Diagnostics tests to determine cause(s) of LUTS.

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What are the basic tests that should be done to determine the cause of LUTS? Based on my understanding at the time, I assumed that my enlarged prostate (98 cc) was causing my LUTS symptoms. I had a PAE in March of this year and I’ve experienced only marginal improvement.  Now from following the posts on the forum, I understand that the symptoms could also be caused or exacerbated by an underactive bladder, an overactive bladder, and/or strictures. I have an appointment with my urologist at the end of August, and I would like to discuss further testing with him before deciding on possible future procedures. The tests that I have seen mentioned on the forum include a bladder scan (to see if there is PVR?), a urodynamics study,  and cystoscopy.

Re: the bladder scan. I’ve been tracking and documenting  my urine output carefully for over two weeks, and there seems to be significant variation throughout the day. Would a one-time bladder scan in an office really provide useful information based on a single reading?

Thanks!

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  • Posted

    Thanks for posting this. I'm just recovering from the second infection in three weeks and am seeing my urologist tomorrow to ask similar questions. Will be interested in others' responses.

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  • Posted

    If you don´t mind please, which were your symptoms after your PAE? Whay do you mean by "marginal improvement'? Best urine flow? Improvement in night urine frequency? Can you elaborate, please?

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    • Posted

      My symptoms after my PAE were similar to the ones before, just somewhat less pronounced. When I've taken a tamsulosin, my stream is much better than before (when I had taken a tamsulosin), and when I've been off Tamsulosin for several days I have less urgency and better stream than before, but still not good. I also have periods where I don't need to urinate for 3 or even 4 hours, which pretty much never happened pre-PAE. With that said, I still have occassional episodes of extreme urgency, and nightime frequency is pretty much the same. The main concern is that both pre and post PAE, if I haven't taken a tamsulosin in a few days, the first time I awaken after going to sleep, I have difficulty starting urination, and have to lie down and stand up a second time to finish. That's a little to close to AUR for my peace of mind.

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    • Posted

      i had the PAE procedure 21 months ago and have been off Flomax for 20 months. I was on two flomax aday and still had problems. A month after the PAE procedure and off flomax I was peeing as good or somewhat better than when I was on flomax twice aday. After 21 months I am still off flomax, but  the finishing process takes a little longer now than it did. I have to wait and be sure I am really finished. About 10 percent of the time when I think I am finished it starts again just as if i had not unirated at all. I still do not have retention issues, or a problem having to get up at night. But this new developement indicates something is happening that not good. Will have a psa test in early Oct. I am still satisfied with the results, but concerned about what happens next. 

       

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    • Posted

      Hi Ed,

         Sounds to me like you're really doing well. How is the PSA test related to the urination issues?

          I'm going to try switching from tamsulosin (Flomax) to daily Cialis to see if it helps and doesn't produce the same difficult side effects that the tamsulosin does.

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    • Posted

      The up and down in the PSA seems to track somewhat my peeing efficiency. Tracking status  just before PAE 12plus, six weeks after 3.4, 12 months after 5.8 round of antibotics and back to 4.2. Last checked in May 5.5  Will have it tested in Oct. to see if it has stablized.

      Was taking 2 flomax a day before PAE and none since 4 weeks after the procedure.  I am taking now 5mg of Cialis every other day or so. 

      Will see, hopefully I can get another couple of years before I have to do something else. Maybe longer .. If it stays where it is now I will be a happy camper. 

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    • Posted

      seem to have mild pain behind the eyes several hours after use. Have not noticed any others. I use to cut the pills in half which gave me 2.5 mg a day. Now just take one 5mg every other day or so.Seems to work better that way. The damn pills are so high in the US vs Canada. four times as much
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    • Posted

      Eye problems are know issues with Cialis. I found that my vision was slightly blurred at times. They did a study with 2.5 mg cialis (4mg constant blood serum level) and found improvements but not quite as good as with 5 a day. YMMV. 

      Jim

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    • Posted

      Jim, not clear on what you meant that 2.5 mg cialis" found improvements was not quite as good as with 5 a day."

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    • Posted

      From memory, a study showed favorable results from both daily 5mg and 2.5mg doses, but the results were better with the daily 5mg doses. I believe they also may have tested higher daily doses as well but 5mg/day was the sweet spot. That said, if 2.5mg/day works for you, then I don't see any need to take more.

      Jim

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    • Posted

      That would be improved LUTS (not ED improvements )?

      I'm starting with 2.5 mg (just took my first a half hour ago), and hoping to eventually get by using it every other or every third day. Tonight will be the first test .., the last tamsulosin that I took was 8 days ago, and my first night time urunations have slowed to a crawl.

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    • Posted

      Yes, I believe the study focused on LUTS but I would assume a higher concentration of Cialis would (5mg daily versus 2.5) would be more beneficial with erections as well.

      If the tamsulosin has cleared your system, it will take 2.5mg/day of Cialis several days to get up to it's steady state serum concentration of around 4mg. At that point you will see how the 2.5mg/day is working. If you wanted to speed up the process, you could take 5 mg for a couple of days and then transition to 2.5mg a day. 

      Jim

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