Enlarged Prostate

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Was advised by male family members to take a PSA test, which I did and results came back as 3.4 ( I realise this might not seem huge but when you're expecting 0 it was ). Was advised to see doc for discussion. Examination was carried out and sure enough I have an enlarged prostate. I'm 57.

Now the waiting game . . . Can anyone tell me how long ( roughly ) I have to wait to see the urology specialist and possibly start treatment.

Also, I've had pain in my hip for quite a while, could there be a link ? I was blaming sciatica but only bothers me when sitting.

DIP over 2 years ago

I've been told by my GP that my PSA is normal, although he hasn't told me the exact figure. A Less than 1ng/ml requires repeating the test every 2 to 4 yrs and between 1ng/ml to 3ng/ml , every 1 to 2 years, if the rectal exam is normal. My only symptoms right now are urinary frequency at night. My doctor has made a referral for me to see a Urologist but I have to wait at least 26 weeks. My prostate is normal in size and my digital exam was also normal. I am a healthcare worker. When you get to see a Urologist, they will repeat my PSA test, do an MRI scan ( which is very detailed) and if it looks suspicious, a biopsy will be performed. In the meantime, I can't see me waiting for that long and worrying about it. I will speak with my GP about having this scan privately. It costs about £1,000. If cancer is suspected, then a biopsy would be ordered much sooner. Hope this helps.

Mac3 over 2 years ago in reply to DIP

Every bit of info helps, thank you.

Rival over 1 year ago

When considering treatment options for benign prostatic hyperplasia (BPH), it's crucial to evaluate the full spectrum of available procedures and their respective benefits and drawbacks.

Comparing BPH Treatment Options

Minimally Invasive Procedures

Focal Laser Ablation (FLA) and Prostate Artery Embolization (PAE)

Both FLA and PAE stand out as minimally invasive procedures that preserve the original urethra:

FLA uses MRI-guided laser technology to precisely target and ablate prostate tissue, reducing pressure on the urethra naturally as the treated tissue shrinks.

PAE involves blocking blood flow to the prostate, causing it to shrink over time.

These procedures offer several advantages:

Outpatient treatments with minimal side effects

Preservation of sexual function

Effective for treating specific areas, including the median lobe more so with FLA.

Potential for longer-lasting results compared to UroLift.

It's worth noting that urologists may not frequently recommend FLA or PAE, as these procedures are typically performed by interventional radiologists.

UroLift and Optimune

While UroLift and Optimune don't shrink the prostate, they offer alternative approaches:

UroLift mechanically holds enlarged tissue away from the urethra. This could push prostate tissue into the bladder, not a good outcome.

Optimune manages symptoms without the risks associated with physically squeezing the prostate tissue.

However, these methods may have limitations in long-term efficacy as they don't address the underlying prostate enlargement.

Surgical Options

For larger prostates, HoLEP (Holmium Laser Enucleation of the Prostate) emerges as a highly effective surgical option. It offers advantages over traditional TURP (Transurethral Resection of the Prostate) and newer techniques like Aquablation:

More complete removal of obstructing tissue than TURP and lower risk of bleeding compared to Aquablation.

Particularly effective for very large prostates

Other Treatments

Green Light Laser: While effective, it destroys the original urethra, unlike FLA.

Rezūm Water Vapor Therapy: Creates small holes in the urethra, which may be less favorable compared to FLA's non-urethral approach. FLA can target prostate protrusions into the bladder and around the bladder neck better as well.

Making an Informed Decision

When considering BPH treatment, it's important to recognize that patients have the power to choose their own destiny. The three procedures that often make the most sense are:

FLA: For precise, minimally invasive treatment

PAE: As an alternative minimally invasive option

HoLEP: For cases involving very large prostates

It's crucial to understand that a drug-based approach is generally not considered an acceptable long-term solution for BPH. Patients should be aware that they have options beyond what their urologist might initially recommend, especially considering the potential benefits of FLA and PAE.

In conclusion, while each procedure has its merits, FLA and PAE offer compelling advantages in terms of being minimally invasive, preserving urethral integrity, and potentially providing longer-lasting relief. HoLEP stands out as an excellent surgical option for larger prostates. Patients should carefully consider these options and discuss them with both urologists and interventional radiologists to determine the best course of treatment for their specific situation.

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