Has anyone had laser prostate surgery?

[THAIJAMES]

On 5/25/2019 at 7:29 PM, elektrified said:

rumak, I got your message but have no idea how to answer on the mobile app.

I would definately go see the urologist that the other poster recommended. Take urine tests, check PSA, DRE....etc. before taking Cipro. Discuss your symptoms, etc.

 

I will say this much, urologists in Thailand are not very proactive. You have to do a lot of research on your own, ask lots of questions, etc. They are quick to recommend biopsies (often I think they are not necessary). I suggested for years that I may be suffering from prostatitis and neither of my surgeons were interested in discussing it. They always said "oh no, you have negative UA. No prostatitis." Finally after pressing one of them, he conceded I could have non-bacterial prostatitis after my 2nd biopsy showed inflammation on some of the cores. He recommended I take Levofloxacin 500 mg. for 30 days and I felt better than I had in years. Very rarely now do I ever get up at night to pee.

I think this is my case also. I mentioned to the doctor that I may have an infection because slight burning down below. But both doctors that I saw dismissed it as my urine analysis was clean.

 

I was set to receive a biopsy and was given a course of antibiotics a few days as a preventive.

On the day that I was supposed to receive my biopsy I mentioned to the doctor that my symptoms mostly have gone away the first day after taking antibiotics. So we decided to wait a few weeks before doing a biopsy.

 

The antibiotic was cefdinir so I am assuming it will not be strong enough to completely remove any bacteria infection and may come back after I am off the antibiotics in a couple days.

 

I have an appointment to see him in a couple weeks. I will take the free PSA test along with a PSA test before I see him.

 

If my PSA level has not improved do you think I should be trying Levofloxacin 500 mg. For a month before I commit to a biopsy.

[elektrified]

2 hours ago, THAIJAMES said:

I think this is my case also. I mentioned to the doctor that I may have an infection because slight burning down below. But both doctors that I saw dismissed it as my urine analysis was clean.

 

I was set to receive a biopsy and was given a course of antibiotics a few days as a preventive.

On the day that I was supposed to receive my biopsy I mentioned to the doctor that my symptoms mostly have gone away the first day after taking antibiotics. So we decided to wait a few weeks before doing a biopsy.

 

The antibiotic was cefdinir so I am assuming it will not be strong enough to completely remove any bacteria infection and may come back after I am off the antibiotics in a couple days.

 

I have an appointment to see him in a couple weeks. I will take the free PSA test along with a PSA test before I see him.

 

If my PSA level has not improved do you think I should be trying Levofloxacin 500 mg. For a month before I commit to a biopsy.

Urologists in Thailand are very diligent when it comes to suspecting prostate cancer. That much I will say. But for other issues, unfortunately you need to be proactive on your own and do a lot of reading and asking questions, making suggestions, etc. Fortunately, there is a ton of information on the Internet. Interestingly enough, in medical publications published around the world, a couple of researchers and frequent contributors to numerous papers and International conferences are Professors from Thailand - a couple from Chiang Mai even. But they don't seem to apply their knowledge here based on the fact that most people in Thailand (and insurance companies) won't pay for the cost of the newest technology and many surgeons at government hospitals will just recommend removing the prostate if there are endless problems (a 3 hour operation with substantial blood loss and the possibility of impotence and/or incontinence)!

 

Do you have other symptoms of prostatitis? A burning feeling during urination is one. It took years before one of my doctors conceded that I could have non-bacterial prostatitis or even bacterial prostatitis that was "inactive" during urine tests. I complained for years of symptoms of prostatitis. Had I not pushed the issue and asked for treatment (Levofloxacin 500 mg. for 30-days; twice), nothing would have happened....

 

Has your PSA "spiked"? Has it gone up 50% in a short period of time? That is the issue that is most concerning. An increased PSA as we get older is normal due to the gland increasing in size and therefore more hormones are released. But spiking is something to be concerned about. Have you been having regular DRE and PSA's? I was having them 2-4 times a year for a few years.

 

I haven't heard of Cefdinir being used for prostate issues. Usually they try Bactrim, Flagyl, and/or one of the Fluoroquinolones; particularly Levofloxacin which is the best at penetrating the blood/prostate barrier. But some patients have reported adverse reactions to the Fluoroquinolones

 

The problem with taking Levofloxacin for 30 days before you take a PSA is that it will (due to its anti-inflammatory properties), reduce your PSA. So if your PSA is high, then you will not get an accurate PSA. My PSA went from 13.4 to 8.8 after 30 days on Levofloxacin.

 

If it was me, and I could go back in time......I would have done things differently before having the first biopsy. But only you can decide what is best for you. If your PSA has not spiked and your DRE is normal (and if you have symptoms of infection or prostatitis) you may consider treating that first. You should also consider an MRI before a biopsy. That way, if there is an area of concern, they know where to focus the biopsy cores.

[rumak]

4 hours ago, THAIJAMES said:

I think this is my case also. I mentioned to the doctor that I may have an infection because slight burning down below. But both doctors that I saw dismissed it as my urine analysis was clean.

 

I was set to receive a biopsy and was given a course of antibiotics a few days as a preventive.

On the day that I was supposed to receive my biopsy I mentioned to the doctor that my symptoms mostly have gone away the first day after taking antibiotics. So we decided to wait a few weeks before doing a biopsy.

 

The antibiotic was cefdinir so I am assuming it will not be strong enough to completely remove any bacteria infection and may come back after I am off the antibiotics in a couple days.

 

I have an appointment to see him in a couple weeks. I will take the free PSA test along with a PSA test before I see him.

 

If my PSA level has not improved do you think I should be trying Levofloxacin 500 mg. For a month before I commit to a biopsy.

I started a thread not too long ago about fluoroquinolone antibiotics ........  Four members of TV forum responded as having serious side effects.   I also posted this site:   floxiehope.com  if you would like to read some "recovery stories".    I know that some guys here have not had any problems.  You can make your own decision...

[elektrified]

11 hours ago, riclag said:

The Psa is a false negative unless of course it sky rockets from your last test.You should have a digital exam,IMOP I don’t know if you ever had a biopsy,it’s a piece of cake

Hardly. Well the 12 core biopsy wasn't too bad but the 26 core biopsy was far from "a piece of cake", with acute inflammation, pain, and urinating blood for 2-3 weeks.

[THAIJAMES]

Do you have other symptoms of prostatitis? A burning feeling during urination is one.

I do have a slight burning sensation, but it is all the time.   I did have this problem 2-3 years ago and it went away after one month.  I would have ignored it except for the PSA score and the fact they found a growth on my prostate.

 

Has your PSA "spiked"? Has it gone up 50% in a short period of time?

Unfortunately my last test was 3 years ago, it was 4.2 then it is 8 now.  According to my urologist, the size of my prostate is so big that a reading of 8 is not that unusual for it's size.

As far as the growth near the prostate, he said that he was not concerned and would not order a biopsy based on it but only on the elevated PSA score.

 

I haven't heard of Cefdinir being used for prostate issues.

The only reason for it was to reduce the bacterial count in order to avoid infection when doing the biopsy, as there is a 6% chance of getting an infection as the instrument has to go though feces.  Since the antibiotics had a definite effect, it was decided to hold off the biopsy and do another PSA test in a month.

 

The problem with taking Levofloxacin for 30 days before you take a PSA is that it will (due to its anti-inflammatory properties), reduce your PSA. So if your PSA is high, then you will not get an accurate PSA. My PSA went from 13.4 to 8.8 after 30 days on Levofloxacin.

I will be off antibiotics tomorrow (10 day course), and will not take Levofloxacin until I have my psa and free psa tested and see the urologist.  As you say, the effect may not be from anti-bacteria but anti-inflammation.  So it could also be the case that I have an enlarged prostate helped by the anti-inflammatory proprieties of the antibiotic.

 

If symptoms come back in a few days after the antibiotics have stopped working, I am thinking of trying an anti-inflammatory for a couple of days to see what effects that has.  Trying to determine if it is BHP or prostatitis.

 

 

If it was me, and I could go back in time......I would have done things differently before having the first biopsy. But only you can decide what is best for you. If your PSA has not spiked and your DRE is normal (and if you have symptoms of infection or prostatitis) you may consider treating that first. You should also consider an MRI before a biopsy. That way, if there is an area of concern, they know where to focus the biopsy cores.

 

I will wait a week or two before I have the psa and free psa test.  If the results have spiked then I will have an MRI done as per your suggestions before doing a biopsy so they know where to focus the biopsy cores.

 

if there is no spike or the score has gone done then i need to figure out if I have BHP or prostatitis.

 

I am planning to see another urologist next week for a second opinion.

 

Does that sound like a good plan?

 

[THAIJAMES]

1 hour ago, elektrified said:

Hardly. Well the 12 core biopsy wasn't too bad but the 26 core biopsy was far from "a piece of cake", with acute inflammation, pain, and urinating blood for 2-3 weeks.

The hospital wanted to completed sedate me and had anesthesiologist on hand.  He wanted completed blood tests, EKG, and chest X-ray before he wanted to proceed.

That was a factor in me wanting to postpone the Biopsy.  26 core biopsy.

[THAIJAMES]

2 hours ago, rumak said:

I started a thread not too long ago about fluoroquinolone antibiotics ........  Four members of TV forum responded as having serious side effects.   I also posted this site:   floxiehope.com  if you would like to read some "recovery stories".    I know that some guys here have not had any problems.  You can make your own decision...

Yes I read it and took your advice.  He was going to give me these antibiotics to prevent infection due to the biopsy procedure.  I asked him for an alternate and he gave me Cefdinir, which also penetrates the prostate.

[rumak]

11 minutes ago, THAIJAMES said:

Yes I read it and took your advice.  He was going to give me these antibiotics to prevent infection due to the biopsy procedure.  I asked him for an alternate and he gave me Cefdinir, which also penetrates the prostate.

I am not familiar with Cefdinir but it reading about it...it is NOT a flouroquinolone.  Really horrible stories from many many people who were adversely affected.  I am indeed happy that the doctor gave you something different. !

[canopus1969]

2 hours ago, THAIJAMES said:

The hospital wanted to completed sedate me and had anesthesiologist on hand.  He wanted completed blood tests, EKG, and chest X-ray before he wanted to proceed.

That was a factor in me wanting to postpone the Biopsy.  26 core biopsy.

I was knocked out when I had my biopsy - woke up as right as rain but they kept an eye on me for an hour or so before letting me go

[elektrified]

17 hours ago, THAIJAMES said:

Do you have other symptoms of prostatitis? A burning feeling during urination is one.

I do have a slight burning sensation, but it is all the time.   I did have this problem 2-3 years ago and it went away after one month.  I would have ignored it except for the PSA score and the fact they found a growth on my prostate.

 

Has your PSA "spiked"? Has it gone up 50% in a short period of time?

Unfortunately my last test was 3 years ago, it was 4.2 then it is 8 now.  According to my urologist, the size of my prostate is so big that a reading of 8 is not that unusual for it's size.

As far as the growth near the prostate, he said that he was not concerned and would not order a biopsy based on it but only on the elevated PSA score.

 

I haven't heard of Cefdinir being used for prostate issues.

The only reason for it was to reduce the bacterial count in order to avoid infection when doing the biopsy, as there is a 6% chance of getting an infection as the instrument has to go though feces.  Since the antibiotics had a definite effect, it was decided to hold off the biopsy and do another PSA test in a month.

 

The problem with taking Levofloxacin for 30 days before you take a PSA is that it will (due to its anti-inflammatory properties), reduce your PSA. So if your PSA is high, then you will not get an accurate PSA. My PSA went from 13.4 to 8.8 after 30 days on Levofloxacin.

I will be off antibiotics tomorrow (10 day course), and will not take Levofloxacin until I have my psa and free psa tested and see the urologist.  As you say, the effect may not be from anti-bacteria but anti-inflammation.  So it could also be the case that I have an enlarged prostate helped by the anti-inflammatory proprieties of the antibiotic.

 

If symptoms come back in a few days after the antibiotics have stopped working, I am thinking of trying an anti-inflammatory for a couple of days to see what effects that has.  Trying to determine if it is BHP or prostatitis.

 

 

If it was me, and I could go back in time......I would have done things differently before having the first biopsy. But only you can decide what is best for you. If your PSA has not spiked and your DRE is normal (and if you have symptoms of infection or prostatitis) you may consider treating that first. You should also consider an MRI before a biopsy. That way, if there is an area of concern, they know where to focus the biopsy cores.

 

I will wait a week or two before I have the psa and free psa test.  If the results have spiked then I will have an MRI done as per your suggestions before doing a biopsy so they know where to focus the biopsy cores.

 

if there is no spike or the score has gone done then i need to figure out if I have BHP or prostatitis.

 

I am planning to see another urologist next week for a second opinion.

 

Does that sound like a good plan?

 

How did they find a "growth" on your prostate? No MRI? Did they feel it on the DRE?

 

PSA of 8.0 is not uncommon, but it has doubled over 3 years. Basically the same as I; at the time.

 

I would definitely wait 2-3 weeks before testing your PSA again.

 

That sounds like a good plan; especially getting a 2nd opinion and getting an MRI. If it was me, I would go to Bangkok and get the Tesla 3.0. The resolution is much, much better. There is just too much guessing on the Tesla 1.5 MRI's. I had two, read by different radiologists; one from Siriraj and one by the Professor of Radiology at CMU and both were wildly different and both were given PIRAD 4. Nothing was found on 26 core biopsy. I forget now where you can go to get the 3.0 Tesla MRI, but I think Siriraj, Chulalongkhorn, and Bangkok General. You may wish to post a question in the Health Forum where to go to get the Tesla 3.0 Prostate MRI as moderator Sheryl knows everything that goes on in Bangkok.

 

Please keep us posted. There is a good network of prostate patients on the Health Forum who contribute a lot and share their experiences both here and abroad.  The urologists in Thailand don't say much or spend much time explaining things to patients so there is a lot of good info shared in the forum.

 

[THAIJAMES]

7 hours ago, elektrified said:

How did they find a "growth" on your prostate? No MRI? Did they feel it on the DRE?

During my checkup I also had an ultrasound of the abdominal area.

Quote

 

I would definitely wait 2-3 weeks before testing your PSA again.

 

I will

Quote

That sounds like a good plan; especially getting a 2nd opinion and getting an MRI. If it was me, I would go to Bangkok and get the Tesla 3.0.

I have created a topic in the health forum asking for advice on the Tesla 3.0

Quote

Please keep us posted.

I will, thank you for your very helpful information and advice, it has really helped me!

 

You mention you were given PIRAD 4 and have a biopsy that is negative.  That must be frustrating.  I suppose the Tesla 3.0 would clear up this ambiguity or at least be able to better target the Biopsy if something was found?

 

[Puwa]

This topic really belongs in the Health subforum. Only tangentially related to CM.

[Muzarella]

The best treatment for enlarged prostrate is to have a lot of sex....at any age, and Thailand it is probably the best place to look for that kind of treatment.

[scubascuba3]

The best treatment for enlarged prostrate is to have a lot of sex....at any age, and Thailand it is probably the best place to look for that kind of treatment.

Serious point, if what you say is correct, your prostate doesn't know whether you are masturbating, so doesn't have to be sex

[elektrified]

7 hours ago, THAIJAMES said:

You mention you were given PIRAD 4 and have a biopsy that is negative.  That must be frustrating.  I suppose the Tesla 3.0 would clear up this ambiguity or at least be able to better target the Biopsy if something was found?

 

Yes indeed.

[Tracyb]

I’m happy that this topic has opened discussions regarding prostate health and treatments.  For many guys, this is a topic that may have been somewhat “sensitive.”  Now there seems to be a healthy discussion taking place.  Best wishes to all!

[thaibeachlovers]

On ‎6‎/‎26‎/‎2019 at 12:44 AM, THAIJAMES said:

I have an elevated PSA score (in the grey area between 4-10), I prefer avoiding having a biopsy if not necessary. 

 

Does anyone know if other tests are available in Chiangmai.  For example free PSA test, p2PSA or "The Prostate Health Index" test.

 

Also is a high resolution Telsa 3.0 MRI-S Scan available anywhere in Chiangmai and can they do Prostate C.M.P?  It looks for cancerous legions.

 

Thank you in advance.

Never have an operation based on a PSA alone. 

I had a biopsy and it's not that big a deal. Some discomfort and a pinch at each site. Bit of blood in the stool after.

[bkk6060]

I would not have a biopsy if between 4 and 10.

Mine was there and my doctor told me to stay off my motor bike for a  week, do not sit much, drink less booze and drink lots ( 12 bottles a day) of water.

Went back and it was 1.9.

Have had 3 subsequent tests all in the same range.

I also ejaculate at least once a day.

I would make a few life style changes and get additional tests first.

Worked for me.

 

[muffy]

On 5/4/2019 at 1:04 PM, Tracyb said:

I’m considering Bangkok Hospital here in CM.  I’ve been taking flomax and avid art for six years now and my prostate continues to enlarge.  I’m at the end of the pharmaceutical line.

Where do you buy Flomax am in bkk

[GroveHillWanderer]

On 5/23/2019 at 8:27 AM, elektrified said:

Sounds like you would benefit from one of the alpha blockers. I take Alfuzosin and never get up at night anymore.

I guess everyone reacts to medicine differently. I took Alfuzosin for about 6 months - it never made the slightest bit of difference to either my urine flow, or frequency of urination.

[Tracyb]

1 hour ago, muffy said:

Where do you buy Flomax am in bkk

Flomax is sold under a different name here in Thailand.  It’s called Harnal.  Tamsulosin is the generic name for this drug.  Available without a prescription and most pharmacies carry it.   Just ask for Harnal!

 

[BritManToo]

1 hour ago, GroveHillWanderer said:

I guess everyone reacts to medicine differently. I took Alfuzosin for about 6 months - it never made the slightest bit of difference to either my urine flow, or frequency of urination.

Entirely the opposite to me.

The doxazocin helped me wee for 20hrs/day at the start of my treatment (started off with a total blockage and a catheter for 3 weeks).

And the Finasteride has clearly done some shrinking as I can now wee 24/7, and it's still getting easier.

[stephenterry]

Very interesting discussion. I appreciate the wealth of experience in resolving anything relating to prostate health. Thanks, all, for the info. 

 

I am approaching 75, and at my age I was getting up a few times a night, and my urinating was poor, and dribbling, taking an age to pass, although during the day, it was a normal natural flow if not strong. 

 

After reading up about it, I found a post that recommended the following natural remedy:

 

Stop fluid intake a few hours before sleeping, plus eat a small handful of raisons, and enjoy your sleep. It works well. I maybe wake once a night, after about 5 hours blissful sleep, take a normal leak with no discomfort, and resume fluid intake first thing next morning. I have found that eating raisons up to 4 hours before bed is as effective. 

 

There is no doubt that the human body is so complex, that it's mostly impossible to devise a natural nutrition plan to rectify health issues. Experiment with what works for you, is a start. 

 

 

 

 

 

[THAIJAMES]

On 6/29/2019 at 4:18 PM, bkk6060 said:

I would not have a biopsy if between 4 and 10.

Mine was there and my doctor told me to stay off my motor bike for a  week, do not sit much, drink less booze and drink lots ( 12 bottles a day) of water.

Went back and it was 1.9.

Have had 3 subsequent tests all in the same range.

I also ejaculate at least once a day.

I would make a few life style changes and get additional tests first.

Worked for me.

 

Very interesting.

 

I definitely think that's sitting too much has something to do with me getting inflammation of the prostate. I often sit on a hard surface for a few hours.

 

And I don't I drink enough water so your suggestions make sense.

 

You mentioned ejaculating once a day.  I wish I had known this much earlier in my life but ..

I have discovered that the prostate can contribute to an orgasm.

 

Maybe my problem is the way I was ejaculating wasn't creating an orgasm from the prostate and only from the penis.

 

I know this sounds crazy but sitting too much and not ejaculating correctly and not enough fluids means that the prostate is not getting enough blood flow?  Which leads to easy infections and an enlarged prostate or worst.

 

in the meantime I took antibiotics and that brought down the infection by 90% right after that I took oregano oil and that completely removed the infection.

 

So I have absolutely no symptoms whatsoever right now.

 

I will follow your suggestions and hopefully in a couple weeks when I get tested again there will be some improvements in the PSA score.

 

 

 

[THAIJAMES]

I did a quick Google search:

 

Gay men had significantly lower rates of prostate cancer but higher rates of other cancers.

 

I'm assuming that gay men stimulate their prostate and have prostate orgasms.

 

Not using that muscle maybe problematic for non-gays?

 

I now know that it's a simple matter of activating the prostate muscles to contract at the same time as the penis when having an orgasm. Something that most men probably do naturally but that some of us don't.

 

Another Google search:

If you ejaculate frequently, your risk of getting prostate cancer may be reduced. How often is frequent? A study at Harvard Medical School says 21 times a month. A similar Australian study points to seven times a week.

But there’s a catch: one study suggests it’s only an effective preventative measure in men age 50 and older.

 

Comfirming what Bkk6060 said!

 

[emptypockets]

On ‎5‎/‎18‎/‎2019 at 12:41 PM, BritManToo said:

Holy shit!

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

and get 50,000 cash back for your kidney removal.

[emptypockets]

On ‎5‎/‎22‎/‎2019 at 7:58 PM, rumak said:

thanks,   that is helpful.   The only one on that list is I do have to get up several times a night ( average of 2)

I really think that is "normal" for a great majority of men over 60.  I will look further into it,  but have yet to

get to the point where just cannot pee.  Daytime any problems, but still fairly weak.

Many men over 60 have to pee several times a night. Unfortunately some don't get out of bed to do so!!

[emptypockets]

On ‎6‎/‎29‎/‎2019 at 4:18 PM, bkk6060 said:

I would not have a biopsy if between 4 and 10.

Mine was there and my doctor told me to stay off my motor bike for a  week, do not sit much, drink less booze and drink lots ( 12 bottles a day) of water.

Went back and it was 1.9.

Have had 3 subsequent tests all in the same range.

I also ejaculate at least once a day.

I would make a few life style changes and get additional tests first.

Worked for me.

 

What are you taking for the RSI for the wrist?

 

Just joking mate.

[thaibeachlovers]

10 hours ago, THAIJAMES said:

If you ejaculate frequently, your risk of getting prostate cancer may be reduced. How often is frequent? A study at Harvard Medical School says 21 times a month. A similar Australian study points to seven times a week.

Had that been true I would still have my prostate. IMO it's just the genes that we were born with. Hence, some smoke like a train till they die and never get lung cancer.

[Wandr]

Has anyone had radio frequency treatment to shrink the prostate? It uses heat from radio frequency treatment to 'burn' tissue.

And is it available in Chiang Mai?