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Mr Vlad
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The sensation is more one of pressure than pain in my view , but one's mans pressure is another mans agony to misquote the old adage.

If you do have a urinary problem not dealt with quite satisfactorily by Tamulosin you might in the first iinstance ask your GP to prescribe something called Combodart ,or a clone of it , this is Tamulosin combined with Dutasteride . Personally, I found this was better than just Tamulosin. 

f you are in pain (razor blades), or finding it difficult to urinate then lie in a warm bath and you will find this helps a lot.

The other thing you can do is not drink after tea time. Sounds obvious ,but basically the emptier your bladder the less likely you are to get up at night. My personal record on that (when in RA flare) is 15 times between 12 and 6pm.

What Herbie was referring to may possibly (I use that exact word for a reason) be helped by specific excercises to retrain the muscles of the bladder to improve your ability to retain urine. I won't link that, it's easy to search out.

Of course sometimes the enlargement reaches a critical point where only intervention is going to help. Of the alternatives available I know physical reduction can be problematic ,but comes with good probabilities of success. Personally, I favour Ablation simply because it is less invasive and recovery issues are less. There is apparently a great laser treatment developed in the US, but it is not available in my region. Might be in yours. Worth a check.

Any questions ask by all means. Not only do I have the same problems as you guys ,but fortunately I have a wife although retired has seen (in a professional sense) an awful lots of willies with problems and she is a fount of knowledge.😃

 

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16 minutes ago, Boomer54 said:

The sensation is more one of pressure than pain in my view , but one's mans pressure is another mans agony to misquote the old adage.

If you do have a urinary problem not dealt with quite satisfactorily by Tamulosin you might in the first iinstance ask your GP to prescribe something called Combodart ,or a clone of it , this is Tamulosin combined with Dutasteride . Personally, I found this was better than just Tamulosin. 

f you are in pain (razor blades), or finding it difficult to urinate then lie in a warm bath and you will find this helps a lot.

The other thing you can do is not drink after tea time. Sounds obvious ,but basically the emptier your bladder the less likely you are to get up at night. My personal record on that (when in RA flare) is 15 times between 12 and 6pm.

What Herbie was referring to may possibly (I use that exact word for a reason) be helped by specific excercises to retrain the muscles of the bladder to improve your ability to retain urine. I won't link that, it's easy to search out.

Of course sometimes the enlargement reaches a critical point where only intervention is going to help. Of the alternatives available I know physical reduction can be problematic ,but comes with good probabilities of success. Personally, I favour Ablation simply because it is less invasive and recovery issues are less. There is apparently a great laser treatment developed in the US, but it is not available in my region. Might be in yours. Worth a check.

Any questions ask by all means. Not only do I have the same problems as you guys ,but fortunately I have a wife although retired has seen (in a professional sense) an awful lots of willies with problems and she is a fount of knowledge.😃

 

Sorry, just as an addendum if you are being given a cytoscopy just for frequent urinary issues have you first had a simple flowtest? Can understand the cystoscopy if there are other concerns being investigated, but if it's prostate enlargement causing urine frequency issues I would have thought they would start with a simple flowtest.

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1 hour ago, PCM said:

I'll be having one on Tuesday week, and another Prostate Biopsy; all under general anaesthetic.

Not looking forward to it, but such is life.

BEST wishes to all.

Piers

 

Hope all goes well Oiers, both the procedure and the outcome.

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Thank you for all the positive comments, and as always, words of wisdom.

I WILL read through them again - thoroughly.

There are always nuggets to be found. 

( For me it's a high (16) PSA, blood in urine, vague MRI. )

Thank you again.

Piers.

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5 minutes ago, PCM said:

Thank you for all the positive comments, and as always, words of wisdom.

I WILL read through them again - thoroughly.

There are always nuggets to be found. 

( For me it's a high (16) PSA, blood in urine, vague MRI. )

Thank you again.

Piers.

Then the pathway is right. Chin up my brother had all the above some years back and just let's say I have more problems now than him ! The joke in the club house loo is everybody leaves when he comes in 'cos it's firehose time. Best wishes.

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12 minutes ago, Boomer54 said:

Sorry, just as an addendum if you are being given a cytoscopy just for frequent urinary issues have you first had a simple flowtest? Can understand the cystoscopy if there are other concerns being investigated, but if it's prostate enlargement causing urine frequency issues I would have thought they would start with a simple flowtest.

Not quite sure who this was directed towards Stephen but for my own part I'll say yes, I've had almost any and every test known to man.

I'm almost 66 now and I first became aware of these problems when I was about 15 or 16 and beginning to explore the world of pubs and beer. Before that I'd just assumed that all kids were the same and I'd 'grow out of it', but it wasn't to be. All my life I've been worried about bladder and/or prostate cancer because all the symptoms of it are quite normal for me.

Hesitancy in getting the flow to start; weak and interrupted flow when it does start; an urgency to go but only getting rid of an egg-cup full when I do, and no matter how much I try to get rid of every last drop, there's always dribbling when I zip back up. Apologies if some think that's too much information but that's my normal daily life.

Although the PSA test seems to have fallen out of favour these days I still have one every year anyway because my numbers are so closely grouped that it won't take much of an increase for me to get other tests done. For my age, any score up to and including 4 is considered to be alright and for the last six years my numbers have been (if I remember correctly) 0.55; 0.51; 0.52; 0.59; 0.52 and 0.51. At some point I may have had a 0.71 in there somewhere but it's all been below one anyway.

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All the best Piers with your treatment. 

I forgot about this thread lol.

My own situation now is that I very rarely get up in the night. Well my night is between 4pm and 10.45pm as I start work at midnight. I have 4 cups of coffee whilst I'm up. About 0.5 litre of juice and that's my lot liquid wise. My last drink of the day is around 12 noon.

I take multi vitamins and cod liver vitamin d tablets. Any excess just gets peed out lol.

My flow rate is acceptable and much better than a few years back. Not gushing but good. Only my first wee after getting up can be a bit more than a dribble but thats not often.

Funnily enough I have a follow on appointment week on Wednesday at the urology department. It'll be interesting what the doc has to say.

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Herbie, what I was writing about is typically more directed at age related issues. You are clearly outside that remit given your history. I am fairly confident you will have been through every mill on this over the course of your life. I wouldn't dare to think I had anything to offer on your situation other than my sympathy.

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Just now, Boomer54 said:

Herbie, what I was writing about is typically more directed at age related issues. You are clearly outside that remit given your history. I am fairly confident you will have been through every mill on this over the course of your life. I wouldn't dare to think I had anything to offer on your situation other than my sympathy.

And a bottle of Belgium beer.

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I started checking my PSA values annually after reading Stephen Fry 's reports some years ago and unfortunately i also got the call"we better do some more testing now". Went into hospital several times and had external and internal scans ( through the backdoor) and up to now the diagnosis is only an enlarged prostate always followed by the question, "do you want medicine"? I read about the side effects and that really scared me off so up to now i pushed it away. Time will come however beeing 62.

But here is my question. Friend of mine living in Switzerland had his prostate reduced by Cryotherapy ( freezing). He told me all easy peasy no problem and all resolved now. Overhere in Holland they dont do that, propably too expensive?  Anyone with more knowledge about that?

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9 minutes ago, dutchie01 said:

I started checking my PSA values annually after reading Stephen Fry 's reports some years ago and unfortunately i also got the call"we better do some more testing now". Went into hospital several times and had external and internal scans ( through the backdoor) and up to now the diagnosis is only an enlarged prostate always followed by the question, "do you want medicine"? I read about the side effects and that really scared me off so up to now i pushed it away. Time will come however beeing 62.

But here is my question. Friend of mine living in Switzerland had his prostate reduced by Cryotherapy ( freezing). He told me all easy peasy no problem and all resolved now. Overhere in Holland they dont do that, propably too expensive?  Anyone with more knowledge about that?

I thought I had heard of all the approaches, but 'freezing' is a new one on me.

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2 hours ago, dutchie01 said:

I started checking my PSA values annually after reading Stephen Fry 's reports some years ago and unfortunately i also got the call"we better do some more testing now". Went into hospital several times and had external and internal scans ( through the backdoor) and up to now the diagnosis is only an enlarged prostate always followed by the question, "do you want medicine"? I read about the side effects and that really scared me off so up to now i pushed it away. Time will come however beeing 62.

But here is my question. Friend of mine living in Switzerland had his prostate reduced by Cryotherapy ( freezing). He told me all easy peasy no problem and all resolved now. Overhere in Holland they dont do that, propably too expensive?  Anyone with more knowledge about that?

Reading up I think we need to understand a distinction. Cryotreatment is used to kill cancerous cells in the prostate and unless I missed something not for reducing an enlarged but non cancerous prostate. Two different issues and dare I say different treatments.

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22 hours ago, Herbie said:

Not quite sure who this was directed towards Stephen but for my own part I'll say yes, I've had almost any and every test known to man.

I'm almost 66 now and I first became aware of these problems when I was about 15 or 16 and beginning to explore the world of pubs and beer. Before that I'd just assumed that all kids were the same and I'd 'grow out of it', but it wasn't to be. All my life I've been worried about bladder and/or prostate cancer because all the symptoms of it are quite normal for me.

Hesitancy in getting the flow to start; weak and interrupted flow when it does start; an urgency to go but only getting rid of an egg-cup full when I do, and no matter how much I try to get rid of every last drop, there's always dribbling when I zip back up. Apologies if some think that's too much information but that's my normal daily life.

Although the PSA test seems to have fallen out of favour these days I still have one every year anyway because my numbers are so closely grouped that it won't take much of an increase for me to get other tests done. For my age, any score up to and including 4 is considered to be alright and for the last six years my numbers have been (if I remember correctly) 0.55; 0.51; 0.52; 0.59; 0.52 and 0.51. At some point I may have had a 0.71 in there somewhere but it's all been below one anyway.

I'm told that Pumpkin seeds are also good for prostates...

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17 hours ago, Boomer54 said:

Reading up I think we need to understand a distinction. Cryotreatment is used to kill cancerous cells in the prostate and unless I missed something not for reducing an enlarged but non cancerous prostate. Two different issues and dare I say different treatments.

You are correct in what you say.  Cryotherapy comes under the umbrella of 'Focal Therapy' and is used more in the USA than in the UK.  In the UK they  more frequently use HIFU (High Intensity Focal Ultrasound), provided it can be focussed where the tumour is located and calcification does not make HIFU ineffective.  Both forms of treatment can be used as primary treatment or as salvage treatment for failed Radiotherapy. Another relatively recent form of Focal Therapy is often referred to as 'Nanoknife' which uses shorts bursts of electricity to blow holes into the tumour via needle probes to destroy cancer cells DNA.  It is called Irreversible Electroporation and as yet is only available in a very small number of hospitals.  There are also other forms of Focal Therapy for suitable patients at an embryonic or trial stage in the UK and FLA (Focal Laser Ablation) in the USA.

Some men just have an enlarged Prostate  referred to as Benign Prostatic Hyperplasia or BPH  leading to their having a PSA higher than their age range.  However, men can have an enlarged Prostate and some cancer.  Prostates grow with age, some at a faster rate and there is the possibility that this will impinge on the Ureter and restrict flow, although there are other reasons why flow and voiding can be affected.          

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  • 2 weeks later...
On 10/21/2023 at 1:47 PM, Mr Vlad said:

All the best Piers with your treatment. 

 

Hello all,

Well... I had my  Cystoscopy and Prostate Biopsy on Friday, at about lunch time. I was told it might be a bladder biopsy as well, but I don't think it was in the end. ( No pun intended. )

All the staff were brilliant.

I also feel my option for a General Anaesthetic was the right one for me.

The comments here prepared me well. Yes, there was the razor blade sensation. Gone now. But still the dull ache and pain 'downstairs'.

And I know there will be blood themed unpleasantness continuing for some while.

( The most stressful part was my wife driving home in the dark. Seemingly aiming for potholes etc?! )

Now I rest and wait...

I salute everyone here for any medical issue they tackle, and the staff who help them get there.

Best wishes to us all.

Piers.

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Good of you to let us know Piers.

Funnily enough I had an appointment on Thursday for a check up. I actually saw, for the first time, the consultant and not his assistants. A really good chap.

He wasn't happy that a blood test hadn't been done on me since 2019 and that a particular test, I think or was it a sample, wasn't done.

He spoke about the cystoscopy results and confirmed a small blockage and about an operation to unblock the tube. I've refused the op as its not, or wasn't last time I looked into it, reliable. 

Ouch. Did you upset your wife somehow to make her retaliate by deliberately hitting every pothole on the way home? Sorry for the pun but that made me cringe a bit. 

Hope you're recovering well. 

Something eye opening my consultant said after asking of my coffee intake. After stating I drink about 1.75 litres of it a day he suggested I try decaf because the prostate doesn't like caffeine. So decaf I've changed too. Taking some time to get use to it however. 

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3 minutes ago, Mr Vlad said:

 

He spoke about the cystoscopy results and confirmed a small blockage and about an operation to unblock the tube. I've refused the op as its not, or wasn't last time I looked into it, reliable. 

 

Thank you.

Interesting. I think I am pragmatic also about such things. Some treatments I will willingly accept, others I might politely decline!

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I think a couple of factors come into play. Exactly what level disruption is being experienced by leaving something untreated. That is, is it manageable, or something beyond that. What is the likely prognosis if you leave the issue untreated. What is the probability of success of taking the treatment including of course what can you expect for the post procedural pathway. When you weigh things up like this some decisions are easier than others. I have deferred prostate intervention for at least a couple of years  ,because the current situation is manageable through medication. If that were to change then so would my decision. By contrast when they told me I was 95% + occluded on all my major heart vessels and I would probably be dead in the near future then needless to say the decision virtually made itself. A 3 in 100 chance of failure was more than acceptable.

Hard sometimes to be objective about these things, but it is best to try to be just that.

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Piers and All ……. Hey, we’re all getting old and knackered to some degree and once you’ve been nigh on that last journey ……. and having by some miracle and lots of NHS tlc come thru to the other end that’s kept you actually alive ….. and comparatively able to keep going forward, ……. then we, well me anyway, just KNOW we’ve got to make the very best of each and every day that we actually awaken ……. AND maybe go buy that next Lexus to pamper ourselves …… it does no harm and actually quite gives one a huge uplift in spirits ……. the cost is irrelevant ( hopefully ) and the next happy adventure awaits ……. assuming there’s the energy left to do it …….. now then …….. what’s the new adventure to be eh !  🌞🥳👌

Malc  

answers on a postcard 😂

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13 minutes ago, Malc1 said:

Piers and All ……. Hey, we’re all getting old and knackered to some degree and once you’ve been nigh on that last journey ……. and having by some miracle and lots of NHS tlc come thru to the other end that’s kept you actually alive ….. and comparatively able to keep going forward, ……. then we, well me anyway, just KNOW we’ve got to make the very best of each and every day that we actually awaken ……. AND maybe go buy that next Lexus to pamper ourselves …… it does no harm and actually quite gives one a huge uplift in spirits ……. the cost is irrelevant ( hopefully ) and the next happy adventure awaits ……. assuming there’s the energy left to do it …….. now then …….. what’s the new adventure to be eh !  🌞🥳👌

Malc  

answers on a postcard 😂

Well, it certainly shifts one's perspective on life. It's a gift and not to be wasted. In the 9 years after my heart bypass I ran and sometimes walked, approximately, 3.75 x 25k the circumference of the world. Just a tad over 90k miles with Sunday being a rest day. That stopped about 4 years ago with the onset of Arthritis, but I'm glad I had the opportunity to turn back the clock whilst it lasted.

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Would arthritis and whatever be ameliorated should you go swimming I wonder 🤔

I go 2/3 sometimes 4 X a week just 20 lengths, up and down, a half hour …… and all those sodding aches and pains I get with walking seem to just vanish ……. it’s a blessing and gets a Lexus or two out and about to fro the local swimming pool too 👏

Malc 

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47 minutes ago, Malc1 said:

Would arthritis and whatever be ameliorated should you go swimming I wonder 🤔

I go 2/3 sometimes 4 X a week just 20 lengths, up and down, a half hour …… and all those sodding aches and pains I get with walking seem to just vanish ……. it’s a blessing and gets a Lexus or two out and about to fro the local swimming pool too 👏

Malc 

Yes Malcolm swimming is key with arthritis/ bladder/ bowel piles / fissure conditions and for those swimming in the tropical sea daily a perfect fix for most conditions 

the Dead Sea, perfect for arthritis, so I'm told 

with regret, I can only manage a couple of trips a year so only get a little respite but thankful nonetheless

my surgeon also says the same swimming, is by far the best 

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16 minutes ago, Malc1 said:

Would arthritis and whatever be ameliorated should you go swimming I wonder 🤔

I go 2/3 sometimes 4 X a week just 20 lengths, up and down, a half hour …… and all those sodding aches and pains I get with walking seem to just vanish ……. it’s a blessing and gets a Lexus or two out and about to fro the local swimming pool too 👏

Malc 

I swim like a block of concrete so i thought I would rather go driving. Swimming and indeed walking in moderation is pretty much recommended for people with Osteoarthritis which I do have, but they have no remedial benefit to people who have Rheumatoid Arthritis which is a completely different thing which I also have.  I am 4 years in on treatment for that ,but nothing as worked to stabilise me yet except Cortisone injections ,but they won't give those too often because of side effect issues. Fortunately, I am fairly resiliant so on any given day I say f... it and do whatever I can do and I call it a win.

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