BPH - are we sure there are no other options?

Posted , 20 users are following.

Sorry if this has been posted before or offends anyone, just wanted to have a constructive discussion about it since I am curious and frustrated.

I have been dealing with BPH and LUTS for a while now and have recently been exploring all the pharma, homeopathic and surgical options available to make the situation better. One topic I read about recently dealt with the idea of prostate massage which seems to help, as described in a paper from Columbia University that I just read. I learned about such a procedure done by a professional and also a way to do it at home.

I'm frustrated with my prostate, not clear why it grows and causes me not to be able to empty my bladder, so I am researching all options. I am in my late 50s and don't want to take meds for the rest of my life, or have to carry a catheter with me or pay $$$ for surgery that seems to work mostly but not permanently.

Does anyone have any theraputic commentary on this approach to managing a growing prostate?

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  • Posted

    The only thing I've read regarding massage it that if you have an infection you can make it worse. I don't know if thats even true. If you decide to try it please post your results. I'd like to know more. I've heard it can be quite pleasurable also.

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  • Posted

    Expanding on my original topic a bit, here's a research paper discussing Traditional Chinese Medicine in the treatment of BPH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739225/

    https://benthamopen.com/ABSTRACT/TOUNJ-2-20 is an interesting article from The Open Urology & Nephrology Journal entitled "Evaluation of an At-Home-Use Prostate Massage Device for Men with Lower Urinary Tract Symptoms"

    I'm just not satisfied to follow the status quo in traditional thinking on this topic!

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  • Posted

    The prostate is normally about the size and shape of a walnut and weighs about 20 grams (less than 1 ounce). As men age, the prostate gradually increases in size. Generally, the prostate does not grow beyond about twice its normal size because the outer capsule of the gland restricts expansion. Because of this restriction, further tissue growth compresses against the inside of the gland, which can constrict the urethra and cause urinary symptoms.

    Prostate enlargement appears to be a normal process because it is so common. The only factor that can prevent prostate enlargement from eventually occurring is the elimination of testosterone. Men who have had their testicles removed or have had diseases that left them unable to produce testosterone do not develop benign prostatic hyperplasia (BPH) or prostate cancer.

    Prostate massage will not reduce its size though it is said to help prostatitis symptoms. With some people (me!) even a DRE can stimulate the vagus nerve and put them into atrial fibrillation.

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    • Posted

      I must disagree with you here. While some prostate enlargement is normal with age, BPH is a pathological disease due to uncontrolled cell proliferation or hyperplasia for reasons which are not understood. Its etiology is believed to begin with acute prostatitis that goes untreated and develops into chronic prostatitis later in life. This sets up a continual cycle of prostatic tissue destruction and growth mediated by the immune system which results in a never-ending inflammation cycle (hyperplasia). Hence it is believed to be an auto-immune disease which is why BPH responds so well to anti-inflammatories. BPH is not a normal part of the aging process - it is a chronic disease and must be viewed in that light.

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    • Posted

      I first went into AF after having my aortic valve replaced in 2012 but second cardioversion put me back into sinus rhythm. All was well until I had a colonoscopy over a year later that stimulated my evidently sensitive vagus nerve. I'm watching the procedure on the screen and on the other screen I see my BP dropping to 40/29 and heart rate 30. I think are they going to do something about this? They suddenly panic and start pumping drugs into me. BP and heart rate went fairly normal by evening and they let me go. I only live a short distance from the hospital and started to walk home. I suddenly felt my heart rate change and was back in AF.

      Back in NSR after another cardioversion until I had the DRE in January 2015 and have been in permanent AF since although my heart rate does not go all that high. They say that another cardiovesrion will not work as my left atrium is enlarged and I turn down their offers of various types of ablation. They say an ablation might reduce my left atrium size and a cardioversion might then work. My EP though asks why do you want to be in NSR anyway ?

      Yes, you should avoid 'The fickle finger of fate' as they used to say on Rowan and Martin Laugh in 😃

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  • Posted

    First you need to come to terms with the reality of BPH- it is a chronic progressive disease. There are a great many speculations about what causes BPH but no smoking gun. It is generally considered to be an auto-immune disease. So unless you are willing to have your prostate removed the best we can all hope for is to manage its progression as we get older and it continues to grow. For some men, a 50 cc prostate completely blocks their flow so some immediate intervention is required. For other men, like myself, a 300 cc prostate still allows me to have a good natural void supplemented with CIC.

    All the treatments currently offered, whether they be surgical, drug or naturopathic only help to manage the progression of BPH. They ALL have their strong points (symptom relief) and weak points (side effects) and like a "religion" they all have their fervent "disciples". The key for you is to identify the specific causes of your own LUTS problems and then choose a treatment option(s) best suited for your own pathophysiology, lifestyle and wallet. This forum is the best place to be for this journey. Good luck. Howard

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    • Posted

      Thanks Howard. I'm in that space of learning of all the options and trying to figure out a plan. Right now I'm on daily 0.4mg Tamsulosin that seems to work fairly well. I tried an experiment recently where I stopped taking it to see what would happen and it wasn't pretty. Up all night trying to empty my bladder, just not good. So it seems that my symptoms are hidden by the Tamsulosin and they are getting worse.

      Urologist is pushing for a Urolift and I've read all of Kenneth's helpful writings. General doctor suggests increasing Tamsulosin to twice a day then adding finasteride which seems to have negative side effects like impotence which is not what I want.

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    • Posted

      Have you considered one a day Cialis as tamsulosin has some nasty side effects. I once asked the practice nurse what was her most complained about drug and that was it. I said, Yes by men. She replied No, by their wives.

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    • Posted

      Michael!

      Tamsulosin is an alpha blocker like Prazosin and Flomaxtra etc. etc.. They try to confuse us with a magnitude of names. This also helps deflect Adverse Reaction reporting. I was prescribed alpha blochers 4mg a day 2006 to 2015. Though urologists had known since 1995 an increased dosage would be needed beyond 2 years no one had done the research for it to be prescribed. When I sought an increase in dosage in 2014 I was prescribed 5ARI Duodart. Dutasteride + 4mg Flomaxtra (Tamsulosin). Also many market and drug names. So I already was getting 8mg a day alpha blocking anyway. Unresearched. I really did not have to risk the 5ARI at all but was unaware of so much then.

      Alpha blockers smooth the bladder neck muscles. In 2015 Prostate Cancer and RP followed my BPH medication. Without prostate, shorter/straighter urethra and all that bladder neck muscle alteration incontinence goes on and on and on. Every medication has a list of side effects as long as your arm with a few still hidden. Think twice about any BPH medications.

      Barrie H

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    • Posted

      Funny you'd mention this... I just received 60 pills of 5mg Cialis (generic Tadalafil) from my favorite Canadian pharmacy and plan to take this daily beginning today. I've had 5mg Cialis in the past and it does "wake up" erection activity which is fun and refreshing. Previously I was dealing with low libido due to the Tamsulosin (i assume) and lack of sleep from getting up multiple times a night. Should be interesting to have this chemical in my bloodstream every day!

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