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Benign prostatic hyperplasia and Tamsulosin

Posted , 15 users are following.

Barneybear
Barneybear

Hi.  My husband suffered urinary retention for the first time just over two weeks ago.  He was seen in A & E and urine drained via catheter.  Went home that morning with the catheter which filled with blood so back to A&E where they decided he needed a larger catheter and bladder washout.  He was admitted for one night.  He was discharged and told appointment would be made.   However the next day we saw a urologist privately who explained what he thought the problem was and ordered blood tests plus PSA and ultrasound.  He also started him on antibiotics and Tamsulosin.  Tamsulosin had a very quick good effect with his peeing.

When we saw the consultant again last week he said the PSA was 1 point something and blood tests and scan OK.  He has suggested he continues with the Tanmsulosin and considers TURP.  We've put that on the back burner for now but what really worries me : is he likely to have further retention or do the tablets prevent this.  I think I worry more than he does as it was such a shock!

Thanks for any help.

 

0 likes, 43 replies

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  • dl0808
    dl0808 Barneybear

    Posted

    Ur husband is suffering from BPH. Retention is the consequence of the urine channel is blocked or severely constricted.

    obviously, the first step of treatment from all urologists is drugs. If drug works why suffers the complications from surgical intervention as all surgical technologies have complications?  There are only two classes of drugs to treat BPH though with different brand names. The class ur husband is taking has the effect of relaxing the muscle around the urethra or channel and as a result, the channel is More opened up. Ur husband is lucky as the drug work.

    The next step is to check if the drug has any side effects on him and how much the drug is helping him. If the answers are no side effect and help him a lot then do nothing as the problem is resolved.

    to find out what is wrong with the prostrate. There are 3 tests. Cystoscopy: a scope is put inside the prostrate to find out the seriousness of blockage.. Urodynamics: a plastic tube is inserted inside the prostate and measurements are made to decide the bladder pressure,retention or post void volume, urine discharge volume, urine flow speed, etc. Rectal 3D unltrasound: measure how much the prostrate has enlarged. But all these are not treatment but to understand the situation. If insurance covers them, u may consider doing them, but also listen to ur urologist.

    the next step is when the drug has side effect, ur husband does not want these side effects or simply does not want to me the drug year after year, then the only option left is surgery invention.

    there are many technologies for BPH symptoms relief, it will take a long time to understand the advantages and disadvantages for each and which is best suited for him or u could just follow the advice of ur urologist.

     

    • richp21
      richp21 dl0808

      Posted

      Thanks for your post. A couple of comments:

      >>Cystoscopy: a scope is put inside the prostrate to find out the seriousness of blockage.. <<

       I don't believe it is put in the prostate. It is put in the urethra and snaked up the entire length to the bladder.

      >> or u could just follow the advice of ur urologist.<<

      I would be careful doing that. They can have a procedure that they recommend because they have a lot of experience with it, when another procedure might be a better choice. Particularly if it's a procedure performed by IR's and not urologists, such as PAE and FLA.

      Rich

       

    • Motto
      Motto dl0808

      Posted

      Interesting. My Uro did not mention ANY of these tests. He's ready to do his TURP. 

    • oldbuzzard
      oldbuzzard Motto

      Posted

      TURP should almost NEVER be the first option - it should be the last and is pretty much obsolete. Any doc who recommends it as a first line treatment for BPH is committing borderline malpractice. I would find another urologist ASAP
    • Motto
      Motto oldbuzzard

      Posted

      Yeah, I agree. Thanks Old Buzzard. Great name BTW. I am in the process of leaving him. 

       

    • dl0808
      dl0808 richp21

      Posted

      I agree. Her husband has two choices: listen to his urologist or spend A LOT OF TIME to understand various treatments for the disease or both.
    • dl0808
      dl0808 Motto

      Posted

      Without knowing the condition of the prostate and wanted to do TURP is truly INCREDIBLE!

      TURP is well known not to work well for prostrate size >80 cc.

      also u may want to understand the pros and cons of various technologies. For example, HeLEP is known to be one of the best technologies for large prostrates, etc.

      if ur insurance covers it, u may want to get those tests done so u know what u have.

    • derek76
      derek76 dl0808

      Posted

      The poster from expressions used is in the UK. In up to date hospitals they now have all urology tests done on the same day. However ones that say TURP are obviously not up to date.  .
    • dl0808
      dl0808 derek76

      Posted

      Lucky u, people from UK!  UK takes good care of u!!!

      In the US, except for rectal ultrasound($4xx) both cystoscopy and urodynamics each costs over thousand dollars (like 2XXX dollars). My Urologist did not offer to do them for me and I have to ask for them.

      I had them done. 

      Also I called Columbia medical center urologic department about aquablation, which it does not offer anymore. The dr's assitant told me that 

      out of pocket, hospital stay is $22,XXX, Doctor fee $8,XXX, and anaesthesialogist $?????

      definitely BPH is a disease for people who have a good size bank account.

    • dl0808
      dl0808

      Posted

      Or good medical insurance.
    • hank1953
      hank1953 dl0808

      Posted

      Hi dl, many US people on this forum had cystoscopy and/or urodynamics, yet I've not read anyone complaining about having to pay for it, especially at the prices you mentioned. Hank

    • dl0808
      dl0808 hank1953

      Posted

      From your reply, It seems that most medical insurance  policies cover cystoscopy. It is expensive because it involves Dr fee, anathesialogist fee and facility fee.
    • hank1953
      hank1953 dl0808

      Posted

      Let me guess: you don't have US Medicare. Hank

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