Been on Dutastearide + Alfusozin+Urotone for 4o Days? No Improvement

Hi Jagdeesh,

Sounds like your major problem is number of trips to the bathroom. What others symptons are you having such as painful urination, urgency, incontinence, etc? Also, what is your PVR (post void residual). PVR is how much urine is left in your bladder after you go to the bathroom. I'm sure your urologist measured this in the office with a bladder scanner and/or it was part of a bladder/kidney ultrasound study. Knowing your PVR is important in determining whether your frequent bathroom trips are caused by incomplete emptying or an overactive bladder which can then determine appropriate next steps.  Speaking of which, what tests has your urologist run? Bladder/kidney ultrasound study? Cystoscopy? Urodynamics? Flow rate? 

Jim

From the meds list of what was prescribed I assume doc thinks your retaining urine. As Jim asked did he do all the tests jimjames asked? Seems from the drug list doc suspects a bladder issue but also seems big.

Jagdeesh:

Rapaflo helped me more than Alfuzosin.

Dutasteride didn't help me.

Re: bathroom trips:  cut out alcohol and caffeine (if possible)

The way doctors work is that they will start you off with meds, some of which are patient samples left by manufacturers reps .Many do not work. After a while the doctor will recommend surgery to you. Don't rush into anything but do some research.

I found Terazosin (Hytrin) to work best in my case instead of Rapaflo and Flomax. I had a weak bladder and this one seemed to work the best. I also tried Bethanechol for a time after reading about it here. It seemed to help with the starting of urination, as did the Terazosin. My Dr. was concerned about me being on Bethanechol long term, as he wasn't sure of long term effects. There was a lot of data on Terazosin, so that one didn't bother him. (It is also used to reduce blood pressure). 

I am not taking anything now, as my surgery has worked and I am off all the meds. 

Two nighttime trips, 15 during the day?  It's usually the other way around.  You're taking Dutasteride.  Some men have fewer problems and symptoms after three months of treatment, but a treatment period of at least 6 months is usually necessary to see if it will work for you. Give it time.

If any of those drugs work the same as fernasteride it takes 6 months or more for them to start shrinking  your prostate. Ive been on fernasteride since March 2016. In December I started to see results from it. I have also been on tamsulosin since May 2016. That helped with in a few weeks.. Recently swapped dailey cialis for the tamsulosin. Jury is still out on how well it works.

jagdeesh,

You have to give Dutasteride 4 ot 6 months to act before you give up on it. 2 night trips is not bad. Good luck.

 

Hi. Dutasteride is a super-set of Finasteride (and more expensive!). It works on two parts of DHT rather than one. I was on it for a short while. It takes 6 mths to a year to have any real effect. If it doesn't work then one of the various operations may be needed. Your prostate isn't too big yet (mine was 130gm) but a lot depends on it's shape and whether it is starting to protrude into the bladder like mine was. Also my bladder had been stretched due to urine backup so you may need to consider a few things to help decide whether an op is necessary. I finally had a very successful HoLep but your needs may be very different.

Hi Jagdeesh,

Where are you located and how old are you? 

First of all, none of us are doctors here, or have access to your medical records, so please keep that in mind. 

That said, your symptons are more suggestive of overactive bladder syndrome than typical BPH with retention. 

For that reason, I'm a little puzzled at the drug treatment your doctor has suggested. For example, Urotone seems increase bladder contractions while your problem seems that you have too many bladder contractions.

I also question Duasteride which shrinks the prostate, and yet your prostate is not that large, and again you do not have retention. Duasteride can also have some unwelcome sexual side effects, possibly permanently.

Alfuzosin is sometimes indicated for overactive bladder but it doesn't seem to be working. Either that or the Urotone is interferring. Some studies Tamsolsin is better than Alfuzosin or that both should be used in combination.

Pelvic floor exercises and bladder retraining are also often suggested for overactive bladder. Also, the avoidance of caffeine (coffee and tea) as well as alcohol. 

If it were me, I'd seek out a second opinion, with a urologist not affiliated with the same hospital for a more objective view. Another possiblity is prostatitis. I would certainly not rush into any type of surgery or procedure at this point.

Jim