Posted 4/5/2021 6:49 PM (GMT -6)
I realize this forum is for PCa but I see you also respond to BPH questions and after reading many of the posts now for several weeks I've decided it would be worth asking some questions. I just reached 65 and was diagnosed with BPH at 55 when my PSA started going out of "normal" range, to 4.5. A local Uro recommended biopsy I think when I was 58 and it hit 7, so I had one done and it turned out negative. That is about all I remember, I must have gotten a Gleason score but don't think I have any documentation. I finally decided to see another Uro in a larger city about an hour drive away because all the local Uro would recommend is more biopsy's. The new guy says no need for biopsy and recommended starting with an MRI, so did that and he put me on Flomax and Finasteride which I have been taking now for about 6 yrs. He does the DRE each year and I get the PSA each year, which is usually between 1.7 (last yr) to 3.6 (2017). Says since I take Finasteride the real PSA is about double what the test says. A few years ago the annual urine dipstick found borderline blood so they did a blood analysis which was also borderline so I had my first Cystoscopy in 2017. After researching that I was very anxious! It was not too bad however and only really hurt when it moved through the prostate. I think I also experienced several days of pain during urniation, no fun. Nothing was found.
Sorry for going on so long with that history. I have been reluctant for years to do anything other that dread the annual visit to the Uro and hope he continues to not find anything alarming. He always says my prostate is large but I do not know how many cc's. I can only go about 2hrs now at night before having to get up and have been thinking about finding another Uro as this one never has much to say, and as long as he does not feel any bumps on the DRE he has no reason to suggest treatment. So I have been reading about the treatments now and thinking maybe I should consider having one. My one biopsy many years ago was painful and I was not excited about having that done each year. Reading now about all the treatments, UroLift, Rezum, Greenlight Laser, PAE, Aquablation, HoLEP, TUNA, TUMT, TURP, HIFU, has me confused about being able to pick one. Jeez, and maybe I missed a few! I found some described as being great until I start reading posts from people that have had them (like here). Thinking I should start with a new Uro, but realize that no all Uro's can do all of the treatments. Wondering what you would recommend I do to find a new Uro. Looking at the posts I did not find much on this issue. I've noticed that some treatments like Rezum and Greelight Laser are not done by any Uro in my state! I think my big fear right now is that I could wake up one day with acute retention, or complete blockage, something I had not heard of before visiting your forum. The more posts I read, the more anxiety I have, worried that I could be in for a lot worse. Maybe I am past due for another biopsy. Also concerned about picking a Uro only to find out he primarily does only one or two of these treatments and is biased towards others. Do I try to pick the treatment I think would be best and then find a Uro that does it, or just find a Uro that seems to have good ratings/credentials and go with what he recommends? So far, I have been trying to do both, but it is difficult to find sites that compare most of the treatments in ways that make sense and it is even harder to get good information on doctors, including patient ratings, up to date specialties, number of surgeries/treatments performed, or otherwise all the things you would want to know.