45 yr old with LUTS
Posted , 8 users are following.
Hi, I'm 45 years old and experiencing lower urinary tract symptoms. I thought I was too young to be experiencing these problems and yet here I am. My problems started spontaneously about 3 weeks. Got home from work feeling a bit "off". This feeling of "off" was also accompanied by some mild pain in my lower groin. But I really became worried when I tried to urinate later that night and just couldn't. At 2am it became unbearable and decided it was time to go to hospital. I jumped in the shower to get freshened up and as soon as the warm water started running, I could feel my muscles relax and was able to urinate. That was my life for the next week. I was home bound and only able to urinate in a warm shower or warm bath. I saw the doctor that same night and he organised some blood tests and ultrasounds and urine test. He thought it may have been a UTI, but the urine tests have come back negative. Likewise my PSA (and CRP) levels are normal. The ultrasound showed that my kidney, bladder and prostate all look fine and that my prostate is not enlarged. I have now seen a urologist who has booked me in for some Urodynamic function tests to identify where the problem is, but I have to wait a few more weeks for that test.
For now, my doctor has prescribed me Flomaxtra (tamsulosin) and this has helped a lot. Took about 3 days to notice the affect but urination has sort of returned to normal, although some days are better than others for reasons I don't understand. The only side effects I've experienced are the sexual related ones. I seem to now have retrograde ejaculation, and the orgasm intensity is significantly reduced. I'm happily married and with children, but as a 45 year old male this is all very alarming and has really gotten me down over the last few week, to the point of feeling very depressed. I don't know if I will have to stay on these meds long term or if there is another solution for my problem, once they can work out what the problem is.
I was thinking of switching to Alfuzosin which seems to work as well as Tamsulosin, but with less sexual side effects. I'm wondering if anyone has experience with both medications and what their experience was? Do you prefer one over the other?
I'm not seeking a medical diagnosis, but it would just be nice to hear from some people with similar experiences and how they have managed. This is all very new to me and not something I expected. Are there any other people here in my age group with the same problem as me?
Many thanks.
Tony.
0 likes, 13 replies
kenneth1955 Tony300
Posted
Hey Buddy
Sorry that you are having a problem
First of all you need to get off both of them medications. Flomax and Alfuzosin both suck. I was on both and I had retro ejaculation and it took my orgasm away. If you take these medication it can take away your ejaculation and you orgasm away for ever. You will never get it back.
You need to get a medication from your doctor that will work and give you no sexual side effects. At 45 I would not want it and being 65 there is no way.
Here are a few that you can ask your doctor for. Myrbetriq or Vesicare. They will work
Also they have compared Flomax to Viagra which will work the same without any side effects. They have been giving a low dose of Viagra for BPH and it works great.
Take care and do what you have to but talk to your doctor and ask for a medication that will cause you no sexual problem. That is your right. Don't put up with anything you don't have to
Take care....Ken
hamza1995 kenneth1955
Posted
Vesicare will fix the overactive bladder problem, it will lower his urgency to go to toilet every 30 minutes or so, but it won't fix his urine retention issue. In fact, Vesicare will make him retain even more urine. Are you sure Flomax or Alfuzosin take away orgasm and ejaculation forever? I have never read that anywhere. I am on Alfuzosin for 2 months now, I am still firing like crazy. Better than before in fact. Tamsulosin, I was on for 2 months before for LUTS, and that did cause retro ejaculation, but I never had altered sensation of orgasm except for no semen coming out.
@Tony300, since Flomax has worked for you, your problem is either a bladder issue or a prostrate issue. Urodynamic is a good test to pinpoint the cause of your problem. When they insert catheter, make sure it's well lubricated and no more than 7Fr. Let the lubrication come into effect first before they insert it. The lubrication must come into effect. Best of luck.
kenneth1955 hamza1995
Posted
Hey Buddy
As you know each man will have a different reaction to medication. Years ago before I had my Urolift I was on Flomax and Rapaflo. It gave me retro and no orgasm. It just want flat. Nothing and it p****d me off because he did not tell me about it. I stopped taking it and told my doctor and 2 weeks later I had the procedure. It is over 7 years still wide open.
I do take Vesicare but I do not have a overactive bladder. I have a tight internal sphincter. It will relax the whole groin area. I take it at night. I only go 2 or 3 times
a day. Depends on how much I drink.
There were a few guy's on here years ago that were on Alfuzosin for a few year and stopped and nothing came back. It affect some men different.
Yes I think he has a bladder problem. I hope he is able to get some help
Take care......Ken
Tony300 hamza1995
Posted
thanks for your comments hamza1995. If I wanted to switch from Tamsulosin to Alfuzosin, what's the correct process? Is it just simply a case of stopping the Tamsulosin and start taking the Alfuzosin at the same time of the day that I was taking the Tamsulosin previously?
Thanks
Tony
hamza1995 Tony300
Posted
That's up to your doctor. Tamsulosin is a lot more potent than Alfuzosin. Hence the unwanted side effects. Don't stop taking the medicine without contacting your doctor.
Allondon Tony300
Posted
Hi Tony,
45 is not early for prostate issues for some...
To me 2 facts do not sound right:
You may wish to have an MRI which is much more informative than an ultrasound.
Regarding the medications: Tamsulosin, Alfuzosin, Doxazosin and Silodosin have similar side-effects, more for some, less for others. You may try 5mg/day Cialis instead.
It may be a good time to learn self-catheterisation.
Good luck!
Tony300 Allondon
Posted
Allondon, yes, its all been very strange. According to all my blood tests, urine tests and scans i am perfectly normal. And yet i can not urinate without warm water to relax the muscles or use of medication like Tamsulosin, which also relaxes the muscles. The Tamsulisin also seems to control the urgency. Because the other strange thing is, that while i cant urinate, there is an urgency to pee every couple of hours. And even when peeing using my warm shower trick, i felt like on many occasions i couldnt empty my bladder properley and within 30 minutes, it felt like i had to pee again. Even though there was nothing in there. On Tamsulosin at least, this is controlled and back to normal.
I thought it best to add more info; while the urine retention issue came on suddenly i feel like my urine flow has decreased a little over the last year or so. No issue with urination per se, but just a slightly weaker stream. Never thought much of it, but in hind sight, maybe that was an initial sign of future problems.
Also, since this began a few weeks back, i sometimes get a dull ache in my perineum, especially when standing for extended amounts of time. This is a new thing, never noticed aches or pains there before.
From what ive read, this sounds like some sort of prostatitis....ie, pain in the perineum, difficulty urinating but also an urgency to urinate. But on ultrasound my prostate is normal size, my PSA is normal and my urine test is negative. So im really confused.
Not really looking forward to the Urodynamic tests as the insertion of catheters scares me. But i feel its the only next logical step to try and determine whats going on.
michael31017 Tony300
Posted
I had a urodynamics test done late last year when I was completely blocked after 2 TURPs and my urologist wanted to see the entire system working to figure out next steps. It's all a mind game before and during the test. Read up on the procedure and how it works, become an active participate in the data gathering vs simply a patient. Note in your mind that you are a 45 year old Formula One race car that needs some dynamometer testing for maximum (urination) performance.
The catheter that goes up into the bladder is really thin and well lubricated. This is used for filling the bladder with saline to see how the body responds to a filling bladder. I had a really nice female nurse inserting the catheter and my only concern that day was if I would have an erection from being handled by her. (Diversions like this are nice) (And if I did get an erection, no worries because that's life!)
Two sensors are stuck around your bumhole. A small lubed up pressure sensor is stuck up your rectum a few inches. Since you are standing with wires and a catheter connected to you, it's rather funny to experience and not painful at all. You can laugh at your situation and make jokes. It's ok.
The urologist slowly fills your bladder with saline via the catheter. His goal is not to fill you up like a big water balloon, it's to see how your brain/body react when the bladder gets to that "time to pee" fullness. The urologist should say "tell me when you start to feel a need to pee, tell me when you'd start looking for a bathroom, tell me when you need to pee immediately". The computer/device records all your data on a chart that shows how things are working. Soon, it's over and you can empty your bladder and go home. I went to the pub for a celebratory beer afterwards.
Tony300
Posted
Thanks everyone for your comments. So I've read a lot about the prostate related issues that could be causing my problems. But I know very little about bladder related issues? What could be wrong with my bladder? Ultrasound of my bladder showed everything was normal. But what other things could be wrong and not picked up by ultrasound?
Many thanks
Tony.
michael31017 Tony300
Posted
Hi Tony. I found it very useful to study how urination is supposed to work, considering the Internal Urinary Sphincter (IUS), the External Urinary Sphincter (EUS), bladder/brain interactions, how IUS is controlled by the brain, EUS is controlled by you, etc. My Urologist is smart but has a poor "bedside manner" such that he throws words around that made no sense to me until I did some studying. Knowledge is Power! This information will come in handy during Urodynamics testing, Cystoscopy.
pav886 Tony300
Posted
You can have bladder neck obstruction(especially if tamsusolin works it can be either bladder neck or something with prostate), damaged wall of the bladder, etc.. There is a lot of things that can make this problem.
Solution is one to be 100% sure. Urodynamic or uroflowmetry and cystoscopy - the first and the last is not very pleasant diagnostic method, but we have to do all to be healthy.
TKM Tony300
Posted
Tony,
I found that Afluzosin had less side effects than Tamsulosin but did not improve urinary flow as well as Tamsulosin. Tamsulosin and Afluzosin caused me temporary Retrograde Ejaculation but I get it back within about 12 hours, so if I time it correctly it does not affect my sex life. Kenneth is wrong when he says Tamsulosin and Afluzosin cause permanent Retrograde Ejaculation. I think he is confusing Aflusosin with Avodart. Avodart changes hormones in the body, and can cause permanent loss of libido. Afluzosin and Tamsulosin work by relaxing the prostate, and do not cause loss of libido or permanent Retrograde Ejaculation.
Thomas
kenneth1955 TKM
Posted
Hey Buddy
Tamsulosin and Afluzosin will work different on everyone. I was just saying what a few guy's had got after being on them for 3 years.
What every you take do research on them before you take anything. Some doctors do not know all the side effects of all the medication that they give out. They should but they don't they are just trying to help you pee better. Your sex life does not matter to them
I remember reading about one of the guy's late 40's the doctor told him that your ejaculation should not matter when you are picking a procedure or medication. You don't need it unless you are having kids or doing porn. I'm sorry but that should not be up to the doctor.
All the best....Ken