Finasteride, or not? Potential urolift
Posted , 6 users are following.
I've just joined and can't find a way of searching this forum, so apologies if this has been covered.
I've had BPH for several years and was prescribed Tamsulosin some time ago. I stopped taking it as It worried about testosterone levels and how it might affect my gym work. A year ago (age 66) I suddenly had severe retention, resulting in a trip to A&E for a catheter. They gave me Tamsulosin, sent me home and said I would get the catheter removed after 2 weeks. This I did, but I only managed to pee a couple of times before the tap shut off again, so back for another catheter which lasted a couple of months before I persuaded the doc to try another TWOC (a consultant had simply recommended TURP, which I've been extremely reluctant to consider, despite 2 colleagues having successfully gone through it). This worked well, and I no longer required a catheter. In January I had a follow-up call with a urologist. I told her about my reluctance for TURP, and she agreed that potential reduction in libido/sexual function was a concern for many men. I asked about Urolift and she said she performs it. However, she won't do it if one is already on a catheter, and the prostate has to be below a certain size. She said she would be happy to prescribe Finasteride but I said I'd hold off for now. Her summary letter said that if after 6 months of Tamsulosin and Finasteride I was still having problems then she would look at Urolift (subject to a new scan on prostate size) or Holmium Laser.
I've read many comments on Finasteride and I'm really reluctant to go on it. There's the question not only of sexual impairment but the fact that it can last for a long time even after stopping the drug, plus claims that enlargement can accelerate when it's stopped. I've seen references to depression, and as I've already prone to that it would be made even worse by the thought that my sex life may be over.
Just to add that although I can still pee, it has deteriorated somewhat since the TWOC. Flow can be poor during the night and first thing in the morning. Later isn't really a problem, though I still get frequent urgent needs to go.
Your experiences and thoughts would be welcomed.
0 likes, 12 replies
johnny90372 chris31014
Posted
Have you had an ultrasound or MRI done on your prostate to see the size and shape of it? My condition is similar to yours. I have more retention at night. I'm taking finasteride the only between 1 mg and 2.5. mg. I have had the condition for about five years. My doctor wants to do a TURP and won't recommend me for other procedures. During my ultrasound recently the urologist can see mild damage to the bladder already because I have not got it treated. Another option I'm thinking is Resum procedure however they charged $6000 to have it done even though it only takes a few minutes in her urologist office. Do you have severe retention at night?
chris31014 johnny90372
Posted
Johnny, sorry for the late response - I'd expected to receive notifications!
I had an MRI done 3 years ago - it was 69 cc. The urologist said I'd need a recent one to determine if it was still within the size limits for Urolift.
There have been developments since. Things had been working pretty well for the last 12 months, then I started getting very slow flow during the night. During the day was still mostly ok. Then 3 weeks ago I again had retention one morning. This time I didn't wait too long. After 2 hours I went off to the hospital and quickly had my bladder drained and catheter inserted. Blood tests (for kidney problems) were still clear so I went home. I was invited back 2 weeks later for a TWOC. I was sceptical (as was the nurse!) that I'd be able to go home catheter, but after 3 hours of flow tests things were deemed good enough. It's been a week now, and things haven't been too bad. The nurse recommended 'double voiding' (peeing 10 min after the first) to try and train the bladder and reduce the need for a catheter. The nurse has sent a report to the urologist and mentioned my reluctance to go on Finasteride, and preference for Urolift over TURP, so now I wait to see. Of course, I could go into retention at any time again.
michael12274 chris31014
Posted
Chris it's looks like you are yet another victim of poor health service in your country. By the sound of it - doesn't look like you have been ever tested for STD or aerobic/ non aerobic bacterial infection. in 80% of cases this is what is causing prostate problems/ inflammation.
do not rely on your GP /first contact doctor as they are useless and only testing your urine.
You need to find local IVF clinic or very good laboratory (not all of them are good by the way). You must do semen culture test and Stamey's test (prostate fluid culture test). Prepare yourself for a shock. There is good chance you will learn that you are infected with bacteria.
Good luck
hank1953 michael12274
Posted
Michael, are you referring to chronic bacterial prostatitis? If this is the case, shouldn't he have other symptoms as well ? Hank
michael12274 hank1953
Posted
Hi Hank. Yes I'm referring to chronic bacterial prostatitis. You have loads of symptoms when you develop acute bacterial prostatitis (temperature to high or too low /chills/ running to toilet like crazy/ burning sensation/ perhaps heart palpitations) it is easy to mistake that with water infection. Most doctors will give ya short dose of antibiotics believing that this is only a water infection. They will never refer you to Urologist. They will never tell you to do semen culture test or Stamey's test. This is when your serious problems will start.
Chronic bacterial prostatitis has fewer symptoms. Usually there is no high temperature unless you develop UTI or bacteriuria. You feel generally unwell/ flue like symptoms- your immune system is down, suppress by bacteria. U will develop muscle ache, perhaps joins pain( coming and going/). Your semen will develop different colour( yellowish). It's gonna bee painfHi Hank. Yes I'm referring to chronic bacterial prostatitis. You have loads of symptoms when you develop acute bacterial prostatitis (temperature to high or too low /chills/ running to toilet like crazy/ burning sensation/ perhaps heart palpitations) it is easy to mistake that with water infection. Most doctors will give ya short dose of antibiotics believing that this is only a water infection. They will never refer you to Urologist. They will never tell you to do semen culture test or Stamey's test. This is when your serious problems will start.
Chronic bacterial prostatitis has fewer symptoms. Usually there is no high temperature unless you develop UTI or bacteriuria. You feel generally unwell/ flue like symptoms- your immune system is down, suppress by bacteria. U will develop muscle ache, perhaps joins pain( coming and going/). Your semen will develop different colour( yellowish). It's gonna bee painful after ejaculation or you will start notice erectile problems. It will all come in stages. not at once.
You white blood count will go down . You will notice that your symptoms are getting worse after sex / ejaculation. Perhaps you will have some skin problems like unusual rush. Mainly around your private part. Rush will come on go on its own. Using trush creams is pointless as it is bacterial not fungal. Main evidence that your doctor messed up your health is ultrasound picture of your prostate gland. Eventually you find calcification/ calculi on your prostate- this is happening ONLY as a result of bacterial infection. It is like a scar in the infected part of prostate.
michael12274 hank1953
Posted
Hank. Yes I'm referring to chronic bacterial prostatitis. You have loads of symptoms when you develop acute bacterial prostatitis (temperature to high or too low /chills/ running to toilet like crazy/ burning sensation/ perhaps heart palpitations) it is easy to mistake that with water infection. Most doctors will give ya short dose of antibiotics believing that this is only a water infection. They will never refer you to Urologist. They will never tell you to do semen culture test or Stamey's test. This is when your serious problems will start.
Chronic bacterial prostatitis has fewer symptoms. Usually there is no high temperature unless you develop UTI or bacteriuria. You feel generally unwell/ flue like symptoms- your immune system is down, suppress by bacteria. U will develop muscle ache, perhaps joins pain( coming and going/). Your semen will develop different colour( yellowish).. It's gonna bee painful after ejaculation or you will start notice erectile problems. It will all come in stages. not at once.
You white blood count will go down . You will notice that your symptoms are getting worse after sex / ejaculation. Perhaps you will have some skin problems like unusual rush. Mainly around your private part. Rush will come on go on its own. Using trush creams is pointless as it is bacterial not fungal. Main evidence that your doctor messed up your health is ultrasound picture of your prostate gland. Eventually you find calcification/ calculi on your prostate- this is happening ONLY as a result of bacterial infection. It is like a scar in the infected part of prostate.
p.s. sorry for that other post . don't know how that happened. just ignore it
hank1953 michael12274
Posted
Thanks Michael. Hank
cali-mike1970 hank1953
Posted
is the calcification / calculi dangerous long term. does that need to be eradicated to get over the CBP?
michael12274 cali-mike1970
Posted
U can't remove calcification once it appeared in your prostate unfortunately. It is for life. Unless you remove the Prostate gland itself. Calcification makes things more complicated as it is so called reservoir for bacteria and antibiotics can't always reach this part- lack of bloodstream network on it. Prostate gland has very few little veins. Antibiotics are mostly distributed through veins.
chris31014 michael12274
Posted
As you will see from my reply to Johnny, there is no doubt that BPH is the cause of my problem. My GP diagnosed it several years ago (digitally) and I've been annual PSA tests since. And the size has been confirmed by MRI. As it happens I've had STI tests (for other reasons) and they've always been clear.
TKM chris31014
Posted
Chris,
First of all Tamsulosin will not affect Testosterone levels. You might mean Finasteride which will affect your hormone levels. You didn't mention results of testing. Before opting for surgery, you should be getting all the usual testing, flow test, post void residual test, TRUS (Trans Rectal Ultrasound) to measure size, MRI can also measure size but is more expensive. You should also have some tests done for bacterial infection.
If you want to avoid all the surgery, drugs, loss of libido, etc. you can try self catheterization. Many on this site have been doing it for years. There are some good discussions about it, you can search for, many of them started by Jim James.
chris31014 TKM
Posted
It's funny that I mentioned self-catherisation to the urology nurse (and how I couldn't imagine doing it). She said lots of people do it. It was only later that I wondered why it's never been suggested as an option.
I had the flow tests done again last week, including ultrasound to determine residual volume, but other than blood tests to check for kidney infection I'm not sure any were for prostatitis. I may query with the nurse.