BPH

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I am now 74  year old person.First in the year 2011 i have undergone abdomen scan. Then my prostate size is just 27 cc. i met an urologist in india and he has suggested urimax 04 mg after the rectal examination. He said that i need not undergo surgery for this.Since the symptoms are very less except slow flow, so i have not taken any medicine.After three  years i went for another abodmen scan and observed that my prostate size  has grownup to 42 cc.So the eurologist prescribed  Dutasteride 0.4 mg. i have been taking this medicine since 2014. I confessed to him i did not take any medicine from the year 2011 to 2014. Except the slow flow i AM NOT EXPERIENCING  any other symptoms like urgency for urination, burning sensation while urinating, drop by drop urination, getting up frequently for urination . Some times i do not get up in the night for urination and some times i get up for only once to do this. My question is whether MY PROSTATE IS BEHAVING WELL WITH ME  AND WHETHER DO I HAVE TO GO FOR SURGERY OR OTHER METHODS?

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  • Posted

    Evening to you Vedanth,

    It's just gonna keep growing,  that's what it does.    I don't know what the avg size of the prostate is when in mid 70s.    Perhaps you should keep an eye on how much your bladder has in it before you feel like you have to pee.   That would require a visit to your urologist in the morning time and drink water till you have to go pee then just before have your doctor do a bladder scan,   Then go pee in a plastic container and see how many cc you peed out then have your doctor do another bladder scan and see if you are emptying out your bladder.    If you are then I would think you are good!   If not then of course you would want to discuss what your options are with good Ol Doc.     A lot of the men on this site have been talking about something called a PAE. (Prostate Artery Embolisim).  It's where a radiologist does the work not a urologist.   In essence the artery that feeds the prostate is blocked off which starves the prostate and is suppose to shrink it,   Which I have heard on this site, by somewhere around. 25%.

      So that is my input for you.    Prostate may be big but it you empty your bladder ok then,   I would feel like it's ok.   

    Have a nice evening V.

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  • Posted

    If you don't get up multiple times at night then its unlikely that you are having trouble emptying. If your situation is managable and other than a few extra seconds peeing everything is working OK, I'd leave well enough alone.

    None of the procedures are free of possilble complications and side effects and 42 is just barely above normal. Unless and until your prostate starts impacting your quality of life, I'd stop worrying about it and not look for trouble.

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  • Posted

    I would not rush into any type of surgery with "slow flow" being your only sympton, but would continue a "watchful waiting" strategy. Do you know how slow your flow is? Average flow for someone your age is around 10ml/sec, about half of what it would be for someone aged 40. This assumes your bloodwork and ultrasound are normal (no kidney issues). As to PVR (post volume residual) as metioned in another post, a moderate PVR in and of itself doesn't necessitate an operation if everything else is OK. A lot of folks here, even those who have had operations, would trade their symptons for yours. Don't mess with the prostate unless you really have to.

    Jim

    Jim

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  • Posted

    Since your symptoms are mild, I'd just stay with the Dutasteride.  My prostate was 86 grams, and even with tamsulosin and dutasteride I was getting up frequently and having a very slow flow.  Last January I had the HoLEP surgery, and that solved the problem completely.  Prostate now 46 grams, and PSA 0.2.  My research led me to believe HoLEP is the best surgery; the only problem is finding an experienced urologist who will/can do it. 
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  • Posted

    18 months ago,I had mild symptoms of BPH but was always able to eventually empty my bladder so didn't take action. During routine visit to my general practitioner (GP), he suggested I schedule visit to Urologist (UG) to check it out. Urologist did digital exam and endoscopy exam and informed that I had a huge prostate. For several more days after those exams, I started having spotting and way more severe BPH symptoms of all sorts which culminated in total blockage. Neither My GP nor UG was available but Nurse Practitioner (NP) sent me to various labs for more testing which took the rest of the workday to confirm total blockage. Late that afternoon a call from NP instructed me to go to emergency Immediately to get catheter inserted. After 4 hr wait, Emergency personnel did cath me and prescribed antibiotics and put me on FloMax. Took about a week to get catheter removed. Been on FloMax and Finasteride ever since. Hoping Finasteride will shrink bladder enough to get off FloMax.

    Point being, I feel that much of this misery could have been avoided if UG had just prescribed FloMax during initial visit to see if that would have relieved symptoms. Probably endoscopy and catheter and emergency visit all could have been avoided.

    labs for more testing which took the rest of the workday to confirm total blockage.  Late that afternoon call from NP instructed me to go to Emergancy Immediately to get catheter inserted.  After 4 hr wait, Emergancy personnel did cath me and prescribed antibiotics and put me on FloMax.

    Point being, much of this misery could have been avoided if UG had just prescribed FloMax during initial visit to see if that would have helped with my symptoms.  Probably endoscopy and catheterization and emergancy visit all could have been avoided.           

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