pull the trigger on what to do.

Aquablation is another procedure I will seriously consider due to minimal side effects

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@delmar418

Hey there, I am exploring the PAE option after doing research on the internet. After watching the outcomes of others and reading in various other forums to make comparisons, I'd rather opt for this than the others- providing it's available to me here in Europe. I have not had any procedure other than an indwelling urethral catheterization going on three months. I see this urologist this coming Monday. Maybe I'll get some answers. A PAE for P. Cancer? This is a good question. I can only guess at this point that they would need to have the exact location of the cancer. If they can do this with the radioactive seed implants, maybe. But this treatment is for shrinking the prostate without taking finasteride and tamsulosin and other bladder-specific drugs. I would ask this question definitely.
On your end, I'm happy you're already planning a back-up, they say everybody is different- doesn't this make us the same? I hope EVERYTHING turns out in your favor with a LASTING outcome. Please keep us posted, often. I'm hoping that you'll hear good news!

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"Everything" seems to be following the textbook. There is one disturbing thing that is in the textbook but still disturbing. One month out and when urinating the start of the urine has a brown color. Sometimes blood red. Other than that, everything is peachy.

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Had a bladder diverticulum 20 years ago along with a TURP! Bladder is now atonic, and I self cathertize 4 times daily!

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Urologist suggested I get a "Laser" procedure. He called it the "green laser" treatment, where tissue of the prostrate is carved out with a laser. I'm looking the procedure, but do not recall what the medical term is, so I can read some more information. Doc says it is a common outpatient treatment. Thoughts?/

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@cent66

Urologist suggested I get a "Laser" procedure. He called it the "green laser" treatment, where tissue of the prostrate is carved out with a laser. I'm looking the procedure, but do not recall what the medical term is, so I can read some more information. Doc says it is a common outpatient treatment. Thoughts?/

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Good morning @cent66…..If you ask Google the question “Green Light Laser Prostate,” you will find several articles written about it!

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@delmar418

There is a new procedure called P.A.E. Prostate Artery Embolization.
They don't go through the urethra, they go through the ephemeral artery in the groin or the wrist with a catheter that injects tiny beads into the prostate to cut off part of the blood supply to reduce the size of the prostate. This is performed by an Interventional Radiologist, using x-ray guided imaging to position the beads. I've been reading a lot on this, I'd love to hear from someone who has had this done. I've only seen a couple of non-promotional videos. No sexual problems, retro-ejaculation, incontinence. I have a 99cc prostate and they have has success with prostates larger than mine with the PAE. It's an in-office under light sedation procedure. This is the second time I've posted this and I've had to reset my password here three times.

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Similar to all of you in this email string, I have had difficult prostate symptoms for many years, have a very large prostate, but I have always rejected any drugs except finesteride and certainly reject TURP, despite urologist’s vigorous recommendation of it to me. When I told him of my recent discovery of PAE, he admitted that he was biased against it as a urologist but nevertheless referred me to radiology for assessment. I’m 76 years old, very active, in very good health. For the radiologist, I have answered a series of questions about my symptoms and have had a pelvic CT Scan that looks fine, so I am a good candidate and waiting to hear what’s next from the radiologist. I definitely plan on having the procedure. Will let you know!

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@riverpark

Similar to all of you in this email string, I have had difficult prostate symptoms for many years, have a very large prostate, but I have always rejected any drugs except finesteride and certainly reject TURP, despite urologist’s vigorous recommendation of it to me. When I told him of my recent discovery of PAE, he admitted that he was biased against it as a urologist but nevertheless referred me to radiology for assessment. I’m 76 years old, very active, in very good health. For the radiologist, I have answered a series of questions about my symptoms and have had a pelvic CT Scan that looks fine, so I am a good candidate and waiting to hear what’s next from the radiologist. I definitely plan on having the procedure. Will let you know!

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I also mentioned the PAE to my urologist and he too, was biased toward it. He said it was "too experimental" and there isn't enough evidence that it works. So he offered HOLEP. Well, that's all well and good, but I told him that I found evidence that, contrary to his claims, had after effects, sexual and incontinence. Now, I have also seen that men have reported a good outcome post procedure with HOLEP, with no issues after the usual experienced during the recovery process. I look for unpaid testimonials. On the other hand, with PAE I have not seen any unpaid testimonials from men who are reporting post procedure issues of concern, sexual, retroejac, incontinence and long term self-catheterizing. I may express that I am willing to wait until the procedure is available; I cannot undo what is done. PAE, has been around for at least five years now, perhaps not specifically for prostate reduction, but for other causes with successful outcomes. Compared to other procedures, this IS the definitive of "least invasive" and doesn't require any general anesthesia Propofol. Conscious sedation Sublimaze (fentanyl) and Versed. There needs to be more discussion about it because if it isn't and I hate to put it this way but, no demand-no market. This is still a business.

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@riverpark

Similar to all of you in this email string, I have had difficult prostate symptoms for many years, have a very large prostate, but I have always rejected any drugs except finesteride and certainly reject TURP, despite urologist’s vigorous recommendation of it to me. When I told him of my recent discovery of PAE, he admitted that he was biased against it as a urologist but nevertheless referred me to radiology for assessment. I’m 76 years old, very active, in very good health. For the radiologist, I have answered a series of questions about my symptoms and have had a pelvic CT Scan that looks fine, so I am a good candidate and waiting to hear what’s next from the radiologist. I definitely plan on having the procedure. Will let you know!

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By the way, congratulations for at least getting a referral to a radiologist and it looks good for you. Please keep me posted on this.

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@delmar418

I also mentioned the PAE to my urologist and he too, was biased toward it. He said it was "too experimental" and there isn't enough evidence that it works. So he offered HOLEP. Well, that's all well and good, but I told him that I found evidence that, contrary to his claims, had after effects, sexual and incontinence. Now, I have also seen that men have reported a good outcome post procedure with HOLEP, with no issues after the usual experienced during the recovery process. I look for unpaid testimonials. On the other hand, with PAE I have not seen any unpaid testimonials from men who are reporting post procedure issues of concern, sexual, retroejac, incontinence and long term self-catheterizing. I may express that I am willing to wait until the procedure is available; I cannot undo what is done. PAE, has been around for at least five years now, perhaps not specifically for prostate reduction, but for other causes with successful outcomes. Compared to other procedures, this IS the definitive of "least invasive" and doesn't require any general anesthesia Propofol. Conscious sedation Sublimaze (fentanyl) and Versed. There needs to be more discussion about it because if it isn't and I hate to put it this way but, no demand-no market. This is still a business.

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Thanks, delmar418, for your great comments. Definitely food for thought. I have a non-profit health provider, so I don’t see motivation for them to “sell” me an untested procedure for some kind of business profit. Still, I’d say just about any step beyond doing nothing that we might end up taking toward easing our prostate symptoms is a hard call, definitely tainted by uncertainty, doubt, and risk. I am choosing PAE because it is performed by a number of prestigious medical facilities across the country, and it promises the least potential negative consequences which, I admit, is probably directly proportional to the degree of symptom mitigation it actually provides.

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@kayak461

Good morning @cent66…..If you ask Google the question “Green Light Laser Prostate,” you will find several articles written about it!

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Thanks..

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