Sorry if this has been posted before or offends anyone, just wanted to have a constructive discussion about it since I am curious and frustrated. I have been dealing with BPH and LUTS for a while now and have recently been exploring all the pharma, homeopathic and surgical options available to make the situation better. One topic I read about recently dealt with the idea of prostate massage which seems to help, as described in a paper from Columbia University that I just read. I learned about such a procedure done by a professional and also a way to do it at home. I'm frustrated with my prostate, not clear why it grows and causes me not to be able to empty my bladder, so I am researching all options. I am in my late 50s and don't want to take meds for the rest of my life, or have to carry a catheter with me or pay $$$ for surgery that seems to work mostly but not permanently. Does anyone have any theraputic commentary on this approach to managing a growing prostate?
The only thing I've read regarding massage it that if you have an infection you can make it worse. I don't know if thats even true. If you decide to try it please post your results. I'd like to know more. I've heard it can be quite pleasurable also.
Expanding on my original topic a bit, here's a research paper discussing Traditional Chinese Medicine in the treatment of BPH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739225/
https://benthamopen.com/ABSTRACT/TOUNJ-2-20 is an interesting article from The Open Urology & Nephrology Journal entitled "Evaluation of an At-Home-Use Prostate Massage Device for Men with Lower Urinary Tract Symptoms"
I'm just not satisfied to follow the status quo in traditional thinking on this topic!
The prostate is normally about the size and shape of a walnut and weighs about 20 grams (less than 1 ounce). As men age, the prostate gradually increases in size. Generally, the prostate does not grow beyond about twice its normal size because the outer capsule of the gland restricts expansion. Because of this restriction, further tissue growth compresses against the inside of the gland, which can constrict the urethra and cause urinary symptoms. Prostate enlargement appears to be a normal process because it is so common. The only factor that can prevent prostate enlargement from eventually occurring is the elimination of testosterone. Men who have had their testicles removed or have had diseases that left them unable to produce testosterone do not develop benign prostatic hyperplasia (BPH) or prostate cancer. Prostate massage will not reduce its size though it is said to help prostatitis symptoms. With some people (me!) even a DRE can stimulate the vagus nerve and put them into atrial fibrillation.
First you need to come to terms with the reality of BPH- it is a chronic progressive disease. There are a great many speculations about what causes BPH but no smoking gun. It is generally considered to be an auto-immune disease. So unless you are willing to have your prostate removed the best we can all hope for is to manage its progression as we get older and it continues to grow. For some men, a 50 cc prostate completely blocks their flow so some immediate intervention is required. For other men, like myself, a 300 cc prostate still allows me to have a good natural void supplemented with CIC. All the treatments currently offered, whether they be surgical, drug or naturopathic only help to manage the progression of BPH. They ALL have their strong points (symptom relief) and weak points (side effects) and like a "religion" they all have their fervent "disciples". The key for you is to identify the specific causes of your own LUTS problems and then choose a treatment option(s) best suited for your own pathophysiology, lifestyle and wallet. This forum is the best place to be for this journey. Good luck. Howard
Tried a "device" commonly available on line for this purpose. Perhaps didn't give it enough try...but didn't work for me. In hindsight, can't imagine prostate massage can shrink the prostate. So our task -- short of invasive stuff -- would appear to be managing the condition and symptoms with a combination of the "therapies" mentioned in these pages. Good luck.
Welcome to old age. And no. There are NO cures for BPH. You just have to manage it. Drugs were not an answer for me and thank goodness I did not take them. Holistic treatments may help but do not work to the degree that you want. Urologist will butcher you in most cases. We are basically down a black hole. If you don't want to spend you own money then you better just go with a Uro and use your insurance. Some treatments they offer work.
I went FLA for a lot of logical reasons. Very please for the last two years. I think now it is very proven but I was the first for BPH. But my prostate has not and never will stop growing. When the time comes, I will do FLA once again because the relief was so good for me. I am hoping for 3 to five more good years then I will climb in the saddle again and have the precise controlled reduction of only the tissue that is causing the problem. Until then, thing are good.
Just except where you are, do your research and by all means, treat it soon than later. I wish I had not had to wait for a good treatment to come along. Urologist will not support FLA because the are not capable of doing the procedure and second they do not make any money suggesting the MRI direction to us men.
I know where you are because I was there once. Good luck. We are all in the same boat.
I must disagree with you here. While some prostate enlargement is normal with age, BPH is a pathological disease due to uncontrolled cell proliferation or hyperplasia for reasons which are not understood. Its etiology is believed to begin with acute prostatitis that goes untreated and develops into chronic prostatitis later in life. This sets up a continual cycle of prostatic tissue destruction and growth mediated by the immune system which results in a never-ending inflammation cycle (hyperplasia). Hence it is believed to be an auto-immune disease which is why BPH responds so well to anti-inflammatories. BPH is not a normal part of the aging process - it is a chronic disease and must be viewed in that light.
John, I would also mention PAE as an alternative (which is performed by interventional radiologists).
Everything currently available has been said on this forum many times over. The commentators here know more than the professionals and if a sure permanent solution comes about you will learn about it here. Stay tuned.
Yes I would mention it to Michael, but I must confess that except for going to visit and interviewing both Dr. Isaacson and Dr. Bagla in person for my diligence when selecting my choice of treatments, I have no first hand experience with PAE. My single close friend that chose PAE had to do it twice and did not achieve the results he wanted. He is now looking at other things. But this is not to say that PAE is not a good treatment. I decided that it was not for me with a 125cc prostate and a large median lobe issue. I needed visual contact with the tissue being removed to be sure the correct tissue was opened up. I wanted to see the issue and I wanted to know the doctor that was removing the tissue was looking at it when he did so. Kind of like the theory of looking at the nail when you swing the hammer.
PAE is a good offering for some men. It is random in the control of the shrinkage area through atrophy of the tissue and I needed something that was precise in removal of only the spots and the tissue was that was causing the blockage. But PAE has had good results for a lot of men and works.
My main point to Michael is that first he needs someone to tell him his specific situation of his individual prostate. He need to see the film of his prostate and be shown the real issues that are causing the problem. Then, if he is already experiencing the horrible symptoms of BPH at his early age, he should not wait to find a treatment and suffer. We all know what we can do to our bladders by waiting. A younger man also wants to make sure the selected treatment gives him the absolute best changes of no sexual side effects. I feel FLA and PAE offer that and that is a major positive for my selection. Personally, it was the most important selection factor for me. And, he wants to be sure his problem is a prostate issue he is having and not a bladder issue from the beginning. Unfortunately, he may have to seek this analysis from a urologist.
Also, I hope he understands that Urologist will not present to him anything except the "flavor of the month" treatment that they are currently using and selling for BPH. So speaking to them about PAE or FLA is a useless effort and will try to block his consideration of these treatments. Research will show him the truth about this.
It is a sad spot to be in and most of us are in it, or have been there. The growth of the prostate NEVER stops no matter what treatment you pick. But Michael has a lot of options and should have a lot of hope. FLA and PAE are not fully supported by the insurance companies as of yet, and the Urological Associations and Lobbies are fighting hard to keep it that way.
I wish him the best and know that diligence and research will give him power through knowledge. He can get a lot of leads and knowledge of other men's experiences on this site. But, in the end he should research and talk to as many doctors with possible solutions as possible. Only he can make his decision. Money should not, if possible be the first or most important consideration.
In studying this, If one uses logic, and can be shown how and why the procedure has success, then apply that logic to their specific situation, the chances for a good experience is very high. Ask to be shown HOW and Why something will work and ask the practitioner doing the procedure. Have them show you on your specific condition. If they don't have the time, effort or ability to deliver those answer then; you actually have your answer to their offering and you best stay away from them.
Eventually medication and/or surgery catches up with all BPH sufferers, unless you want to self cath which appears to be almost exclusive to the States.
In the UK the only ones I knew who used catheters did it as a short term measure while waiting for surgery. The American Forumites do it long term because they for various reasons want to keep their prostates.
Hi John, Good to hear from you! What's the latest you've heard about Rezum? Best wishes, Fred
What about ITind? iTind is an innovative treatment that can provide lasting relief from the urinary problems caused by benign prostatic enlargement (BPH). I had good results from a PAE and i am hoping that this ITind procedure comes to the US and is accepted, as i sounds non invasive and has had good results from what propaganda I have read. Steve
Definitely don't want A-Fib as a result of something that should be helpful!
Thanks Howard. I'm in that space of learning of all the options and trying to figure out a plan. Right now I'm on daily 0.4mg Tamsulosin that seems to work fairly well. I tried an experiment recently where I stopped taking it to see what would happen and it wasn't pretty. Up all night trying to empty my bladder, just not good. So it seems that my symptoms are hidden by the Tamsulosin and they are getting worse.
Urologist is pushing for a Urolift and I've read all of Kenneth's helpful writings. General doctor suggests increasing Tamsulosin to twice a day then adding finasteride which seems to have negative side effects like impotence which is not what I want.
I wonder if the prostate is "used" or massaged or somehow manipulated, does it release fluid which makes it smaller? Do our prostates increase in size as sexual activity decreases? It seems logical (i'm an engineer so I'm always looking for logical) but if so, is there something we can do about it? This is why I started this thread.
Once I try some at home therapy, I'll share my findings with the group.
Thanks for the detailed response. I commented above on my Urologist's advice but I'm not sold on it. You make a good point about doing something now rather than later when the bladder is damaged due to lack of clear path for drainage.
Curious, how do you guys know that your prostate is 125cc or 50cc or some specific size? My urologist seems to have guessed by size via DRE which doesn't seem very accurate to me.
I'm not opposed to traveling a distance to find a good Urologist such as the person in Virginia (USA) who has been mentioned on this website a few times. I worry that something invasive like the various types of TURP (cutting, vaporizing, cauterizing) will cause permanent impotence.
I find it funny (in a annoying way) that my urologist and primary care doctor have one solution each and don't ever offer to discuss all the options. My PC doctor even gets annoyed when I do research online and bring him new information for discussion. "I am the doctor!" is his reply! (yes, I need to find a better one soon)
I'm really happy to have found this forum website. Until now, I was limited to reading material from medical providers plus good whitepapers from researchers, not from real people.
Are most of you in the UK?