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TURP versus PAE versus natural methods

by Gene
(LA, CA)

Hi Ron,

Unbeknownst to me, I was harboring a bladder stone found in an ultrasound, and was told it was most likely related to bladder voiding issues. I knew I was having occasional trouble (frequency, hesitancy and slow flow) but it didn't seem over the top. CT scan revealed no abdomen or pelvic masses; PSA of 1.3; Prostrate volume of 105 (66 years old), no cancer.

The urologists however, was horrible. Rammed a Cystoscopy up the urethra so hard that I screamed in pain. Right afterward, he said, "You'll need prostrate surgery right away." To which I replied, "What about the stone?" "What stone?" he said, "I didn't see any stones."

I went home perplexed and in terrible pain. 24 hours later, I was in agony and could no longer urinate. A visit to the ER revealed that I had an antibiotic-resistant UTI caused most likely by "dirty medical equipment". Within hours of a combo treatment, I could urinate again, albeit very slowly, and was no longer in pain.

Long story short, the UTI resolved in 10 days, and so did the urination problem, but the BPH is much worse now than before this all started. So now my PCP is recommending addressing the prostrate enlargement.

He recommends Prostate Artery Embolization, which is a form of radiation treatment to shrink the prostrate. He says in his practice he has seen much better success and far less complications with PAE than with traditional TURP (Green Light Laser included) for BPH. Having already experienced the wrath of bad medical care, I'm hesitant and want to be thoughtful.

So my question is this: What advice would you give if one decided to go the medical route, and which treatment (PAE or TURP) in your opinion is preferable for BPH? Is there another treatment you have heard of that is better than these two? And finally, how would you go about trying a natural approach first, to see if that solves the problem before resorting to medical intervention?

Can't wait to read your book, and thanks in advance for answering this.



Ron here...

PAE (embolization) is the least invasive as it blocks the arteries feeding blood supply to the prostate, thereby supposedly shrinking the prostate. It may work but for how long is one question I would ask your doctor and see if he can show you longer term studies... it has only been around for 10+ years.

It also has an unknown risk that I don't see being addressed: blood flow allows flushing of the prostate of potential toxins and what happens if blocked over time? It could lead to future problems. I got no lasting results from it.

TURP was a surgical procedure which is now being replaced by Green Light Therapy. The skill of the doctor is crucial for the best results.

Rezum is a steam-based therapy that may be an option less invasive than the laser.

Natural approaches can work, but requires time and real lifestyle changes... and it may also depend on how calcified the BPH is. At over 100 ml, your prostate is about 5 times larger than normal. If you go this route, see if you start getting improvement and if not then you will have to decide what to do. In the meantime gather all the pros and cons of each therapy and ask questions of your doctor and get a second opinion at least before deciding.

Hope this helps.

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