I'm 59 with an enlarged prostate (120 cc), which is 4x normal size for my age. I had an MRI-fusion guided biopsy 18 mos. ago that showed no cancer. Another 3T-MP MRI a year later showed nothing of suspicion. However, following my Bx in 2015 my PSA has shot up (10) and bounced all over between 5 and 7. Before the Bx, my PSA was between 3.5 and 4.5. I have tried every natural supplement out there, including DIM, IC3, progesterone cream, beta sitosterol, pygeum, maca, etc. Things have gotten worse since the Bx. My prostate might be too big for TURP, TUIP, but I might be a candidate for GreenLight, and open prostatectomy is an option. Anyone have any success with alternative medicine or is surgery 100% a given for a man in my situation? PS - I bled for weeks after the biopsy and my symptoms have only worsened. I won't go thru that again.
I tried natural supplements without a noticable response to my symptoms: flomax didn't help much either. There are many alternatives out there now so I suggest (if you haven't already) investigate each one to determine if the treatment fits your situation. PAE, Holep, urolift, etc. are all treatments but each man's situation is somewhat different. Have you had different opinions from different urologists? What do they tell you?
Had no luck with supplements. Highly suggest you research HoLEP, which proved to be excellent for me and a multitude of others with situations similar to yours. Open prostatectomy is a BIG DEAL with higher oportunity for side dffects i.e. ED and incontinence and a longer recouperation time. HoLEP is the modern day "TURP" and absolutely the best way to go in my opinion.
Have you considered PAE? It has a high success rate. Very few side effects. Check it out.
Further to my coment on HoLEP. Assuming you are in the USA this procedure is covered by Medicare. I don't think PAE is coverded.
Rx meds do very little and may cause side effects. Herbal meds are a scam and do nothing. Green Light is as bad as TURP, bloody for months. Do your research for the various procedures and get a second or even third opinion before you decide which is best for you. Remember that what has worked best for someone else may not be best for you. Everyone is different. Good luck.
I would go with the surgery where they do the blood embolism from the testicular area so you decrease the testosterone and DHT flow to prostate thereby shrinking prostate. You will still have prostate in tact and be able to have reproductive function. Do not do Greenlight , your sperm with go into your bladder.
Good advice, thank you.
Have seen two uro's. One recommended TURP last year, the other is more conservative and says to hold out on any procedure as long as I can. I did read that for very big prostates, TURP is a little riskier...and at 120 cc, mine is very large.
Flomax helps me urinate (normal flow) but I have zero libido. I can't use Proscar because of strong family cancer incidence, and Proscar can cause aggressive cancer type is some men.
I think I've taken over the last 6 months more saw palmetto than most men take in 20 years. Same for maca, curcumin, pumpkin seed oil, zinc, sitosterols, and on and on it goes....
I've tried every "natural" supplement in the known universe.
I'll check out PAE. And HoLEP. I dread having to do an open prostatectomy for BPH. I can see something that drastic for a high grade, local cancer, but for BPH? But if it means 20 years of misery or major surgery, that becomes a difficult decision.
wow, thanks James. Will definitely research HoLEP further.
I literally cringe when thinking about TURP and the thought of a week in the hospital and a week or longer with a catheter following open surgery is equally distressful.
Seems like decisions for BPH are harder than for cancer. If a man has a localized cancer, even aggressive like Gleason 9 or 10, then open prostatectomy sounds like an absolute lifesaver. But for BPH? Maybe too drastic. I wonder though if a surgeon can cut out 40-60 cc and leave me with a smaller prostate, it might be worth it.
Going to research HoLEP. Is that the same as "GreenLight"?
Yes, I'm in the US. Also, my insurance is good so I think I will be financially safe w/ any procedure I opt for. PAE could be too new for insurers to cover. From the little I've read (today) it seems minimally invasive - much less so than TUIP or TURP.
Thanks Craig.
Yes, I did a little digging today per your suggestion. It does sound very promising. I hope it catches on at major urology centers (like Mayo or Johns Hopkins) - in that case, the insurance companies will cover it and there will be much more data collected to compare it to TURP and other procedures.
And, the procedure does not sound that daunting (unlike TURP, which sounds very intimidating).
Unfortunately, I think you are right, Lester. I've tossed more than a few thousand $ at "natural cures". Have barely seen any improvement after 2-3 years.
Rx meds (Flomax, Proscar) have some brutal side effects. I tried Proscar years ago. But only for a short time. Flomax is still a drug I've come to depend on.
I bled for weeks from the biopsy. I dread having a TURP or any procedure thru the urethra.
Thank you.
Sounds like retrograde ejaculation. Even meds like Flomax and Proscar can have that side effect.
I've been reading up on the PAE procedure you mention. Does not seem like it's widely offered so far. It does sound promising.
Big cities U.S have it.
Being you have no cancer and you are fine there are many reason for your PSA to up and down. Try a less evsaive procedure first before youstart cutting away at the prostate. There are to many side effects from them. Don't get me wrong that sometimes you have to but why take the chance of causeing more problem. There was a man on here that was talk into have a turp and all it did is give him more problem. He has been leaking for over a year and can't get any help for it. Research some of the others first Please for your own good Ken
Thanks Ken.
I think I have some time to think this thru. A negative biopsy and then a year later a completely negative MRI is good news. And my PSA density is about 0.06, which it should be under 0.1.
I'm looking at PAE and HoLEP. I'd do open surgery as a last resort if symptoms worsen. I found an amazing surgeon but really would prefer not to undergo major surgery if there's no cancer.
I am concerned about undergoing a procedure and having more health challenges afterward.
These are difficult decisions.
Open prostatectomy is an option that you should not even consider for BPH.
I had an early version of GL PVP in 2005 for my 75grm prostate (when 71) It was a walk in the park. It was done far from home on a Friday afternoon and the catheter was out on the Saturday morning and I had expected to travel home by train that day. It took me until about noon to void a good amount and it was as red as it had been into the overnight bag. A scan showed that I was still retaining a large amount so they decided that I should stay for another night in case I needed help when at home.
It took me until the Sunday afternoon to void fully and be allowed to travel home. Really from the next day life was back to normal and I went to the races on the Monday.
Over time my prostate regrew to 135grms and I had a Thulium/Holmium laser procedure three years ago. It is rather similar to Holep in that they can obtain tissue for a histology report. In my case 37grms was sent off. This time I bled a I lot more after the procedure probably as I had been taking Warfarin and it was still in my system. The surgeon said that I could go home with a catheter and have it removed the next week. There were crossed wires on that and it was left in for two weeks and much of the time I was passing clots and debris. Once it was out my urine was completely clear. Volume was good and I had no retention but as after the GL I was not impressed with my flow that even now fluctuates and no reason has been found for it.
Frequency does not exist I can go hours without needing or thinking about going. No more going out with a toilets map in my head.
Gradually my night time needs went down from three to one
My PSA came down from around 9.0 to 0.74. Apart from the tissues sent to histology I don't know how much was taken away he just said 'A lot' When I last had my prostate checked two years ago it was 55 grams.
After GL where they did a bladder neck sparing version I had no RE. However after taking Tamsulosin prior to the Thulium laser procedure I was well on the way to it and the procedure did the rest.
HOLEP is done through the urethra. I'm the same age as you and my prostate is about the same size as yours. I was dead set on having HOLEP and it still is my second choice. Recevery time is reasonably short, no bleeding, low chance of ED. Biggest thing is retrograde ejaculation is just about guaranteed. I'm planning on having FLA done.
Michael
I am 65 years old and had a 125 cc prostate. I have dealt with it for over 8 years. I researched all options for almost 2 years. Tried many herbs and alternatives. Would not do the RX meds.
I would very highly recommend you look deep into Focal Laser Ablation. I had it done in the middle of December. I had a blockage of the urethra, nocturia, and a large median lobe that was causing retention. This was visible by the 3TMRI and a procedure was done in Houston that corrected all the symptoms in just over a month. It was safe, little to no blood at all. Would not preclude doing any thing else if it did not work. This procedure did not damage or enter the Urethra so no damage. There was no sexual side effects including no retrograde ejaculation.
If you have interest in hearing the specific details, you can personal message me or call me as I will send you my contact. The doctor I used was dr karamanian and you can look him up..
Hi Michael,
It's not just about prostate size or even prostatic obstruction, as your garden variety urologist might make you believe. So before even considering any one of the prostate reduction surgeries you mentioned, make sure you and your doc have done the homework..
What symptons are you experiencing? Do you know your IPSS (International Prostate Sympton Score)? If not, google it and take the 5 minute test. What diagnostic tests has your doc done? Have you had imaging studies, do you know your PVR (post void residual), have you had a cystoscopy or urodynamic studies?
As to natural supplements, I think you have answered your own question. You've tried them all and things are getting worse.
-- Jim