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

Posted , 12 users are following.

I have been taking  Dutasteride , Alfusozin, and  Bethanecol Chloride( Urotone) for  over  40 Days  for BPH-- as prescribed by an experienced Urologist at a  well-known hospital ; ; No improvement  ( Reduction ) in    number of  my  Trips to the washroom.( it is about  15 trips per day); and  Two times in the Night;  

Size of Prostrate  -- 65 to 70 ;  Total  PSA   test  results : 1.06.

Would  Not   like to rush into  surgery,,,( no surgery  so far .

No side-effects experienced so far  from medication  .

I earnestly seek    Advice/ Suggestions  from  dear members  on the following  pls : a) How long do I need to  be on  Medication  before  I see improvement ?  b)Secondly   are there  any  Medicines  which  are better / more effective  than  those  prescribed  above -- so that I  can go back and discuss with the Urologist .. c)  Any  other  suggestion  pls   which   would result in  Reduction of Trips to the Washroom ,  thanks :   Jagdeesh         

 

0 likes, 16 replies

Report / Delete

16 Replies

Next
  • Posted

    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

    Report / Delete Reply
    • Posted

      Dear Jim,,        

      Thanks for prompt reply and showing concern.  The Ultrasound Report mentions  My PVR is  about 30 ml,-- , Average Flow Rate is  9ml/ sec-- during the Uroflow Tests.;  Even after  several Trips to the Bathroom, I still get the feeling that the Bladder is not Empty;

      My Age is 62 Years ;   I  am off   Alcohol, Coffee, for last  four months;

      No incontinence,  No Painful Urination;   ... Urgency-- Occasionally:

      Your  Advice/ suggestions   would  be Useful ;

      Also  would  Urotone , Dutasteride( Fenasteride)  , Alfusozin,,  cause  any Side effects   if taken for  four-six months pls ?

      Your  experience, , suggestions would be   certainly useful pls >

      Members in this Forum are experience , Knowledgeable and well- reasearched,, Would  seek their  views ;

      Thks Jagdeesh  

       

      Report / Delete Reply
  • Posted

    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.
    Report / Delete Reply
  • Posted

    Jagdeesh:

    Rapaflo helped me more than Alfuzosin.

    Dutasteride didn't help me.

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

    Report / Delete Reply
  • Posted

    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.

    Report / Delete Reply
  • Posted

    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. 

    Report / Delete Reply
  • Posted

    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.

    Report / Delete Reply
  • Posted

    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.
    Report / Delete Reply
    • Posted

      Alfuzosin helps relax the muscles in the prostate and bladder neck, making it easier to urinate.Avodart (dutasteride) prevents the conversion of testosterone to dihydrotestosterone. Urotone tablet works by increasing the contraction of the urinary bladder muscle. Finasteride shrinks the prostate.
      Report / Delete Reply
  • Posted

    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.

     

    Report / Delete Reply
  • Posted

    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.

    Report / Delete Reply
  • Posted

    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

     

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up