Has anyone had laser prostate surgery?

[BritManToo]

1 hour ago, xylophone said:

You stated that you were prescribed levofloxacin, but that you have never been prescribed a fluoroquinolone – – well sorry to have to tell you this, levofloxacin is a fluoroquinolone.

Nope my TGH doc only gave me doxazosin 2mg which he increased to 3mg one week later.

I bought levofloxacin (Voxin 500mg) and finesteride (Firide 5mg) from my local pharmacy on my own after reading a post by 'electrified'. I also ordered Saw Palmetto from iherb on my own after reading some internet discussion.

 

The doc still says no to levofloxacin, but agreed the finesteride might help, he also suggested I replace the doxazosin with Urief, but the TGH doesn't provide it. I'm fine with doxazosin as it doesn't seem to negatively affect me (a little light headiness which I sort of enjoy) and only costs 1bht/tablet from the hospital.

 

Just got a box of Ugo flip valves and bags delivered from the UK, so I'm prepared for a more comfortable catheter experience if i need it again. I've managed to walk 4Km today without much in the way of tendon pain, so far, so good.

 

If you want to put me on ignore, feel free, up to you.

[elektrified]

30 minutes ago, BritManToo said:

Nope my TGH doc only gave me doxazosin 2mg which he increased to 3mg one week later.

I bought levofloxacin (Voxin 500mg) and finesteride (Firide 5mg) from my local pharmacy on my own after reading a post by 'electrified'. I also ordered Saw Palmetto from iherb on my own after reading some internet discussion.

 

The doc still says no to levofloxacin, but agreed the finesteride might help, he also suggested I replace the doxazosin with Urief, but the TGH doesn't provide it. I'm fine with doxazosin as it doesn't seem to negatively affect me (a little light headiness which I sort of enjoy) and only costs 1bht/tablet from the hospital.

 

Just got a box of Ugo flip valves and bags delivered from the UK, so I'm prepared for a more comfortable catheter experience if i need it again. I've managed to walk 4Km today without much in the way of tendon pain, so far, so good.

 

If you want to put me on ignore, feel free, up to you.

 

So sorry to hear about this sudden onset of problems. The catheter situation looks scary. Hope you get some relief from the meds quickly. I take alfuzosin. It is similar to doxazosin but acts directly on the tissue of the prostate and neck of the bladder. It's also a time-release over 24 hours. It's the newest generation of these type of meds. Very effective for me. If you are still not feeling better soon and want to see one of the CMU Faculty urologists, PM me for the contact info of my doctors.

[fhickson]

23 hours ago, thaibeachlovers said:

Yes, and why such a wimp? It's no big deal, and can't you ask for a male Dr to do it if so shy?

After reading some of the other posts here i am now lookjng forward to getting it done and catching any probkems early.

[BritManToo]

23 hours ago, thaibeachlovers said:

Yes, and why such a wimp? It's no big deal, and can't you ask for a male Dr to do it if so shy?

The nurse doing my catheter was extremely young, very pretty, and full nurse outfit with hat and skirt.

I was worried there might be a problem!

[BobBKK]

On 5/15/2019 at 11:49 AM, xylophone said:

The Da Vinci robotic system is usually used for prostate removal (amongst other delicate surgical procedures) and is certainly an improvement over the old-fashioned method which could leave men with incontinence, erection problems and so on.

 

The operation that Tracyb has had would appear to be the equivalent of the old-fashioned TURP, but using a laser to blast away at the overgrown internal part of the prostate, whilst still leaving the prostate generally intact.

 

Will be interested to follow his progress

Yes me too... very best wishes of course

[orang37]

On 5/15/2019 at 1:11 PM, BritManToo said:

Just started trying to work my way back into hiking, 3.5Km yesterday, 2Km this morning, no torn tendons yet.

19 days more levofloxacin to take.

Best wishes on your journey back to health !

 

~o:37;

[wgdanson]

Maybe slightly off topic, but I notice in these posts that various medications for enlarged prostate have been mentioned. Levofloxacin, Firide, Dutaseride, Alfudozin, Doxadozin etc etc.

HOW does a doctor decide which of these is the ''çorrect' one for a patient? The same applies to blood pressure medication.

Do they just pick one and say try this for three months and if no change we'll try another.

[BritManToo]

1 hour ago, wgdanson said:

Maybe slightly off topic, but I notice in these posts that various medications for enlarged prostate have been mentioned. Levofloxacin, Firide, Dutaseride, Alfudozin, Doxadozin etc etc.

HOW does a doctor decide which of these is the ''çorrect' one for a patient? The same applies to blood pressure medication.

Do they just pick one and say try this for three months and if no change we'll try another.

Government hospital only has Doxazosin (gen 2 alpha blocker), they sell it to you at 1bht/2mg tablet because it's cheap.

Private hospital will probably try to sell you the most expensive pills, because they can have a bigger markup.

 

Alpha blockers,

Increase your urine flow by reducing the tension in your blood vessels in your groin area.

The higher the generation the less the possible side effects and the higher the cost.

Doxazosin, Urief, Flomax, tamsulosin, and others

 

The other tablets are 5alpha reductase,

These shrink the prostate by playing with your hormones (as a plus you get more hair on your head, as a minus you might grow tits)

Finasteride 5mg aka Firide, Proscar, Stercia 5, et all

 

Antibiotics,

Levofloxacin they ALL say don't take, as they're scared you will get torn tendons, then blame them, but it's one of the few abs that can make it into your prostate, I'm convinced it's helping me (290bht/10).

 

[GarryP]

1 hour ago, wgdanson said:

Maybe slightly off topic, but I notice in these posts that various medications for enlarged prostate have been mentioned. Levofloxacin, Firide, Dutaseride, Alfudozin, Doxadozin etc etc.

HOW does a doctor decide which of these is the ''çorrect' one for a patient? The same applies to blood pressure medication.

Do they just pick one and say try this for three months and if no change we'll try another.

Unfortunately, my dad suffers with BPH and I have inherited the problem. Not getting up at night too frequently but the flow is quite weak. Had a PSA test last year with the result being 0.59, so it clearly points to BPH, especially as I am not in any discomfort apart from getting the flow going and stopping an starting and spending an age peeing. I don't want to go on the meds just yet if avoidable, but Beta-sitosterol 115mg (supplement - not medication) twice a day doesn't seem to be working. May try increasing the dosage. If that doesn't work, I will stop and try Saw Palmetto. Any other supplements worth giving a go. I know different people have different results, so just looking for something that might work for me.

 

Ultimately, I know I will need to go on the meds but hoping to delay that until I am 60 or so.  Only 3.5 years away.  If it comes down to it and I would be best served by surgery, I would go that route too.

 

To this day my dad still suffers even while medicated. After a few years, a medicine he is on no stops working as well as it should and he has to be put on something new.or switched back to something he used to take but since stopped. He is 88 this year and not interested in going for surgery. 

 

However, back to your post. An interesting question. But some of those meds you mention are not used for BPH, and are more commonly used for prostatitis. Once supplements have proven no longer useful, I fancy going on a generic form of Cialis (tadalafil), which is also used for treatment of BPH and studies have shown that long term use is safe. However, I don't believe it is available in Thailand, although I do not see any reason why not as the patent has already expired. But like you, I do not know what criteria the doctors use in deciding which medication to put you on. 

[BritManToo]

43 minutes ago, GarryP said:

Ultimately, I know I will need to go on the meds but hoping to delay that until I am 60 or so.  Only 3.5 years away.  If it comes down to it and I would be best served by surgery, I would go that route too.

The longer you leave it the worse it will be, when you start taking meds.

I'd do finasteride 5mg daily right away, might take 6 months to have an effect.

 

[GarryP]

2 hours ago, BritManToo said:

The longer you leave it the worse it will be, when you start taking meds.

I'd do finasteride 5mg daily right away, might take 6 months to have an effect.

 

With the potential side effects of that one, I think I'd be better starting off with something else. 

 

[hmficc]

The girls complain that the light is blinding- maybe they can wear sunglasses.

[sfokevin]

Has anyone had the UroLift procedure done?...

https://www.urolift.com/what-is-urolift

[Tracyb]

18 hours ago, GarryP said:

Unfortunately, my dad suffers with BPH and I have inherited the problem. Not getting up at night too frequently but the flow is quite weak. Had a PSA test last year with the result being 0.59, so it clearly points to BPH, especially as I am not in any discomfort apart from getting the flow going and stopping an starting and spending an age peeing. I don't want to go on the meds just yet if avoidable, but Beta-sitosterol 115mg (supplement - not medication) twice a day doesn't seem to be working. May try increasing the dosage. If that doesn't work, I will stop and try Saw Palmetto. Any other supplements worth giving a go. I know different people have different results, so just looking for something that might work for me.

 

Ultimately, I know I will need to go on the meds but hoping to delay that until I am 60 or so.  Only 3.5 years away.  If it comes down to it and I would be best served by surgery, I would go that route too.

 

To this day my dad still suffers even while medicated. After a few years, a medicine he is on no stops working as well as it should and he has to be put on something new.or switched back to something he used to take but since stopped. He is 88 this year and not interested in going for surgery. 

 

However, back to your post. An interesting question. But some of those meds you mention are not used for BPH, and are more commonly used for prostatitis. Once supplements have proven no longer useful, I fancy going on a generic form of Cialis (tadalafil), which is also used for treatment of BPH and studies have shown that long term use is safe. However, I don't believe it is available in Thailand, although I do not see any reason why not as the patent has already expired. But like you, I do not know what criteria the doctors use in deciding which medication to put you on. 

Cialis is available in Thailand.  

 

But....go see a doctor.  Spend the money and go to a private hospital for diagnosis and a treatment plan.  You can buy the meds they might prescribe at a local pharmacy and save a lot.  IMHO, The dollars spent for some quality time with a good doctor is the invaluable.  

[sfokevin]

On 5/15/2019 at 6:45 PM, elektrified said:

I take alfuzosin. It is similar to doxazosin but acts directly on the tissue of the prostate and neck of the bladder.

What it the brand name here in Thailand?... What is the price?

[Tracyb]

Hi everyone.  I’m back with an update on my progress after ThuLEP procedure here in CM.  Thank you to all for your good wishes and get well messages!

 

I’m back home after 3 days in the hospital.  Everything went well. So far, five days after surgery, I have not yet had any pain.  None.  Surgery was Monday morning.  Foley catheter removed on Thursday morning just before I checked out of the hospital.  The doc wanted to send me home on Wednesday WITH the catheter in place.  He and I spent some time talking and we both agreed that if I stayed one more day, until Thursday ( 3 days post op) he would remove the catheter then and then wait to see if I could pee on my own, and if so, he would let me go home without it.  Thursday morning came, the catheter came out, I peed on my own three times and voila, out the door I went.

 

Thursday and Friday at home were uneventful.  I drank lots of water, 3 liters plus, each day.  Thursday I peed every hour....even though the night until Friday morning.  Then, after breakfast, I started keeping track of times. I peed.  Throughout the day Friday, the times lengthened to about once every 1.5 hours, then 2 hours.  Overnight into Saturday, I was up only three times.  12:30, 2:30 then 5:30.  I was awake and out of bed at 6:30.  I peed again at 7:00 then at 9:30.  

 

The flow is great.  I haven’t seen such “power” for over 10 years!  

There was, in the beginning, a tiny amount of reddish urine at the beginning of the”event” turning to clear yellow after about one second.

So far today, no red or pink at the beginning of the stream.  I count myself as lucky because there is no burning sensation when peeing, either.

 

My diet is unrestricted, and my physical activity is limited as I am instructed to avoid heavy lifting, extreme exercise at the gym, and definitely no bicycling.  Walking is ok.  Running on a treadmill is out of the question.  I am resuming my daily activities as normal.  Riding in the car and bouncing around on the road bumps and potholes is a bit uncomfortable though so I’m laying low at home for the time being.

 

Ill keep you posted as things progress.

 

I go back for follow up next Thursday.

 

 

 

[giddyup]

19 minutes ago, Tracyb said:

Hi everyone.  I’m back with an update on my progress after ThuLEP procedure here in CM.  Thank you to all for your good wishes and get well messages!

 

I’m back home after 3 days in the hospital.  Everything went well. So far, five days after surgery, I have not yet had any pain.  None.  Surgery was Monday morning.  Foley catheter removed on Thursday morning just before I checked out of the hospital.  The doc wanted to send me home on Wednesday WITH the catheter in place.  He and I spent some time talking and we both agreed that if I stayed one more day, until Thursday ( 3 days post op) he would remove the catheter then and then wait to see if I could pee on my own, and if so, he would let me go home without it.  Thursday morning came, the catheter came out, I peed on my own three times and voila, out the door I went.

 

Thursday and Friday at home were uneventful.  I drank lots of water, 3 liters plus, each day.  Thursday I peed every hour....even though the night until Friday morning.  Then, after breakfast, I started keeping track of times. I peed.  Throughout the day Friday, the times lengthened to about once every 1.5 hours, then 2 hours.  Overnight into Saturday, I was up only three times.  12:30, 2:30 then 5:30.  I was awake and out of bed at 6:30.  I peed again at 7:00 then at 9:30.  

 

The flow is great.  I haven’t seen such “power” for over 10 years!  

There was, in the beginning, a tiny amount of reddish urine at the beginning of the”event” turning to clear yellow after about one second.

So far today, no red or pink at the beginning of the stream.  I count myself as lucky because there is no burning sensation when peeing, either.

 

My diet is unrestricted, and my physical activity is limited as I am instructed to avoid heavy lifting, extreme exercise at the gym, and definitely no bicycling.  Walking is ok.  Running on a treadmill is out of the question.  I am resuming my daily activities as normal.  Riding in the car and bouncing around on the road bumps and potholes is a bit uncomfortable though so I’m laying low at home for the time being.

 

Ill keep you posted as things progress.

 

I go back for follow up next Thursday.

 

 

 

Do you mind saying how much the procedure cost including hospital stay? Was it done at a public or private hospital?

[BritManToo]

Yeah, price and place please.

I emailed McCormick last week and they didn't bother to reply.

So far my only quote is $2,000 from a hospital in Goa.

[BritManToo]

15 hours ago, GarryP said:

With the potential side effects of that one, I think I'd be better starting off with something else. 

 

I'd be interested to know what side effects your dad suffered, or what you expect to suffer.

So far I've had no side effects except for feeling a little light headed (which I quite like).

Early days for me of course.

[Tracyb]

Hi again,

in regards to cost and place....

Bangkok Hospital -Chiang Mai

 

their package for TURP, a less advanced procedure not using the Thulium laser, cost 140,000 Baht +/- all in with 2 days in hospital.

 

Adding the Thulium laser increased the cost by about 50,000 Baht.  So, 190,000 baht +/-  all in with two days in a private room, excellent care, good food, attentive staff, and of course....air con!  My doc and I added another day, so the cost went up about 5000 baht including room, food, nursing care, meds, etc.

 

i went home with needed meds, too.  Levofloxacin for 7 days some meds to help prevent further bleeding.

 

I chose the laser because it is less traumatic (read barbaric) than TURP which uses a hot wire to slice out the inside of the prostate and has an increased risk of bleeding to the extent a transfusion is sometimes required. The Thulium laser is more precise and prevents excessive bleeding because I vaporizes the blood vessels throughout the procedure. The laser also shows better results overall according to my doc and.....according to all the research I’ve seen and read thoroughly. ( I’m someone who needs a lot of detail!)

 

Dr. Wittawat is my urologist.  He’s done over 300 of these procedures.  He’s a young guy, we communicated very easily in English, he’s attentive, patient, and willing to spend all the time you need when you have questions.  ....and I had a million of them!

[BritManToo]

52 minutes ago, Tracyb said:

Adding the Thulium laser increased the cost by about 50,000 Baht.  So, 190,000 baht +/-  all in with two days in a private room, excellent care, good food, attentive staff, and of course....air con!  My doc and I added another day, so the cost went up about 5000 baht including room, food, nursing care, meds, etc.

Holy shit!

Looks like I'll be having a holiday in Goa (60,000bht for the laser treatment + 16K for flights)

[elektrified]

1 hour ago, sfokevin said:

What it the brand name here in Thailand?... What is the price?

Xatral 10 mg. XL is the only brand available in Thailand. It comes from France, imported through Malaysia. I get it for a good price from a friend in Bangkok, but have run out a couple of times when my friend was away and bought it at Dara Pharmacy once - I think 900 Baht for a 30-day supply. Another time I found it at a pharmacy near Mae Jo University for 850.

It's really effective and no side effects at all. The first 2-3 evenings I took it (years ago), I was a little light-headed but after day 3 - not at all.

[Tracyb]

8 minutes ago, BritManToo said:

Holy shit!

Looks like I'll be having a holiday in Goa (60,000bht for the hospital + 16K for flights)

I realize that the cost is high and I respect that everyone must make their own choices.  For me, this was a better alternative than returning to the states, organizing a place to stay, paying the airfare, and risking complications that would alter my return schedule.  I did it here because I liked the doctor and had confidence in him.  To each his own, right!

 

So, your considering the PAE treatment?  It certainly sounds like it is an acceptable alternative to ThuLEP.

 

I wish you the best!  Please keep us posted on how things work out for you.

[BritManToo]

1 minute ago, Tracyb said:

So, your considering the PAE treatment?  It certainly sounds like it is an acceptable alternative to ThuLEP.

No, I'm considering the ThuLEP which I've been quoted $2,000 in Goa, India.

I'm also considering the same at McCormick hospital in Chiang Mai, which I'm told is also around $2,000, a neighbour had theirs done there.

 

 

[elektrified]

9 minutes ago, BritManToo said:

Holy shit!

Looks like I'll be having a holiday in Goa (60,000bht for the laser treatment + 16K for flights)

Just curious, how do you know you need this procedure? As I understand from what you have said, you have not had any problems in the past, have a very low PSA, and only suddenly had extreme difficulty urinating.

 

I've had problems for years now, difficulty urinating, frequently, had 2 X biopsies, 2 X MRI's, etc. but no one has recommended any surgery to me (and Thai urologists are quick to recommend surgery).

Don't you think you should give it some time to see if things improve before undergoing the knife? All I know is that after I took the Levofloxacin 30 days (twice) all of my symptoms of BPH and prostatitis completely disappeared and my PSA dropped by 40%!

[BritManToo]

11 minutes ago, elektrified said:

Just curious, how do you know you need this procedure? As I understand from what you have said, you have not had any problems in the past, have a very low PSA, and only suddenly had extreme difficulty urinating.

Looking to the future.

Original doctor in TGH told me this can only be cured with surgery in my first consultation.

Not really all that keen in having a catheter shoved in for two weeks out of three, which is the way things seem to be going.

I had it taken out Monday and have been fine until today, when the problem seems to be creeping back.

 

 

I'm still taking the Levofloxacin (15 days down, 15 to go). Might increase my Doxazosin from 3mg to 4 mg tonight.

[GarryP]

7 hours ago, Tracyb said:

Cialis is available in Thailand.  

 

But....go see a doctor.  Spend the money and go to a private hospital for diagnosis and a treatment plan.  You can buy the meds they might prescribe at a local pharmacy and save a lot.  IMHO, The dollars spent for some quality time with a good doctor is the invaluable.  

I will go to see a doctor sooner rather than later. I will call my dad this weekend and find out more about his troubles. I have insurance provided by my employer, although rather limited for out patient and social security coverage. I will look into hospitals soon.                                              

[GarryP]

6 hours ago, BritManToo said:

I'd be interested to know what side effects your dad suffered, or what you expect to suffer.

So far I've had no side effects except for feeling a little light headed (which I quite like).

Early days for me of course.

I'll call him later this weekend to get more details. I do know, however, that he became impotent at 62. Something I really want to avoid. But that was 26 years ago, so I assume the available medicines were quite limited at that time (although I could be wrong). 

[BritManToo]

8 minutes ago, GarryP said:

I'll call him later this weekend to get more details. I do know, however, that he became impotent at 62. Something I really want to avoid. But that was 26 years ago, so I assume the available medicines were quite limited at that time (although I could be wrong). 

I'm 63, can't really say impotence is a major concern, not that I could do anything with a catheter stuck in me anyway.

If I was forced to choose between weeing normally, and shagging normally, I'd probably choose weeing.

[BritManToo]

8 minutes ago, AlexRich said:

You’d kill two birds with one stone if your were into “golden showers”.

Or I  could go the ladyboy route, where I don't need an erection to have sex.