Possible BPH, looking for advice

Men's health
1

Hi there. I'm 30 years old, and for the past 6 or 7 years I've been having problems when urinating. It first manifested as recurring non-specific urinary tract infections (which I'm told were the early symptoms of a bladder neck obstruction, probably caused by an enlarged prostate) which eventually settled into a long standing problem where it basically takes a very long time to finish. I'll feel as though I've emptied my bladder but if I wait long enough, more comes out (despite having no real sensation of still needing to go). I've found a couple of ways of encouraging further flow but it's still long-winded. If I get up and leave the bathroom too early I get dribbling, sometimes quite bad. It makes being intimate with my girlfriend kind of awkward because immediately after going to the bathroom I don't really want to risk her feeling anything.

I've tried both alfusozin. At first it worked great, but eventually the effectiveness wore off and all it did was give me massive headaches. I then moved over to tamulosin which again...wasn't terribly effective and resulted in retrograde ejaculation. Now I'm on Saw Palmetto which is reasonably effective but seems to wear off quite quickly. I basically have to choose at which time of the day I can afford to be in the toilet for 30-60 minutes.

So I guess my question is if there are any foods I should stay away from, or any other triggers that I might be able to address to get this under control? I don't drink. I'm a social smoker. Maybe 5 days out of the month. Apart from being partial to a good cup of tea/coffee I don't partake in any other substances.

Really desperate for some advice here. I recently cancelled an operation that I was scheduled for on the grounds that I was quoted a 50% chance of success, and the possibility of incontinence and re-constructive surgery if it goes wrong. Not what I want to be putting up with at 30!

Sorry for the long post. I'd be massively grateful for any help anyone can offer.

2

Your problem is with prostate or hyperactive bladder,this is not clear,But i can tell you from which you should stay away from.

1.Smoking,this could irritate the prostate or bladder!

2.Limit Tea/Coffee intake as this can irritate the prostate too!

3.Increase your fluid intake,i know u need to go to Loo several times but still!

4.Go to gym,exercise daily!

Is there any operation for Prostatitis???If there do let me know.

I would like to know your history in detail,its sad to know you are suffering from so long.I'm actually also a patient with same urinary symptoms so can understand quite well.

Have a good health bro!!

3

I'm 54 and was diagnosed with BPH a few years ago. I had been having similar symptoms to yours for some years ... probably since my forties. I was also on Alfusozin for a couple of years but my urologist did tell me its effectiveness would diminish over time.

I ended up having a TURP in November last year. I had all the typical post surgery side effects that did last for a few months ... bleeding for a few weeks, discomfort, bladder spasms, urgency and frequency. When the bleeding stopped, that's when the urgency and frequency kicked in . I was rushing off to the toilet every hour ... many times I would have to rush back after 5 minutes..It was like peeing razor blades. I was starting to wish I never had the procedure.

I was put on Vesicare to help with the urgency and frequency. It didn't help much to start but then they doubled my dosage. That certainly helped and the urgency and frequency started to back off.

After 12 weeks I was pretty much back to normal. I can now pee like a horse, no dribbling, no getting up at night. It's now 5 months on. I don't take medication anymore and I'm really happy I had the procedure. The possible side-effects are always a concern and the doctors are obligated to let us know. It's only a decision you can make. I'm surprised you were only quoted a 50% chance of success ... maybe there is a bit more to your problem. I would definitely get a second opinion. Whilst my surgeon told me of possible side effects, he also said he was absolutely confident he could fix me up and I would never have to be done again. All the best.

4

I am posting the following on every prostate-related forum on the web hoping to find patients who have experienced the UROLIFT procedure for BPH. Please reply if you have had the procedure. THANKS!!

UROLIFT - .Method invented in California about ten years ago and used around the world in the last few years but not approved by the FDA for use in the US until September 2013.

Not used in large numbers the US since then probably because it wasn't approved for reimbursement by Medicare and Medicaid until March 2014.

From what I can discover, this procedure is the future of prostate symptom relief, will supplant TURP, TUMP, Green light Laser, all the various medications, herbal supplements, etc.

There's a wealth of info and videos about Urolift on Youtube so I won't detail it here, but in a nutshell it is minimally invasive compared to TURP, the current gold standard, or any other procedure. There is actually no incision, just a few stitches placed in the prostate to draw the lobes of the prostate back from the urethra. Studies indicate effectiveness at least the end of three years after the procedure. No longer studies have been done but are in process.

I am interested in the procedure because there have been no instances of retrograde (dry) ejaculation, no instances of loss of erection or any other sexual function. They just simply stitch the prostate back away from the urethra allowing all normal functions to proceed.

It will not be done in some cases; if the prostate is too large, i.e. 80-100cc seems to be the world-wide limit in size. Also, if the blockage is caused by a center lobe of the prostate the procedure cannot be done.

My purpose in initiating this thread is to receive input from post-operative Urolift patients from around the world. It seems to have been adopted most extensively in the various countries of Great Britain but the procedure has been done throughout Europe and the Far East as well. I believe that there has been more activity around London than anywhere else.

I'm a Texan and I know the procedure is being done in Dallas, Houston and San Antonio, possibly other locations. I'll go to one of those world-class health centers an know that I'll get the best of care. I will not find a Urologist who has done hundreds of the procedures. I doubt any US Dr has done more than a few dozen, but if the procedure is as simple as it is touted a lot of experience is not necessary.

There are at least a hundred posts on the internet about the procedure. Every single post has been extremely positive but every one originates from either the manufacturer of the device; Neotract, or Doctors who are performing the procedure and are seeking more patients. Not one review by a person who has had the procedure.

There are at least hundreds, maybe thousands of you out there, guys, from around the world, and there are millions of us who are suffering the same symptoms that you have had and we hope you are relieved of now.

What we want to know is; is there really very little pain, possibly going home in a day with no catheter, a 9-day recovery period of any pain or bad effect from the procedure, no retrograde ejaculation (dry) , no loss of erection, no medication to shrink the prostate, etc?

For myself? I have had symptoms for thirty years or longer. I did lots of supplements and debunked all of them. I've done all of the various meds prescribed by my urologist, who has been excellent for years, but had no knowledge of urolift when I brought it up to him. I have been on Jalyn, a combination of two separate meds for about 16 months and it eliminated most of the frequent urination problems until recently. It's not working well anymore. I helped it along at night by taking two Motrin PM tablets (a sleep aid) at bedtime. That stopped the tiny urges from waking me up and for a year or so of taking Jalyn I didn't get up at all at night and had a couple of minutes every day to find a bathroom. So it really solved that problem but it killed my sexual desire and ability. I gave myself Testosterone injections to keep things working somewhat but not really well. (Builds muscle nicely in a 75-year old though!)

Incidentally, I'm now dependent on the sleep-aid so I'll have to deal with that eventually.

Let's see if we can get a healthy dialog going about this procedure, it may be the best thing since Viagra for all of us!!!!!

Thanks for listening!

Ron

5

Hello Ron,

I had the Urolift Feb 1st of this year by a doctor in San Diego. I was the second guy that he did the procedure on. I was worried at the time about his lack of experience but the inventor of the procedure was at his side which releived my anxiety. I am 62 years old and had BPH symptoms for 15 years. The severity of the condition required that I get up 4-5 times a night. I had a PVR of 100+ mls with no sensation of complete voiding, i.e every trip was an incomplete trip. I avoided liquids but was constantly constipated as a result. It is quite a simple procedure as you say and by my doctor's own words. It took all of 10-15 minutes and I had no negative side effects whatsoever. I took Phenazopyridine for the dysuria after the procedure, which eleminated the pain 100%. Why all urologists don't recomend this med for dysuria is beyond me.

So currently I make one trip per night and the stream is strong. The sensation of fully voiding has returned. I did not have a large medial lobe (rare according to my doctor) via cystoscopy, with a prostate gland size of approx. 40grams.

I put off for years any intervention for my BPH after reading about the possible side effects of TURP and was prepared to go to Europe until US FDA approval of the Urolift in Sept. of 2013. Then I had to find a doctor that I trusted. I feel very fortunate as BPH is no longer an issue. Life has returned to normal again

6

Thanks, John. I really appreciate your input. Now I have heard from two recent, post-procedure patients and both are positive. Very encourageing! I hope I hear from some more and I'm glad to hear the procedure is working for you.

I had an appointment to see a urologist yesterday, I thought for the purpose of his scoping out the bladder and prostate to see if the size  (less that 80mg) and configuration (only two lobes) was proper for the Urolift procedure. Nope, only got a digital exam (yep, you have an enlarged prostate) Duh. Like I haven't been going to my regular urologist for seven or eight years and three others before that. All these records are available but not obtained.  So, I go home having accomplished nothing and am scheduled to return in two weeks. Oh, the PA  (didn't actually see the Dr) told me that they will ask for a $2000 payment upfront as insurance and Medicare are not yet approved for the procedure. I advised him that Medicare did approve the procedure last month but he was not aware of that and I don't think he believed me. So, now I have to obtain evidence of Medicare coverage from the medicare folks and provide that to my Doctor. Or pay $2000 up front and hope I can get reimbursement from the Feds.   I hope others suffering from BPH will gather some insight from our pioneering and can just cut to the chase.  The procedure appears to be a godsend and I suppose I shouldn't be surprised it we have some growing pains. 

We have a real-world source of information here, BPH sufferers! if we can get feedback from a dozen or more other post-procedure UROLIFT patients we will begin to get an idea of how quickly recovery usually progresses, whether medications must be continued and what realistically we should expect in regard to sexual ability, retrograde ejaculation, etc etc.   

7

Hi Ron Texan,

My brother's uroligist Dr. Claus G. Roehrborn at UT Southwestern in Dallas did one of the research studies on the urolift procedure.  My brother was not a canidate for this surgery because he had already had a TURP and a large medium lobe.  Dr. Roehrborn is a professor so the only down side is that you might have your urolift done by a student doctor.

I have BPH and live in Oregon and am hoping I qualify for this procedure (hope I dont have the large medium lobe).  

Have you scheduled your procedure yet?  If so please let me know with whom and how it works for you once you've had it done.

8

Hi Terry, thanks for your reply. I really hope we can get a discussion going among BPH sufferers. Urolift is being touted as the best thing for BPH that has EVER been developed. I'm scheduled this week to have the exam to determine if my prostate is too large or has a median lobe. These conditions eliminate Urolift as an option and leaves one subject to Turp or laser or some such very questionable (at least in my mind) procedure and is to be considered only as a last resort.

I would like to relate here my experience, hoping to encourage others to chime in. 80% of us will eventually suffer from BPH and we can certainly help each other.

Here is my experience. I suffered from BPH for 35 years at least. I'm now 75 and otherwise I can do anything most 50-year olds can do. I mean anything. I have been seeing urology specialists for at least 15 years. I did the Saw Palmetto thing, all of the supplements (medical breakthroughs, just send your money guaranteed) that come and go. In my opinion anything over the counter is totally useless. I've tried them all. My urologist, who incidentally believes in treating with meds as long  as possible and surgery such as TURP only as a last resort and when the patient decides it is time. Undergoing TURP is not easy, it is painful, can have dire, I mean DIRE, PERMANENT consequences and takes months to recover even if you have no ill side-effects. I love the way my Doc has handled my case; first one med for years was sufficient, then switched to another which was ok then finally to, currently, I am on Jalyn which is a combo of two BPH meds which work in different ways. Side-effects are loss of libido, loss of sexual ability, retrograde (dry) ejaculation etc. Wonderful, right? Ok, you're asking why is a 75 year old worrying about his sex life? Well, I have a gorgeous younger wife and I told you I can do anything a 50-year old can do. My Doc gives me a prescription for Testosterone injections  which I do myself and in conjuntion with Cialis I'm able to function sexually despite the damned Jalyn. It also helps an old guy build a body in the gym which would be the envy of most 50 year olds. Nuff said - I may get old but I'm going kicking and screaming.

My urologist didn't tell me about my latest BPH treatment discovery; I have been taking CIALIS for as long as it has been on the market paying what $15 per pill?  Our friends in India started producing a generic Cialis very soon after and sell it on-line or thru the pharmacy you hear advertised on Fox news or other TV-radio for $2.00 per pill. I've been buying that for at least eight years or so and using it whenever needed. The one I'm taking now is Eriacta and it works fine. There's others, I've taken at least three different ones. They all work.  Recently we've all heard about "Cialis for daily use" then I heard that those who take this drug every day are having reduced BPH symptoms!!!. So, I cut my Cialis pills in half and take one every day - Eureka!  It really helps a lot. I'm still taking Jalyn too and my symptoms are reduced to being unconsequential, at least for now. And it helps with my sex life too.

Ok, about the testosterone if you have BPH - if you have prostate cancer the testosterone may make it progress faster, So, you must be under constant care of a urologist if you are taking testosterone and also have any kind of prostate problem. Testosterone does not cause prostate cancer, though. To me the benefit of testosterone far out-weighs any risk, and my urologist is taking good care of me.

Oh yes, there is also this problem of how to pay for Urolift.

So, far the Doc I'm going to for testing to see if I am a candidate for Urolift is not accepting Medicare and medicare supplement insurance. Just charging cash on the barrel-head and having plenty of takers. he says medicare has not approved Urolift. Yet I read on the internet - Google it- that Medicare has approved it and issued billing codes, etc. I don't know but will find out this week. I'm limping along ok with my Cialis, Jalyn, testosterone, etc etc etc.so I don't see paying out of pocket for a procedure that has been approved bt medicare. We'll see and I will post here when I know.

OK GUYS, or girls who may be researching for their guys, I have told you more than I have told anyone, bared my condition to the world, I have opened eyes of many BPH sufferers who read these posts. I act like I know it all, but I don't, there are others out there who can help me and thousands of others if we'll just use the most amazing communication device ever contemplated; the unbelieveable internet. I come from the encyclopedia generation but I have adopted the internet and I"M DOING MY PART!!. Let's help each other.   .          

9

John, your urologist and his staff know if Urolift is covered by Medicare. Can you find out? See my other posts.

10

Terry, your Urologist knows if Urolift is covered by Medicare. Can you find out and let me know? Trying to gather pertinent information of all sorts related to BPH and Urolift. 

11

If it is TURP or Laser that was recommended for you, ask about Urolift instead. Youtube Urolift. Good luck

12

Paul, I have several posts on this blog that relate to your problem. Read my posts, you'll learn something. Reply here so we all learn from your experience. But, I would say, drop the saw palmetto, get Jalyn thru your doc, get on cialis, half a pill every day. Your problem is not diet but there are solutions. Inquire about Urolift. Let us all know.  

13

Ron,

In my case, the out of pocket expenses for the Urolift were trivial compared to the relief in suffering and the "convenience" of not having to risk the brutal recovery and possible side effects of a TURP. I received the "guinea pig" discount from a Urologist here in San Diego, being only his second procedure. Actually he did his first procedure minutes before me!

My regular Urologist was neither knowledgable nor interested in exploring the Urolift option to be of any help. I did over 6 months of research before taking the leap (I recently retired from a career doing research in the field of medicine). Regarding insurance coverage, all I knew at the time was what my primary care doctor told me, that it takes on average 1 1/2 to 2 years for insurance to kick in subsequent to FDA approval (wouldn't suprise me).  Since I was at a point of really needing and wanting to address my BPH, I didn't have a desire to verify the validity of that time frame and just went ahead with the procedure. Glad I did.

14

Well, you are the third report from a post-procedure Urology patient. All very positive. I'm beginning to feel less aprehensive. My regular urologist hasn't done the procedure, actually was unaware of it until I told him about it. He has been my urologist for ten years and has done a wonderful job for me. I particularly appreciate his just subscribing meds until I decided to go ahead with TURP. I didn't want to be his first so i found another urologist who is doing the procedure, says Medicare isn't paying for it, etc. I'm scheduled to have the scoping exam this week to determine if I'm a viable Urolift candidate. I believe that if I am a candidate I may wait for my regular urologist to do a few Urolifts and I'll be his fifth or so. Since I discovered the daily Cialis routine for BPH (I cut a regular Cialis 100mg pill in half) and since it's working so well, along with Jalyn and Testosterone I may just wait as long as possible. 

My second urologist, the one I have actually never met, says that medicare will pay up to a year after a procedure if they get approval. $2500 is a lot of money to me, my wife and I are paying around $500 per month for Medicare and supplement and I want my bills covered, by gum!  All these concerns are for nothing if my prostate is too large or I have a median lobe, so we'll see, this week.

Again let me say that I really, really appreciate your reply and hope you realize that these posts will remain for years and thousands of BPH patients dreading TURP like the plague are going to appreciate your pioneering effort and my spreading this all over the internet for years to come.  Thanks a bunch. Ron      

15

Ron I was looking into the urolift procedure a year ago.  They were doing a clinical trial in Utah.  I decided to go with HoLep laser surgery instead.  I must say I wish I had done the Urolift.  I am very unhappy with the results especially the retrograde ejaculation.  So my recommendation is to go with the euro lift it sounds like the best option out there right now.

16

100 mg Cialis??? The standard tablet in the UK is 20mg.... but as they say everything is bigger in Texas:-)

17

Did they not warn your that retro was at least 60% certain.

I was OK with GL laser but not Thulium Laser but by then the damage had partly been done by Tamsulosin.

18

Yes they warned me that retrograde was 100% for sure.   But they told me that it would feel exactly the same only with nothing coming out.  That's where the falsehood lies.  For me it does not feel anywhere near the same.  As far as recovery and urination that's all fine.  But I would not do it over again.  I would definitely go for that urolift.  

19

Most find that the sensation is the same.

Does anyone know if urolift can be done if a persons prostate has regrown after a previous procedure.

I would have been ruled out for uroloift as my prostate was 125 grms. 

20

Yes, seems like most find it is not that much different.  I am just unlucky I guess.  I am very interested in knowing how people have had success with urolift.  It's too late for me but just curious.