Salut à tous les membres du forum Ozzie et autres... conseils/expériences, s'il vous plaît

Santé des hommes
1

I realise some of your posts are 2-3 years old but I’m hoping to get some advice…so here goes

Like most of you here I’m at an age where a slightly enlarged prostate is starting to affect my life.

Up 4 times a night, slow flow etc.

From my research PAE may be the best place to start for the following reasons.

1 If I’m a suitable candidate it can be repeated if necessary
2 It wont interfere with future more invasive treatments at a later stage
3 Its minimally invasive
4 The danger of side effects (incontinence, dead dick) are greatly reduced.
5 General anaesthetic would be good if possible :slight_smile:

I’m 63, in good health, and work as a self employed private tutor.

I sit approx 2 feet from my students so urinary pads, catheters, leg bags, are out of the question.

I’ll never get to retire so I have to work till I drop. But it’s enjoyable low stress work that provides a solid income.

So minimally invasive is good!

I would like to travel next year and my current condition would make this tiresome and less enjoyable.

PSA is not elevated over my normal 3-4 year average, other cancer blood tests show no cancer markers, and ultrasound shows no problems other than slightly enlarged prostate protruding into the bladder.

My GP has put me on Tamsulosin which have helped a little with the slow flow at night. It does affect my gym workout however as my muscles feel a lot weaker. I would not like to be on this long term.

I notice that some of you are using supplements…do they work? or is it placebo effect?

I’m on a serious campaign to lose 20 kilos (lost 6 so far) but I think weight reduction to ease a prostate problem is probably wishful thinking.

I am seeing a urologist next week to take investigate further and rule out cancer but am optimistic. I understand that other bladder ailments may also play a part…hence the urologist visit 1st.

An MRI should help.

I am 20 minutes from Liverpool hospital and depending on further tests with consider going down the PAE path. If my urologist is anti because not he’s getting a cut (pun intended) then I will move straight to PAE for an evaluation.

From what most of you have reported I have little risk and everything to gain with PAE as a 1st intervention therapy.

What say you all?

2

Hello Bob

First of all. Welcome to the forum. I hope we can help you with your problem. All of us on here have had different procedure we can only tell you what we feel would be good. On the PAE you are not put out so no general. They will give you a IV to make you feel relax but that is it. Maybe someone that had the PAE will tell you about it.

Now I myself had the Urolift done. It has been 3 1/2 years and the clips are still in the same place. If I need to I can have a few more clips put in but for now I am fine. And if I need to the clip and the string can be removed. The anchor can’t but it does not stop any other procedure. It is the only procedure that has no side effects. 100 %

They say you should start out with the lease evasive procedure. Urolift, Rezum and PAE. Please look into everything and give your self some options.

Take care…Ken

3

Many thanks for the welcome and reply Ken.

Rezum is reasonably new in Oz but I am investigating that too.

4

Bob

All I try to do is get men to research and give them self options. Look at the pros and cons of them all before you pick. I do know they do Urolift and PAE over there. Good Luck…Ken

5

Hello Bob,

You are going through what many of us our age experience…this constant feeling to go…seeing the GP or an urologist who recommends Tamsulosin, PSA check, eventually Biopsy to rule out cancer, Turp is the gold standard.

After my experience, do not wait, go for a minimally invasive procedure, which can be Urolift, PAE, Rezum, PVP. It all depends on the size of your prostate and the presence of a median lobe. Your urologist will be able to take the right decision.

I had surgery a year ago and I am so glad I did it. My life is back to normal. The outcome is not guaranteed and if you read all these comments you will hear all kinds of things. But, if you believe and trust your urologist, I would go for it. Being on pills is not the solution. After surgery I did see an immediate result of better flow, had to work against incontinence for a short period of time and which I got under control, need to go up normally once during the night. The reason is that my bladder capacity shrunk over the years of enforcing the bladder. I waited way too long. My advice to everybody is, to get help and do the surgery. If you are lucky all goes perfectly well. Risks are involved, no doubt, but life with not being able to relieve yourself easily is a problem in the long run. Good luck!

6

Hello Bob:

I come from the other end of the spectrum. I went with an “invasive” approach to correct my very large prostate and retention. In August of this year, after a summer of indwelling catheters, I had a Simple Robotic Prostatectomy (SRP), and have no regrets. Actually, it was the best thing I have ever done for my situation. In turn, and speaking from the scary side of invasiveness, I am one and done. I do not take any medications and I am peeing like never before. BPH and retention are no longer ruling my life.

In all fairness to your condition (and yourself), consider all corrective surgeries to include what might be considered invasive. Do not just concentrate on all the minimally invasive stuff. Make a pro/con list and compare all to what you want afterwards, and for the rest of your life.

Best to you,
Dave

7

Hi Bob,

I went with PAE for many of the same reasons you listed. I wasn’t under general anesthesia but something called twilight sedation, the same that’s usually used for a colonoscopy. For me it was the same effect as with general: totally out, no memory of anything.

If you do opt for a PAE, my strong recommendation would be to go with an interventional radiologist who is very experienced. I’m in the States, so can’t help with AUS recommendations.

Happy to answer any other questions.

Rich

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Don’t know why the formatting is getting so messed up. Here’s my post again:

Hi Bob,

I went with PAE for many of the same reasons you listed. I wasn’t under general anesthesia but something called twilight sedation, the same that’s usually used for a colonoscopy. For me it was the same effect as with general: totally out, no memory of anything.

If you do opt for a PAE, my strong recommendation would be to go with an interventional radiologist who is very experienced. I’m in the States, so can’t help with AUS recommendations.

Happy to answer any other questions.

Rich

9

I had HOLEP surgery on the 18 December 2018 and my experiences and progress are virtually the same as yours. Not “p*****g like a racehorse” yet but I plan to watch the racing channel on T.V. for inspiration :smiley: There has been a small improvement in flow however.

Like you I was dreading the catheter and it was about what I expected…uncomfortable and inconvenient but no particularly painful. A couple of Endone took care of any slight pain. It stung for about a couple of minutes after removal. The worst thing about the catheter is feeling like a pinned butterfly…I don’t know how people endure it for 6 days with Rezum and Turp etc.

For all the Australian readers I had my surgery done by Dr Kayvan Haghighi at Campbelltown Private Hospital, and I have nothing but praise for his professionalism. He checked on me twice a day while in hospital and rang me at home after my discharge.

My bladder was being blocked by a median lobe protrusion. My prostate was relatively small and while my symptoms were not severe I could see that they would progress. So I opted for surgery sooner rather than later.

I suspect that I may need bladder retraining to get the full benefits of this surgery…but time will tell. An ultrasound did reveal some thickening of the bladder wall and scarring.

I’m hoping that given time my bladder may make a partial recovery.

No prostate pain as I type, and very little leakage. A slight spot of blood in the pad occasionally, but nothing in the urine.

It’s a little disappointing not to get and instant result like some people have reported but we all vary of course.

10

I’m trying to line up these posts as a continuation of my 1st post but I don’t know if it will work.

Anyway…the 15th of Jan 2019 will mark 4 weeks since my Holep surgery.

Thing are improving all the time…flow is vastly improved and is continuing to improve.

Blood in the urine stopped just after week 2…then started again about a week ago. My Dr told me this would happen as the scabs dropped off the site of the removed tissue. It’s just a small amount at the beginning of the flow; then it clears. This will continue for a little while longer I’m told.

Urination is not painful at all any more and as I said flow is quite strong at times…depending on how much I have drunk.

No incontinence to speak of although I occasionally get urgency from time to time. The quack said this would happen for a while and then just stop suddenly one day.

NO RE!!! In fact ejaculation is much stronger than before the procedure.

The surgeon told my he was very careful and didn’t just go for broke during the procedure…This, coupled with the small size of my prostate (46cc)
has combined to give me a good outcome (RE would not have bothered me at all).

The only thing that have not improved dramatically is the night time trips to the loo. It’s went down from 4-5 times to 2-3 so I’m hopeful my bladder will adjust. I certainly seem to be emptying my bladder fully now. I just seem to have a lot of night time urine. I will be following all of the Nocturnia advice on this forum as well.

Another 10kg weight loss would probably help my bladder too.

Just a post to give you my experiences with Holep.

My Uro practices Turp, Urolift, Holep and full robotic removal if necessary.

I asked him about PAE and he was quite happy to refer me to his colleague at Liverpool hospital…but in his opinion he though his college would not feel I was a suitable candidate…especially as the median lobe protrusion was quite visible on the ultra sound. He said he’s waiting for his colleague to do more PAE procedures and has more data before recommending it over other procedures. He certainly wasn’t anti PAE and has referred some of his patients for PAE evaluation.

Anyway…so far…so good.