Drugs as an alternative to surgeries for BPH ???
Posted , 10 users are following.
In real life, whenever I met an older man, if the situations allowed, I always asked about their health experiences, and recently the questions have been about prostate problems. To my surprise, most of them chose medications over surgeries.
Leo, my neighbor, in his 80's, has been taking meds for over 20 years, never had a need for surgeries.
Oscar, my bus friend, also in his 80's, had TURP when he was in his 60's. "It was so horrible. I will not do it again." He has been taking alfuzosin since.
An, 78, a family doctor, has also been on meds for years, including finasteride. I asked him about surgeries. His answer was: "I will not have surgery unless my situation is life threatening."
On this BPH forum, where I have learned so much, meds takers are like a dying breed. The usual comments are like "Meds are poison. Do not take it. It will destroy you and your sex life." Or "I took meds for a while but I started to lose its effectiveness, so I opt for surgeries." I am sure drugs cause side effects but some did not even give it a try because of these statements.
I don't know why but there is tremendous pressure for men on this forum to recommend surgeries. Not any particular surgery. As long as it is surgery, it is better than meds. Is there a conspiracy, since meds are cheap and surgeries are where the money is ? Despite the facts that most medical web sites put drugs as first line of defense for BPH.
Though well intentioned, this macho man attitude may have caused numerous needless pain and suffering for many people. People are so excited with posts of successful surgeries like "now I can pee like a 20 year old" and overlook the failures. One fellow had 3 surgeries within the last 2 years, the second to fix the first, the third to fix the second, and is still worse off than before. I am sure there are sadder stories out there. Any problems people have, they immediately blame their meds and seek surgeries.
Then the CIC (self cath) movement picked up steam, helping people from rushing onto the cut tables. However, again well intentioned, some CICers started to advise people to get off meds for CIC.
The pressure got to me as well. So much that I have been looking at different procedures, with FLA currently as my first choice. However, now I question myself whether or not I really need any surgery.
I am 63, with 200ml urinary retention and some hesitancy, stop-and-start stream. Sleep all night, mostly thanks to my liquid intake management. I have been on Doxazosin for about 6 years. Just started finasteride 4 months ago to experiment. The side effects so far have been acceptable. A little RE which I care less. A little loss in libido but Viagra will more than compensate for. Also, with the above symptoms, my main problem maybe the bladder, not the prostate, as more and more people on this forum recently found out and unveiled. Surgeries may not help at all.
I also do CIC once a day before bedtime, to empty my bladder for my kidney's sake, and to sleep longer. I actually did go the CIC way for a few months, 4-5 times a day, no meds. However, at the end, I prefer meds over CIC. Some people compared CIC with brushing teeth. 
For me, I would rather brush my teeth. I always have anxiety every time that long catheter was pushed near my prostate, perhaps due to some earlier bleeding I experienced. For me, drugs are easier, more convenient.
I am not against surgeries. I think some people really needed them. I just think that too many people rushed into surgeries without actually searching for an alternative first. CIC is one. Medication should be another. After that, if you indeed need it, which surgery is the right one for you. Surgeries are not reversible. Meds usually are.
So my suggestion to long-time med takers out there on this forum: "It is time to get out of the closet. Please come forward and share your success (or failure) stories. Perhaps your stories will balance out somewhat the frenzy out there, and perhaps helping others in the process."
Hank
0 likes, 50 replies
mark02906 hank1953
Posted
The good news - men are living longer so that conditions like BPH (a very broad spectrum ranging from minor impact (getting up once or twice a night) to ...well you know... ) take up more of our focus. The disappointing news - we are still in the experimentation stage - medicine, surgery, watchful waiting. This forum has educated me to how broad prostate conditions can be. Yes, it's anecdotal. But, it does provide information that men can use in discussions with health professionals. Self interest by the medical community? But, will the market eventually help weed out what is not productive. I had a TUNA about 10 years ago. It turns out from what I have read that it has not been that effective. I would like to think that the TUNA companies/doctors who recommended it have moved on to other things. Eventually, the solution(solutions?) will narrow more and more to things that work. Might not help us. I hope that it will help our sons and grandsons.
hank1953 mark02906
Posted
mark02906 hank1953
Posted
I had TUNA about 10 (maybe 12 years ago). My nighttime bathroom visits (my only BPH symptom) started to creep up to 3-4 times a night. As I was 67, my doctor (as directed by Medicare?) tried Flomax. I was on it for 8-10 months. Slight improvement in nighttime visits about 2-3 per night. Big reduction in cardiovascular endurance. I couldn't run anymore (recreational runner ~10 min/mile pace for a 10K (just a few years ago). Using light weights, I had to stop after 10 minutes to rest for 5 minutes. You are correct that the doctor you choose has their own preferred surgical treatment. His is no Urolift in some cases. After a cystoscopy in Feb 2017, I had the procedure done a few months later and stopped Flomax immediately. Nighttime visits average 1-2. Some nights it's more, some not at all. And I have my endurance back. I am not recommending Urolift. That's up to individual patients. My experience has been mostly good. I do have some bladder control issues. I tried returning to a Spinning class. I lasted 30 (out of 60) minutes. I barely got to a bathroom. I have had a few accidents (wetting clothes), but mostly not too bad. Whenever I have a long car trip, I wear Depends pad just in case. But, I have never really needed it. My comment on TUNA was based on an internet search. But, my doctor is no longer doing it. So it must not be that effective.
hank1953 mark02906
Posted
I am glad Urolift works for you somewhat. Did you have a small prostate and with small median lobe ? Otherwise I've read it won't work well. What is in spinning class ? Hank
hank1953 mark02906
Posted
mark02906 hank1953
Posted
I assume (may be a bad idea) that my urologist saw enough to think that I was a candidate for the Urolift. We did not discuss size. The fact that he was initially skeptical about Urolifts a few years ago led me to believe that he based the decision on some study (he was the same doctor who did the TUNA. I am hoping that the bladder control improves. But, if it is doesn't, I can live with it. My flow is stronger. I can tell that without the flow test. I'll see how long this lasts. I am really glad to be off the Flomax. I recognize that some guys react well to Flowmax, but not me. Maybe it's the combination with my blood pressure medicine My running/exercise is getting better. The loss in conditioning is slower to return as you get older. Regarding the stationary bike (spinning) class - the teachers gear the later morning classes for the older people - I'm sure you probably can do one. The early morning and after work classes have more younger riders. Spinning is easier on the knees and back than running. I wish you the best.
hank1953 mark02906
Posted
derek76 hank1953
Posted
My BPH was first diagnosed in 1994. Since them I have spoken to many real people at hospital clinics, friends, neighbours and as we say here The Man on the Clapham Omnibus. I do speak to a lot of people while travelling on them and as we live in a popular retirement town that is also a holiday resort I meet plenty of older guys with health problems.
The main complaints are the time it takes to get an NHS appointment and a diagnosis, Then the side effects of medications that the NHS prefers to keep surgery waiting lists down and any medication is not on their budget but the GP's. The now retired janitor of our building is still on meds after 12 years. Ask him how he feels and the answer is miserable and that is what many others reply. Many old Guys who are not computer literate have never heard of the surgical options.
As I have said before the practice nurse says that the most complained about medication is Tamsulosin not just by men but their wives as well.
There is still a bias towards versions of TURP in many areas as that is the procedure Uro's were trained in and although GL/PVP is now the recommended NHS procedure some area health authorities will not pay for new equipment. If they get a chance to be funded for a trial by the equipment makers they will take it but be reluctant to fund the procedure later. As BPH is not life threatening I accused our local Uro's of ageism. It turned out that the main two urologists who were anti GL had not told me of the renal surgeon who had also been doing laser prostate surgery for six years and demonstrating it around the world. That was told to me by a locum consultant who did not know the rules.
Ageism does not happen in cardiology and other conditions even though the NHS waiting lists are long
hank1953 derek76
Posted
derek76 hank1953
Posted
The prostate is a closed book to most with initial problems. I still read on a UK Seniors NG that I no longer post to and any who have had surgery had TURP.
I just happened to be diagnosed (1995) with BPH at a time when a journalist was writing a series on his initial BPH diagnosis and his search for something better than TURP and the problems it leads to.
That led me to the reference library and a book called, Prostate: Facts and Misconceptions by Hernando Salcedo who had been Urologist to the American Navy and was by then in private practice. We had some correspondence on TURP and procedures being developed. He advised me against TURP even back then.
hank1953 derek76
Posted
derek76 hank1953
Posted
keith42667 hank1953
Posted
I'm sure you remember that I could have had GL. I was all set up. I'd probably be recovered now. I keep coming up against that "what if" scenerio, feeling like I might haved missed an opportunity. I may get to the point to where I wish I'd taken that option but I'm still not there yet.
Its possible my situation different than some in that I recently turned 65 and, about the same time, was terminated from contractor job, so I have a lot of time to spend at home. I've taken the opportunity to do something about a couple of health problems that have been bothering me. One was the Urinary retention (that came to a head with prostititus) and the other worked out because of new drugs coming on the market.
I had no testing for the cause of my BPH, except for urine & blood, at the Uro. I also had an ultrasound of my bladder on file. I don't know if the pre-op appointment I had would have involved the urodynamics test or a cystoscopy because I had told them over the phone that I was probably going to self-catheterize for some time to come. Instead we talked about CIC a little; they did't seem to understand much about that as a long term stategy but then I was talking to the Doctor's PA. I don't know why he wasn't there.
I'm surprisingly happy about the situation right now. I think I did the right thing for my situation. I switched to a Plan N with my medicare which was probably a good idea anyway. I had a "high F" policy which doesn't pay zilch until you ran up $2200 in deductibles. But I was able to switch and it should cover my catheters; not a huge expense but it matters to me. Actually I still haven't gotten a bill for the last 3 months or so but my supplier has told me that I will get them.
hank1953 keith42667
Posted
keith42667 hank1953
Posted
Just CIC. I'm taking Saw Pimento just so I'm doing something that might slow or reverse my BPH. I don't expect to see any difference from that for months if ever.