I have enlarge prostate and suffering from ed after proscar

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Hello:

i am almost 40, i went to the doctor in january begginning of 2016 after a couple of weeks of antibiotics he prescribed me proscar(finasteride) for the enlarge prostate issue i was having; me going to the bathroom constantly was mostly fixed after a few months (4) but i had to stop it since i started suffering from ed, my libido was going down back then, and my erections were irregulars and took me forever to be in the mood.

So my doctor decided to stop the finasteride for the side efects and he said , the other options i have is to shape my prostate-so is surgery_ by then i was feeling better(not 100%) with my prostate issue. So i just left it there; so fast forward 5 months now; i have a feeling of being hot on my rear end(same feeling when i started this prostate issue) the only difference is that i dont have to go to the restroom often but now i suffer from ed;

my psa test was normal last year and i had an ultrasound and thats when it came out my prostate was big; no cancer or any other issues with other organs; anyone having same issues? or any knowledge about it?

i have an appointment with another urologist next week and i am hoping i have some hope..

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  • Posted

    Hi Eric,

    Do you know if you are retaining urine in your bladder? What are the symptons you are having?

    Do you know your IPSS score? If not, you can compute it here in a few minutes:

    http://patient.info/forums/discuss/what-is-your-international-prostate-sympton-score--453484

    Have you tried any of the alpha blockers like Flomax (tamsulosin hydrochloride)? Flomax can sometimes help.

    Another alternative is Daily 5mg Cialis. It can also help with both your BPH and ED symptons.

    If you haven't, all these things should be considered before surgery.

    Jim

     

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    • Posted

      Hi Jimjames

      ​ipss is 4

      ​mainly the worst i am going thru right now is the non existing libido, no erections and as you see i am not old,

      the second concern is that i feel a disconfort on the lower abdomen area, the same i was feeling when all this nightmare started, like something is not right inside and i feel a little hot on that area.

      ​regarding the cialis or flomax, i dont know about it, i may get hooked up on that and i am still young to have those issues

       

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    • Posted

      Hi Eric,

      If I read your post correctly, your doctor is suggesting a surgical option? Given what you said and an IPSS of 4 (practically normal) I don't see how surgery is justified. See another urologist and try and get your symptons treated without surgery. Sounds like the Proscar may be responsible for your libido issues.

      Jim

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    • Posted

      i was reading online and there is something called PFS(post finasteride sindrome) and basically is the lost of libido causing ed.

      Thing is all they advised to cure it it will cause my prostate to grow back again(probably already grow a bit by now).

      yes, i will get a doctor appointment next week

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    • Posted

      Thanks Jimjames,

      i will check on another doctor next week

      i found pfs (post finasteride symptom) and basically is ed issues

      thing is all the "cures they advised" will make the prostate grow back again(probably is growing back again now)

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    • Posted

      Eric,

      Try and find out your prostate size in grams. Or, if not, get the third measurement so it can be computed. Since you have an IPSS of "4", you may not even have any retention and in that case prostate size, even if enlarged, may not be an issue. There are folks with large prostates and no symptons and others with smaller prostates and lots of symptons. You really need to see another urologist or two, preferably one that specializes in ED issues.

      Jim

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  • Posted

    At your age it is very unusual to have an enlarged prostate. How big did they estimate it to be?
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    • Posted

      hi derek

      5.1x 3.1 cm

      i feel now is a bit better but i am pretty sure not for long, my main doctor said eventually will grow if i just leave it like that

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    • Posted

      The feelings in your lower abdomen and loss of libido are not typical BPH symptoms. Even prostatitis does not usually cause loss of libido.

       

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    • Posted

      is pfs (post finasteride symptoms) but i dont even cured 100%

      to me surgery is a bit extreme,

      thanks for your response

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    • Posted

      If we simplify and treat that as a 4 cm diameter sphere, the volume of such a sphere would be 4/3 times pi times radius cubed.  Radius is half of diameter. Result = 33.5 cubic centimetres.  It has a hole through the middle so say 30.  This will not be accurate.  30 cubic centimetres = 30 grammes as specific gravity (prostate tissue) = 1.  It floats with neutral buoyancy.  I've seen it floating actually in my bladder as part of the video that was taken of my HOLEP operation ! (the morcellator phase). 

      I think 15 to 22 grammes would be about average age 40 from what I've read.  So yours is large for your age, for sure, but all the men in their 70's with 60 gramme prostates will laugh at the notion yours is large.  Yours will grow and cause problems later so if he offers a re-bore (TURP/Holep/Greenlight) or PAE, you might want to take it, I did age 49.  Mine was 22 grammes pre-op (now 10 grammes remain), which is not big, but was chronically inflamed and so causing LUTS, so did seem to need HOLEP. 

      Background reading suggests ED common with 5-ARIs like Finasteride or Dutasteride; other causes of ED at your age could include if very overweight, also heavy smoking occasionally causes it, as can depression.  It also is said to commonly persist AFTER stopping taking 5-ARIs, but not necessarily long term.  I hope it works out for you, I would avoid 5-ARIs as they also cause man-boobs for some (and loss fo chest/body hair).  However, if you are bald on top like me, it does apparently cure that in a trice (I cannot personally evidence this as my uro' advised against 5-ARIs at our first consultation, and I never asked about them again) - that's why "trichology" clinics offer it, a friend confided, as their main non-surgical cure (a prescription for 5-ARIs, that is, for which they charge about £2000 - charlatans !). 

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    • Posted

      Hi Paul and Eric,

      As I mentioned before, regardless of the size of Eric's prostate, the size itself doesn't mean much given his IPSS score is "4" which is "mild". Many men can go through their whole lives with large prostates and no symptons and never need surgery. Others may need to do something with smaller prostates.

      So as to your suggestion that he might take a TURP, Holep, or Greenlight, because of potential future growth, I strongly disagree. First, basically no symptons of BPH. Second, you don't prophylactically do an agressive procedure -- or even a non agressive one like PAE. Again, no symptons! If and when symptons start to interfere with ones life, and the IPSS score starts to soar, that's the time to consider those types of options. Could be years away in this case or never. And years away may present other, better options, than we have today.

      Jim

      PS 

      Your calculations are beyond my pay grade but don't you need a third measurement to compute cubic? But assuming for discussion sake your calculation is correct -- is your result 33.5 cubic cm (30 grams) as first stated, or 60 grams as inferred later, or was that just an example?

       

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    • Posted

      I was 49 when told that my prostate was slightly enlarged. Ten years later I was told that I needed a TURP as a matter of some urgency. I said no and would wait until laser techniques were reliable.That took another ten years.
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    • Posted

      Finasteride did nothing for my lack of hair but I did get breast growth that went when I stopped it.

      Other Ed causes T2 diabetes or it is said a five year early warning of heart disease due to areteries furring up.

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    • Posted

      Derek,

      If you scroll up I think you will find that I suggested Daily Cialis. But I also think it's equally important that he get some input on why his doctor's suggestion of surgery may not be the right decision for someone with an IPSS score of 5, as well as to stop worrying, perhaps needlessly about his prostate size.

      Jim

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    • Posted

      Yes, you did say that. In the UK they are reluctant to prescribe Cialis on the NHS as it is expensive as of course is a private prescription. When I asked for one a day Cialis at my local hospital they said that 'We do not prescribe that here'

      I was surprised at his IPS score. The qualty of life answer should be part of the score and would definately add 5  to it.

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