let's talk BPH, please.

I know it's not cancer but this is the most knowledgeable group of guys around in terms of prostate.

I have had weak urine stream since 1990 or so, and get up three to four times a night. 25 mg Cialis keeps me reasonably well, go two hours on a trip before stopping. Flomax side effect for me is full on ED, so I didn't keep that up.

Is there any long term treatment (maybe greenlight laser) that is virtually free of side effects?

Every time previously that I looked into it the side effects from TURP seemed a lot like RP, with uro's saying "most of my people do pretty well." Last time I looked, it was hard to find numbers but they were higher than I am comfortable with and IIRC, even greenlight laser had 8/9 % ED.

I'm enjoying life, making more trips to the bathroom than I would like but I can live with that better than I can potential side effects.

I am doing Testosterone Replacement Therapy, which generally tends to make BPH worse.

Any comments appreciated.

Yep Ken you are getting old. Like the old uncle in "No country for old men" said "You can't stop what's coming,to thing otherwise...that's just vanity" Or to quote Travolta in one of his pictures."not everything turns out the way you think it should"

 Well I'm 10 years younger than you but way older than you in terms of sexual function for sure. As my signature shows below I was diagnosed with prostate cancer at 52, 7 years ago. I had suffered with bph for many, many years before that, peeing every 2 hours night and day. I found it really, really annoying, getting no sleep. I had tried flowmax and cardura which both made me dizzy when I stood up due to interaction with blood pressure pills. I was about to start avodart when the cancer was found. One of the reasons I chose surgery over radiation was because of the bph. I knew my prostate would continue to grow even with seeding and then I had read turps and other prostate reducing surgeries were much more difficult after radiation. I gambled on the surgery to get the trifecta of no cancer, no incontinence, and no impotence (plus the bonus of no bph!) Alas, I lost on the last one, I still and will always have to use trimix for sex which is a poor substitute at best. But the bph is gone, most nights I don't get up at all. What a tradeoff that was.  Given that I have low T and am taking TRT to maintain a low but normal range of testosterone to prevent osteoporosis my sex life has sort of fallen off a cliff. My wife also has numerous medical problems making her uninterested in sex. As to your  specific question  is there any guaranteed prostate reducing procedure such as a turp or the laser or any other procedure that absolutely, positively will not cause impotence of course not. Doctors have to put in disclaimers to keep from getting their butts sued. If I were you I'd read all the literature on these procedures and see on maybe the franktalk.com website what other guys say about how it affected their sex life. Before I was diagnosed with prostate cancer I considered a turp and was told the chance of impotence from that was 1%. Still it will always be a gamble to mess with the prostate no matter what they say, only you can decide if the gamble is worth it.

Have you looked into GreenLight laser treatment for BPH. A friend went through the procedure without any problems, and had a fast recovery.

thanks for the replies.

I will check these out.

If there are more, I will check them out also.

one other thing.....
Have you ever been diagnosed with varicocele?
A very large % of BPH sufferers (especially younger men) have varicocele.
There is a Gat-Goren procedure that fixes them and reverses BPH.
Problem is that it is only done in Israel/Cyprus and very expensive... think $20K.
But, basically the same procedure is done here in the USA.
It is a varicocele repair done by an interntional radiologist.

You can look for the thread on this site titled "Gat Goren, PAE, LUTS"
https://www.healingwell.com/community/default.aspx?f=35&m=3404502
This thread has been going on for quite a few years and is in its 7th thread. They are all connected and you can wind your way back to the first one by clicking thru the link on the 1st post of each "newly updated" thread.

Lots of reading, but the gist, is that varicoceles reduce the bodies ability to pull the testosterone from the testes to the rest of the body effectively. Because of this, abnormally large amounts of testosterone pool in the prostate and stimulates it to overgrow. Fixing the varicoceles allows the testosterone to be routed back to the body as intended. Supposedly, this "fixes" the BPH problem and also increases testosterone in the body where it is supposed to be.

Happy reading./

Ken –

I'm jumping in here to say a few words because I also am 69 and had to deal with BPH for a while, like you, but in my case along with prostatitis (see signature below).

I ultimately did have the standard TURP (about five years ago) which did indeed do wonders for improving urine flow, but at the cost of permanently dry ejaculations.

But there was also one other thing that happened to me at that time and hasn't been mentioned so far, and it may never happen to you, but it's one thing you really do need to be aware of.

In my case my BPH symptoms got progressively worse until one morning in early July 2011 I woke up, went to the bathroom first thing, and despite having a full bladder, could not pass urine at all! My increasingly enlarged prostate had finally just entirely blocked off any urine flow at all!

Believe me, there is hardly a scarier feeling in the world than having a full bladder and not being able to release it! No matter how hard I tried! And this knowing that my bladder was just going to get fuller and fuller! I had no choice but to proceed immediately to the ER of a local hospital where insertion of a catheter provided great relief, both physical and psychological, and in effect started the ball rolling that eventually led to my TURP shortly after that and finally to a PCa Dx.

Again, not saying this will ever happen to you, but it is possible that it could some day (I'm proof that it does happen), so it's something to bear in mind, if your BPH does indeed get bad enough.

Not wishing to be negative, but it is something you need to be aware of, and something you never want to experience firsthand, believe me.

So now would be the time to take whatever steps you think helpful to prevent such a scary possibility, by dealing with your BPH situation now before it gets any worse.

When I had the biopsy that diagnosed PC Gleason 6 my prostate was discovered to be 137 cc. It was a little unnerving in the midst of my biopsy to have the doctor ask for a technician because he could not get the machine to show the entire prostate without adjustment.

I had slow flow for many years and finally got scoped. My urethra had almost closed so I had a standard TURP about 14 months ago. Flow has been great and did not have any of the negative side effects.

Only possible negative side effect is that if I eventually elect to leave AS I cannot choose seeds after having a TURP.

By the way, finesteride has shrunk my prostate to 40 cc at last biopsy and my PSA has gone from 4.7 at diagnosis to .77 at last reading.