The Counsel is a private coaching practice for founders and leaders, offered one to one or within a small cohort. The work is candid, structured, and held in confidence.

Who is the coaching for?

For leaders who lead something real — a founder, an executive, or a partner — who have outgrown advice, are ready to do the work, and value discretion.

How does the coaching work?

Engagements run in seasons rather than single calls: regular one-to-one sessions of around ninety minutes on a steady cadence, access between them, and a structured review each quarter. There is also a small twelve-week cohort, held twice a year.

The work begins with a conversation. Most clients come by referral, but a direct enquiry is welcome and is read personally, not by a form. You can request a conversation from the enquire page.

Is the coaching in person or online?

Both. Sessions are held in person and online for those further afield.

How much does it cost?

Fees are shared in the first conversation, matched to the shape of the engagement.

Enlarged Prostate Treatment

Explore enlarged prostate treatment in Thailand, including TURP, laser procedures, minimally invasive options and personalised urology care.

TYPICAL COST

Approx. US$6,000–10,000+

TYPICAL STAY

Day procedure to around 3 nights, depending on treatment

RECOVERY

Light daily activities often resume within several days, although recovery varies according to the procedure.

Enlarged Prostate Treatment in Thailand

An enlarged prostate can cause urinary symptoms that become increasingly disruptive to everyday life. When medication is no longer effective or symptoms are more severe, procedural or surgical treatment may be considered.

Thailand offers specialist urologists, modern diagnostic facilities and a range of treatments for benign prostate enlargement, including TURP, laser procedures and minimally invasive techniques.

Siam Medica can help international patients explore suitable providers and specialists, share medical records for preliminary review, request personalised treatment plans and cost estimates, and coordinate care before, during and after treatment in Thailand.

What is an enlarged prostate?

Benign prostatic hyperplasia, commonly known as BPH or benign prostate enlargement, is a non-cancerous increase in the size of the prostate gland.

The prostate surrounds part of the urethra, the tube through which urine leaves the bladder. As the prostate enlarges, it can place pressure on the urethra and interfere with normal urine flow.

BPH becomes more common with age and can range from mild symptoms to significant urinary obstruction.

What symptoms can an enlarged prostate cause?

Common symptoms may include:

Difficulty starting urination
A weak or interrupted urine stream
Frequent need to urinate
Urgent need to urinate
Getting up repeatedly during the night
Feeling that the bladder has not fully emptied
Straining to urinate
Dribbling after urination

More severe obstruction can sometimes contribute to recurrent urinary infections, bladder stones, inability to urinate or kidney and bladder problems.

When may a procedure be considered?

Mild or moderate symptoms can often initially be managed with monitoring, lifestyle measures or medication.

A procedure may be considered when:

Symptoms significantly affect quality of life
Medication is not providing sufficient relief
Medication causes unacceptable side effects
Urinary retention develops
Recurrent urinary infections occur
Bladder stones or repeated bleeding develop
The urinary obstruction begins affecting the bladder or kidneys

The most appropriate treatment depends on prostate size, symptoms, general health and individual priorities.

TURP

Transurethral resection of the prostate, commonly known as TURP, is a well-established treatment for BPH.

A thin surgical instrument is passed through the urethra, so no external abdominal incision is required.

The surgeon removes prostate tissue that is obstructing urine flow, creating more space for urine to pass through the urethra.

A urinary catheter is normally used temporarily after the procedure while the prostate and bladder recover.

Laser treatment

Laser procedures can remove or destroy excess prostate tissue that is restricting urine flow.

Options can include:

PVP, or photoselective vaporisation of the prostate
HoLEP, or holmium laser enucleation of the prostate
Other laser techniques depending on the patient's condition and available expertise

Laser treatment can offer shorter hospital stays and reduced bleeding compared with some traditional surgical approaches in appropriately selected patients.

Minimally invasive treatments

Some patients may be suitable for less invasive treatments that reduce excess prostate tissue without conventional surgery.

One example is water-vapour therapy, in which controlled steam energy is delivered into selected areas of prostate tissue.

Other minimally invasive approaches may also be available.

These treatments are not suitable for every prostate size or pattern of obstruction. The urologist should recommend an option based on the individual anatomy, symptoms and treatment goals.

Assessment and diagnosis

Before treatment, a urologist will usually assess the severity of symptoms and investigate other possible causes of urinary problems.

Evaluation may include:

Medical and urinary history
Physical examination
Urine tests
Blood tests
PSA testing where appropriate
Ultrasound
Measurement of urine flow
Assessment of residual urine remaining in the bladder
Other imaging or urological investigations when required

The specialist may also need to distinguish benign prostate enlargement from other conditions that can cause similar symptoms.

For international patients, previous test results and medical records can often be shared before travel for preliminary review.

Preparing for treatment

Preparation depends on the procedure being planned.

The medical team will review medications, existing medical conditions and previous urological treatment.

Additional blood tests, cardiac assessment or anaesthetic clearance may be required before surgery.

Patients taking blood-thinning medication should discuss this specifically with the treating team rather than stopping medication independently.

International patients should allow enough time in Thailand for assessment, treatment, early recovery and recommended follow-up.

Hospital stay and recovery

Hospital stay varies considerably according to the treatment.

Some minimally invasive procedures may be performed without an overnight stay, while TURP or more extensive procedures may require several nights in hospital.

A urinary catheter may temporarily be required after some procedures.

Patients may experience urinary frequency, urgency, mild discomfort or blood in the urine during early recovery.

Light daily activity can usually resume gradually, while strenuous exercise and heavy lifting may need to be avoided for longer.

The treating urologist will advise when normal activity and international travel can safely resume.

Sexual function and treatment choice

Potential effects on sexual function vary between treatments.

Some procedures, particularly those that remove prostate tissue, can cause retrograde ejaculation, where semen enters the bladder rather than leaving through the penis during ejaculation.

Other possible effects can include changes in ejaculation or, less commonly, erectile function.

Certain minimally invasive treatments may have a lower risk of some sexual side effects, although their suitability depends on the individual case.

Patients for whom preservation of ejaculation or sexual function is particularly important should discuss this with the specialist before choosing treatment.