Αlpha Blocker Isn’t Necessary in BPH Patients Using 5ARIs

Posted , 6 users are following.

From BPH News:

"Patients being treated with a combination 5-alpha reductase inhibitor (5ARIs) and an alpha blocker may switch to 5ARIs alone with no worsening of lower urinary tract symptoms (LUTS), a new study says. But in overweight patients, the withdrawal must be carefully monitored."

For more details, go to BPH News.

I am doing OK with just Doxazosin (alpha blocker) and CICs (to protect my kidneys) for my urinary retention. Due to this article, I just started Finasteride (ARI), hoping that it will help me further and maybe I can stop taking Doxazosin 12 months from now.

Hank

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  • Posted

    I actually did what you did; that is, I was on Doxazosin and a 5-ARI.  I can only say I'm glad I'm no longer on Doxazosin.  As for the dutasteride, it does have side effects, but for me they're minor.  If I knew I was approaching acute urinary retention, I might consider dual therapy again, but only under those circumstances.

    • Posted

      Thanks Alan,

      So you did what the above study indicated. I am glad it works for you. Hank

  • Posted

    I had a 3T MRI around the first of April and it showed the prostate had shrunk to 46ml. I had lots of problems which jimjames helped me out with the first coupe of monthe. I was using the coloplast straight I get from the VA but saw civilian MD and he suggested I should try the coude. So far they have been working pretty well once I figured out how to use them again with jim's help

    Everyone is different. If you are getting a good response after a few days great..

    • Posted

      Hi jw,

      Jimjames has been a big help to me too. I have no problem with the straight whatsoever. With the coude, sometimes I bled a little bit. So I avoid coudes. It is probably because coude tip is more pointy and I have a sensitive urethra.

      BTW, with 46ml prostate, what was your latest PSA ? How about PSA and size before Finasteride ? Just curious. Thanks. Hank

    • Posted

      For me the coude seems to help when entering the bladder. It really seems to me that each guy is so defferent from the next guy that doing a bit of experimenting to figure out what works best for each of our own situations is the way to go. 

      My PSA has been ten plus of minus two for the last 10 years or so. Dont know the volume, had a CT back in 2005 that just said it was enlarged. My PSA last October before starting the finasteride was 11.18 and last Febuary it had dropped to five and doubling it would make it ten which is pretty much where it always is. There is probably a bit of prostate cancer contributing to that (the 3T identified a small PIRADS 4 lesion) but its stable and not growing and I'm the type of guy with the mental makeup that can live with it. 

    • Posted

      Jw,

      That's what the Coude is designed for. Hank and I joke some about Coude vs Non Coude, but I don't want it to get lost that Coude tips were designed for a specifically for men with difficult urethal passages caused by either an enlarged prostate or stricture. As to Hank's bleeding with the Coude, both from personal experience as well as reading the literature, this is the exception rather than rule, and if present, should be able to be resolved by switching to a different type/brand of Coude tip.  

      In my case, for example, I found Coloplast's Speedicath Coude very comfortable but some of the others not so. Hank, found the same catheter not comfortable, but was happy I believe with a different Coude catheter, the Speedicath Flex Coude. 

      Jim

    • Posted

      Jim

      I'm finding that I really like the Speedicath Coude. I still occasionally have a problem with the straights entering the bladder but have  been able to insert the coude's like a warm knife cutting through butter.

      The only problem now is getting my Rx updated in the VA's system I only had about 30 samples and they are about gone. Luckily the straights  work pretty good so I can wait. I'm using the 14 Fr, I still have some 16 Fr straights that will push their way into the bladder if need be but the coude for me is so much more comfortable...

    • Posted

      The Speedicath Coude is still my favorite. Once you get comfortabe with the FR14, try the FR12. The idea is to use the smallest size that will go in. You could try and see if Coloplast will send you some samples while you're waiting for the VA system. Also, you can buy them online (with and without an rx) if you want to go out of pocket. 

      Jim

    • Posted

      Since the civilan doc prescribed the coudes I was thinking of contacting Coloplast and getting some of the new Flex samples I'll also ask for some Speedicath Coude 12's.

      If I  get to where I really think I need them I'll drive the 100 miles to the nearest VA emergency room. The care I get from the VA is actually very good I just tend to be to lazy to seek it out unless absolutly necessary biggrin

    • Posted

      As long as you have an rx, Coude will send you samples. Not a bad idea to get a sample or two of the Flex and 12's, but first I'd see how many of the  FR14's you like they can send you based on the fact that you're waiting on the VA. 

      Jim

  • Posted

    For those that still follow this discussion. After 7 months of taking 5mg Finasteride daily, I just stopped it. The reason is that I have not noticed any noticeable improvements in my urinary functions. Perhaps my prostate is not large enough to actually reap any benefits. Hank

    • Posted

      Hank it took almost a year for finasteride to work for me. I'm pretty sure it has shrunk my prostate

    • Posted

      It might have shrunk my prostate, I don't know, but what relief I was hoping for did not come. I don't want to deal with all the potential side effects, without something to show for. Thanks. Hank

    • Posted

      The main reason is that my symptoms are very mild so it's hard to improve on. Hank

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