comparative diagnosis? how to deal with conflicting opinions?

Kidney and urinary tract
1

I have been diagnosed about 8 months ago with Benign Enlarged Prostate.

Med. treatment (Tamsulosin) worked to some extent. About 3 - 4 weeks ago its efficiency stopped.  Back to symptomes. 

Now comes my dilemma:

One doctor (Urological surgeon) proposes Green Light Laser Prostatectomy

Another one (Urological surgeon) diagnosed Urethral Stricture and suggests Dilatation.

Symptoms for both conditions are very similar:

Painful discharge, Urgency, Frequency, weak flow etc.

Suggested treatments are very different but both unpleasant enough.

Any ideas?

Any similar cases?

Any advice? 

Thanks.

2

You really ought to google these dilation procedure for strictures and ask your surgeon where the stricture is located and it's length in cm. I had a 1/1/2 cm membrane inside my urethra, but that's not the same as a stricture. Dilation is just inserting sounds of increasing diameter into the urethra to tear open the stricture. If they don't work, some surgeons recommend uretha reconstruction which I would stay away from as it involves removing tissue from the inside of your cheeck to graft to your urethra. In Cina they gave men suffering from strictures a large steel chopstick (about 24 Fr) which they inserted in their urethra once a week for more than a year. Strictures are tricky, and cure rates are not great.

They often re-occur regardless of treatment.

I'd also ask the GL surgeon if you have a urethral stricture which you were told on your second opinion. If the stricture is not in the part of the urethra that is in the prostate thaen the GL won't do anything. If it's in the section of the urethra that is inside the prostate, then the GL would get rid of it along with the prostate tissue.

3

Thanks for reply.  Google was the first thing I did. But the situation is rather complicated: 

I am residing in Thailand. Thai Urologist listened to me looked at PSA levels and palpated the prostate. His categorical opinion Stricture - Dilatation next week. That's it - no ultrasound, no idea where it is, whether it really exists, how long it is, why it has formed?   etc.

I am a bit wary...

A Urologist from my country didn't see me. But on the basis of described complaints and the same PSA formed opinion that it is a BPH and intends upon my arrival use Green Light Laser Prostatectomy.  I am equally wary...

4

Maybe it's time to seek out recommendations from your friends and relatives for a third urologist?  Good luck.