Looking for BPH options

Much has already been discussed.  Like many other readers i am dreading TURP or Laser for the fear of retrograde symptoms.   I had my problem at 45 and I am 49 now living with the problem with varying degree discomfort including occasional blockage.   My size is approx 80-100gms.  I am considering options of TUMT or UROLIFT.  

I am currently in Delhi, India and I need a doctor recommendation for this either in UK or USA because i dont believe these procedures are performed in India.   I am taking Saw Palmettor with Flotral.    Symptoms are getting worse and cannot be wait much longer.   Appreciate your inputs.

There are indeed many hospitals in the UK that do these operations, but the waiting lists seem to be 18+ weeks (I am presently trying to find one that is shorter).

Private treatment is supposedly quicker, and costs about £5,000.

I believe such treatments are indeed available in India, and at a much cheaper price - I've been quote $3K - $5K. The surgeons say they have a good experience - one mentioned 15 per month. So I'd have no problem going there to have it done; but there's the visa problem (I understand it can take weeks).

The two surgeons I had reply from are in Mumbai: DR N Anandan MS.,FRCS.,Dip Urol ( London)‏,  quoting $5K; and Dr Sanjay Pandey,  quoting $3K using holium laser (which seems to be the best treatment).

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Dr. Marcus Loo in Manhattan, New York City, USA

I had a TURP 4 weeks ago tomorrow, and today I gave it a run to see if there were any complications like retrograde......and in my case I can confirm there is retrograde.  Very weird feeling but I can live with that as it's still better than the alternative, full retention or retrograde is an pretty easy decision to make!

Go to a Urologist and have the prostate scoped thru the urethra to determine if it has a third lobe. If none the uro will check size of the prostate vis ultrasound thru the anus. Neither procedure is painful. In a half hour you know if you qualify for urolift. If there is no third lobe and the prostate is less than 100mg you should qualify for urolift. Then look up an American-born Indian urologist in San Antonio, Texas by the name of Dr. Naveen Kella. He has done the Urolift procedure with great success. Good luck!. 

Dear Samdelhi:

My case is somewhat similar to yours. However, size only 63 grams.  I am 56 years old and just had turp four weeks ago.  My urine stream improved drastically.  I was taking Jayln once a day, medication used in the US for enlarged prostate. I am recovering now and my post surgery symptoms has improved.   Don't be concern about the Turp procedure.  It is a one day thing with no pain.  If you need further info about the procedure in the US, please let me know.

Good luck  

Read more about TUMT berfore opting for it, it is an old procedure that does not have a good outcome compared to TURP or the Laser versions.

A lot of Laser surgery is done in India with health tourists from Europe and America coming to take advantage of lower costs. If the surgeon can do  a bladder neck sparing procedure you should not suffer from retro.  

Google found a lot of Indian medical papers about Urolift but I did not search out surgeons doing it. Remember being a new procedure there is no long term data on its sucess.

There is plenty of data on urolift to indicate that after two years the positive effect is the same as at 60 days. To me this indicates that it will be effective for at least five years, probably longer. The unquestionable benefit is that it will keep you off the meds for years. Once you take the meds your libido declines, retrograde ejaculation sets in permanently and ed is your permanent condition. Buy yourself some time. If urolift is possible for you it will do exactly that. 

Thanks Ron.    Thats encouraging information.   I would be looking for doctors who have performed this procedure for some period of time. Also this procedure is limited to few countries in the west.

Thanks Derek.  I will discuss this with my Urologist. 

Thanks Ron.  I will contact  Dr. Naveen. 

Thanks. I will reach out to him.

Something that I fail to understand!

"The UroLift System relieves prostate obstruction and opens the urethra directly by retracting the obstructing prostatic lobes without cutting, heating, or removing prostate tissue. The Delivery Device transurethrally pushes aside the obstructive prostate lobes like opening window curtains. Small permanent UroLift Implants are deployed, holding the lobes in the retracted position, and thus opening the urethra while leaving the prostate intact"

 BUT that cannot prevent it from continuing to grow.

moves the prostate to stop/reduce pressure on the bladder but surely it it does not prevent it from continuing to grow.

No, it will continue to grow just as it does with turp, tump, tuvp, GL or any other method that removes tissue opening up the urethra path. They are all temporary, five to ten years I believe and many times less than that. The beauty of urolift for those who qualify is that it is a very minimally invasive procedure that brings immediate painless relief without retrograde ejaculation or any of the possible side effects of the cutting or lasering procedures. No ED at all, no downside at all.  It's simple, the prostate has a strong membrane capsule surrounding it. The stitches pierce this membrane and the Doc tightens the stitches compressing the lobe away from the urethra. The procedure is being conducted around the world and is proven to be as effective after two years as after 90 days. This certainly indicates that it should still be effective for a number of years. To me it is an easy way to get immediate relief, buy some time to allow for more advances in BPH relief technology and above all in my mind, eliminate the need for the BPH meds which within a year or so turn you into a girly-man. Permanently. If you meet the qualifications for urolift and you are contemplating meds instead realize that the meds will emasculate you in short order. If you don't mind that then take the meds, they will work for a couple of years or so then they don't work anymore and you are again facing surgery, except now you are facing surgery and ED simultaneously.   

Dr Naveen Kella, San Antonio, Tx. He has done at least two dozen procedures by now. Charges $2500 flat fee including anesthesiologist and all other fees. I have met him, a very nice man and accomplished urologist. 

When I first found that I had an enlarged prostate in 1994 I waited for something better than TURP. First it was TUMT, cyrosurgery and then various laser procedures. So after twenty years there is still not a good answer.

The only way to stop it regrowing is a radical prostatectomy  with all that ensues.

To relieve the symptoms retro is a small price to pay.The feeling's the same and it's less messy.

When you masturbated as a boy did it suddenly feel better when something spurted out and surprised you?

Now here is a switch I hadn't heard anywhere before. I have stated some of this on another forum so I may be repeating. I went to see my uro a few days ago with a new low PSA report in hand, good report on my kidney function so although I'm retaining 450 or so ml after voiding, so far at least I haven't hurt my kidneys by backing up from a too-full bladder. I went to a urolift uro a couple of months ago and he advised me that my third lobe and 114 mg prostate would disqualify me for urolift.  So I sat down with my uro fully expecting that he would state that tuvp would be necessary befor long. (he does tuvp rather than turp, says it makes a cleaner, quicker-healing job). But he surprised me saying that he has a colleague with the firm who I think you should go see. He does an entirely different sort of procedure. I saw him in four days and he agreed that his procedure would work better. He makes an incision beneath the navel, another into the bladder and cores out the prostate through the bladder neck from the inside leaving the outer capsule with all of the nerves untouched. He said the upside is that it is a permanent fix as there will be no more growth and adverse side effects are less likely than turp, tuvp, tumt, GL etc. It's a one-shot lifetime solution. The downside is that it is a more radical surgery and since it is done through the bladder neck there is some stretching and recovery of the bladder sphincter with some amount of incontinence until the bladder neck recovers. He noticed that I have a navel hernia (an outie in laymen's terms) and said he could fix it while was at it. I asked if he could also graft on four 4 or five inches of tallywacker from a donor but he stated that there is a limit to the advance of urology although it has been dramatic. I told him I would get back to him.     

Hmm, 450 ml left after voiding sounds like a lot to me, I think I was leaving about 300 ml after voiding and that was enough to push me up the priority list for either the GL or TURP.  

Once they got in they decided TURP was the go for me.

 I have been wondering if they would ever be able to do keyhole surgery on the prostate. I automatically just thought that going in through the bladder could possibly have it's own set of complications later...but of course I dont know!

However being able to get your hernia done at the same time sounds excellent, this guy sounds like he's a bit of a 'one stop shop'! wink  

Good luck mate.

Well, you know I have had the hernia for 76 years and it has been no problem other than girls saying ooooo,  what in the world is that? OK it's gross but fixing it is not any kind of a priority. 450 ml is a lot according to everyone but it isn't bothering me and all my signs are ok. I'm just floating along in a lot better condition than I deserve. I guess I'll just stop up one of these days but not to worry (as you would say) as I have a catheter in my ball cap. Piece of cake.  

I dont know what to say! 76 years (is that a mistake) with a hernia doesnt sound too entertaining!

I know very little about the prostate problems we can develope and the way they are dealt with, but I am almost sure if I were to be still holding 450ml after voiding I would of been regarded as urgent here (Australia) and probably rushed into surgery. For example,  when it was time to take my catheter out after having full retention, they said I was going nowhere unless there was 100 ml or less after voiding. That had to be done 3 times and if that couldnt be achieved then I was going to have surgery next day!

As I said I'm no expert on which way is best or who is better,just passing on my experiences.

Please keep us informed on what you decide on doing as who knows whats around the corner for any of us.