Hello Everyone - I posted this in another thread and thought I would start a new discussion with it. If you are a BPH sufferer, and you are overwhelmed by all the procedures being offered for your condition, here are some questions I used for myself as I pursued (and obtained) a solution for my BPH problem: **Will my bladder neck be touched/disturbed?** **Will my urethra be touched/disturbed?** **Will my sphincters (internal or external) be touched/disturbed?** **Will my nerve bundles be touched/disturbed?** **Will I get a short-term fix or a long-term solution?** Next, determine if the following are goals you want to achieve after the procedure is performed: A. Pee freely like you did when you were a young man. B. Continue being sexually active. C. Not have any urgency. D. Not have incontinence issues. E. Not get up multiple times per night. F. Not have to insert catheters up your penis. G. Have the ability to normally hold your bladder. H. Never worry about where the next bathroom is. I. Travel freely, whether to town or around the world. J. Not have to control your fluid intake regardless of the time of day or night. K. Not have to take any medication/herbs/vitamins to control anything to do with your BPH. Finally - "**Is all the above simply a fantasy/wish list, or is this really achievable?**" What I have shared above is about me, my experience 7-months ago, and the outcome I was able to achieve and the goals I was able to meet (yes, I met every one of the goals you see listed). You notice none of above ever mentions the terms **non-invasive**, **minimally-invasive**, **invasive**, or **radically invasive**. These terms scare us first before we ever get a chance to be honest with ourselves about what we really want for our BPH problem. As a result, we could be running away from the very procedure that gives us everything we want. Again, only food for thought. If the above is not where you are mentally or physically with your BPH problems, please disregard. To each his own. Dave **P.S.** My BPH problem was acute full retention with a MRI measured prostate of 265g (no cancer). I had a simple robotic prostatectomy (**NOT** radical), which is a shelling out of the prostate lobes like an avocado, leaving the prostate lobes intact. Access was gained through the abdomen (small robotic incisions), the bladder, and then into the prostate. Released from the hospital 24 hours after procedure and wore a foley for the next 10-days to allow bladder to heal. I do not take (or require) any medication for my now ex-BPH problem. If you would like further information, just private message me and I would be glad to share.
Hey Dave
I’m glad that you took the time to research your problem and I hope all was accomplish. The only thing you did not address is retro ejaculation. You talk about sex but that is only one function ( Have you gotten it back yet ) Hope all feels the same. The ejaculation is also a function
You had a very large prostate so you did not have many options to fix your problem. I hope you have get all your goal match.
Happy healing…Ken
In my case travel was pretty much a priority as our hobby was travel. Soon after my GL we went to New Zealand and travelled around by bus for a month. The buses did not have toilets and it was not a problem. Once on an all day trip to 90 mile beach I did need but fortunately it was at a scenic stop and while the rest were carting down sand dunes on trays I found a quiet spot.
Hey Buddy
Being we are all different We do what is best for us. We all have our own demons that we have concerns. Dave had a very large prostate what ever he was going to do was up to him. With it being so large the option are not to many. He picked the best to fix the problem
I’m glad that all is working out good for him and he had a good doctor that answered his questions and took care of him.
Take care all…Ken
Hi Ken:
Sex after the procedure was not a problem (i.e. erection, orgasm). As for retro ejaculation, right after surgery I assume I had it once or twice because after sex I peed and my urine was cloudy, plus I did not shoot anything out during orgasm. However, this has gone away. When I pee now after sex, my urine is not cloudy. I still do not shot anything out, but when cleaning up I can squeeze clear fluid out of my penis (Note: I had a vasectomy in 1991).
All my goals are met, which includes what I listed in my opening post (ejaculating fluid was not a goal). You are right, the size of my prostate limited my choices, which for me, was a blessing because I did not have to arm wrestle with all the choices and side effects.
Since going through what I went through, and reading all the issues and concerns on this forum, we all still have wants and goals. If we can maybe lead ourselves by staying focused on our wants and goals, maybe others will have a shorter list as well. Who knows. As you say, we are all different, but I cannot help but think we do not share similar wants and goals.
Dave
Hey Dave
I am very happy that it is all working out for you. You are the only one that has to deal with anything. You did your research and you had a good doctor
I hope it continues. Have a great day…Ken
You found the perfect doctor. Tell us where so we can all go there.
Hi Lester - I just private messaged you.
Dave
Hi Derek:
It is interesting how our BPH problems can start controlling our lives, especially peeing, or the management of urination. From May - August last summer I was on a foley and hated life. Prior to that I briefly experienced self-cath and had a terrible experience. In between I experienced urgency and getting up multiple times at night. I remember peeing weak streams every 1.5-2 hours around the clock. To be honest, I am not sure I ever emptied my bladder.
I remember telling my wife that I wanted my “normal” back. I was refusing to live this way. I felt I did not have to live this way. Amazing how motivation can focus us. I dug in and drove myself to a solution. Determination and being pissed off at my situation was a heck of a motivator for me.
Dave
Sounds like f l a . Not invasive. Real-time Vision with an MRI during the procedure sure activity, nothing gets damaged. Shorter recovery. But no Invasion on the urethra no Invasion on the bladder neck controlled removal of tissue wit accuracy up to 1mm.. Excellent procedure to consider. But please understand. Neither Your solution nor FLA or any other treatment will stop The cellular multiplication that happens with BPH. Do not let a doctor fail to tell you that because it is the truth. BPH is treatable not curable.
Hi J1208p:
You are right. “Cure” is a strong word. I like “best” answers to the questions I shared above.
I do not have experience with FLA, but I wonder which route they take to get to the prostate? Also, when the prostate mass is lasered, where does the removed mass go? Do they suck it out during the procedure or is it expected to be absorbed by the body? I have pictures that show my mass removed and it measures 4"x4".
Dave
, yes, here is a strong word. Fact is BPH is a cellular reproduction issue. No one understands why no one understands what causes it no one has any idea how to stop it. It is far too lucrative Define to cure and much more profitable to treat it.
, with regard to the two questions you ask about focal laser ablation, it is done through the rectum under Twilight anesthetic it is not painful and was not even uncomfortable for me I felt nothing. With regard to your question about what happens to the tissue, once the treatment is complete and the tissue has been lasered, it is removed by the white blood cells of the body this takes a couple of months to four months to be complete and yes symptoms improve over that time. This is a natural course and reaction of the body and as it is completed the prostate reforms its new shape.
The most important thing about f l a is the selection of the doctor doing the procedure. I have said many times and fully believe this is as much art as it is science. I am sure that is the same with the doctor that performs the procedure you chose. Removal of prostate tissue in any way without analysis, detailed study and the time it takes to determine what a good job is a foolhardy treatment. That is why Dr selection is most. My doctor had a secondary degree in biomedical engineering which I believe helped a great deal. What I like the most in my procedure is that it is done while in an MRI with real-time eyes on the tissue being removed. That, along with the accuracy detail level of a laser assured me in my choice that I would not lose sexual functions which was my number one priority. My prostate was 125 CC and I have suffered for 9 years. I had this treatment over 2 years ago. And still have the benefits that I wanted to achieve though I do realize the prostate continues to grow and cellularly reproduce itself.
For a non life threatening disease it certainly stops men from living a normal life. I had been told that mine was slightly enlarged ten years before it became a problem and to keep an eye on it.
The laser burns the tissue away. It also if properly done leaves a smooth surface within the prostate. A Uro once said to me that some early badly done ones were left looking like hanging curtains.
You should look at some of the GL and HoLep procedures on Youtube by Fernando Gómez Sancha . There are also some by Graham Watson who did my Thulium/Holmium procedure. In one where he did a demonstration in Germany he complains that the one they gave him was too small.
Hi J12080 - You and I are on the same page- Remove the mass and preserve the nerve bundles, urethra, sphincters, and bladder neck. I agree asking the right questions is a must. At 62 years old, we will have to see how much of mine grows back before I die (procedure done last year at 61). In the meantime, I need nothing for anything and I do not consider myself having BPH.
Dave
I should have said vaporises not burns away.
I read your private message. It would be nice if you could post it publicly so that others could see it and comment on it.
Hi Lester - I could, but I do not know if it is okay to share referral kind of information publically? Privately it is just between you and I, or anyone else that would like to engage with me. Can a moderator rule on this?
Dave
Hi Derek:
I had the same experience. I was told back in 2008 that I had a large prostate. My Uro then performed two biopsies between 2008 and 2009 (this was his go-to procedure). I got tired of being poked and swore off Uros for the next 10-years. Then all of a sudden, acute retention, and it hit me quickly last year. Plus my large prostate became enormous over the 10-years. While ignoring our prostate is not ideal, I figure the 10-years removed all the intermediary steps that I might of tried and the acute retention took me right to the place I needed to be.
Yes, not life threatening, but when you cannot pee naturally and normally, life changes fast. This is a bodily function we should never have to think about. Retention and ER visits are no fun.
Dave
I have seen a lot of it on this site but if the moderator objects it will not be seen.