New to the forum, trying to manage BPH

Posted , 17 users are following.

Hello, 

I've been reading this forum for several years but this is my first post. 

I am 53 years old and my urologist has diagnosed me with BPH more than 5 years ago. I have had several bouts of prostatitis over the past few years, this last one, back in May of 2017, resulting in full urinary retention landing me in the ER with my first Foley catheter.  

I am very healthy and strong in all other aspects of my life.  I work out daily, I have very little body fat , ( I actually have six-pack abs! ) I eat healthy, I almost never drink, I don't take any prescribed medications, my blood tests are great, no high blood pressure, etc, etc.  I am very conscious of my health and I feel like this BPH is some kind of cruel joke being played on me!  

Years ago I was prescribed Flomax , which I only took for 1 week but stopped because of the dizziness side effect.  After this last May, coming out of the ER, I tried 5mg of Cialis daily, which actually did help with frequency and overall flow and of course better erections, but also made me dizzy.  I cut back to 2.5mg daily, but stopped altogether after 30 days.  I don't like medications!  

Today, I manage my fluid intake when I travel ( Flying, driving, etc ) when I know using the restroom will not be easily available.  But still , run into extreme urgency when stuck in traffic or a plane trip.  

I drink a lot of water during my workouts and just go pee every 15-30 minutes afterwords. 

Night time can be hit or miss, depending on when I stopped fluid intake.  It can be 1-3 times up to pee.  

So, two questions for the forum.  First , I am considering some procedure, but I have no clue on which one to go with.  My wife says "go have surgery and all will be great."  But I have read many of the nightmares on this forum.  I just want to be able to pee normally, I mean during those urgent times when I can't get to a toilet, when I finally get there...it just dribbles out and causes a chain reaction of very frequent trips to dribble! 

And secondly, the 3 times I have had prostatitis ,was always a few days after drinking a few beers.  As i said , I almost never drink and so it's easy to see the effects when I do.   I am done with beer for sure, but has anyone else seen a correlation with beer and prostatitis?  I am afraid to have any alcohol at this point for fear of full retention.  

I am looking for guidance and advice and this forum seems to be the most active and comprehensive on the internet.  

As I said, I have been reading your posts for years and so thanks to all for sharing your experiences.   

0 likes, 50 replies

Report / Delete

50 Replies

Next
  • Posted

    Hi Bob,

    If you've been reading the forum for years, then you probably know that there have been successes and failures with all the current procedures, as well as varying side effect profiles, many of them sexual including permanent retrograde (dry) orgasm. 

    If you're still not sure and/or want to see what's on the horizon, you might consider self catheterization (CIC). It's a non drug, non surgical approach that can potentially empty your bladder, protect your kidneys and alleviate your bph symptons as well, if not better, than any surgery available while preserving full sexual function. It also has the potential to rehab your bladder could mean better surgical outcomes in the future, if you so choose, or even the ability to void normally without the catheter most of the time, as in my case. 

    Jim

    Report / Delete Reply
  • Posted

    You do sound like you have pretty standard BPH symptoms. Before you have any procedure, I would get a full workup. I presented a lot like you but had bladder issues too, which surgery can't address. A urologist should do at least a scope to confirm that your urethra is indeed restricted, where and how much. The answers to those questions will help guide the doc/you as to what procedures would offer the best outcomes. Also, have a urodynamics test for bladder function. Years of BPH often take their toll on bladders.

    As for procedures, if any doc you see recommends a full out surgery as a first line of treatment (TURP, Holep, Button TURP) find another doctor. Under the best of circumstances, they are full out surgeries with the associated risks, have a long recovery and will almost surely leave you with RE (dry orgasms) and can leave you incontinent or impotent. For someone young and fit like you, those would be borderline malpractice.

    There are procedures that can be performed in a docs office without putting you under with fewer side effects, quicker recoveries and less risk. They are Rezum, Urolift, iTind, PAE and FLA. PAE and Urolift won't help if you have an enlarged median lobe. FLA isn't covered by insurance. RE is unlikely with all of them, most (maybe all) will require days to weeks with a catheter (I recommend a self cath rather than an indwelling one - don't do any procedure with any doc who won't set you up for that).

    First, get a diagnosis (you have trouble peeing so I recommend a TURP isn't a diagnosis), then see what your doc suggests and make a decision from there. There are lots of threads on each procedure in this forum. Good Luck!

    Report / Delete Reply
    • Posted

      Ive been to my urologist 3-4 times in the past year.  When you say "full work up", what should I ask my doctor to do? I did ultrasound and DRE and flow test.  He prescribes pills and sends me on my way.  

      Report / Delete Reply
    • Posted

      I realize there are many different outcomes, but for me TURP worked great.  The urgency is gone, flow is strong, and no retrograde.  I’m 67 and it changed my life.  I couldn’t be happier.  I know of others who have had good outcomes as well.  
      Report / Delete Reply
    • Posted

      Jim you were one of the lucky few but there have been many that get talk into a TURP and regret it.  It happen with all procedure.  Did you know there is only a 4% or less chance of not getting retro and a 30% chance of it not working and having to have another procedure.  I read a paper from a doctor in London.  He said that 2 out of 3 men with have problem after a TURP.  Don't like the odds to much of a gamble.  Glad your ok  Ken

      Report / Delete Reply
    • Posted

      Happy that TURP worked out for you. Curious how you and your doctor addressed the retrograde issue prior to TURP. Did he give you any idea on what you could expect? 

      ​Jim

      Report / Delete Reply
    • Posted

      Yes, it was discussed and he said there was a chance of retrograde.  It was the middle lobe that caused my BPH problem and I believe that minimized damage to the sphincter at the bladder neck.
      Report / Delete Reply
  • Posted

    I concur with Old Buzzard, that full testing, including urodynamics should be done prior to any decisions. I also suggest a simple void log can give plenty of information and is often overlooked by uros because I guess it's too low tech and can't be charged for smile Just write down the time and volume of each void for 24 hours. Not a bad idea also to include an column for fluid intake, again write down how much was taken in and when. You also might want to google "IPSS Score" and take the simple test to see where you relatively fit into things sympton wise. BTW do you know your post void residual (PVR)? It's measured with a simple ultrasound scan in your urologist's office. 

    Jim

    Report / Delete Reply
  • Posted

    Good morning Bob.  First of all I am sorry for what your going through.  You need to listen to what the other guy's are saying.  Do you really need a procedure.  You have to find out if your prostate is the problem it could be your bladder.  Yes if the urologist first thing out of his mouth is you need a TURP or LASER surgery.  Say thank you and go right out the door.....get a another opinion.  At your age or any age a man has to see what side effects he can deal with retro ejaculation, erection problem or some others.  Just because your sex life is good now once they start cutting away at the prostate you just add to your problem.  Don't let you problems pick your procedure.  Take care and good luck  Ken      

    Report / Delete Reply
  • Posted

    I have had the ultrasound done, and doc says emptying is good, even though I have high frequency.  I did do a test where I urinated into a funnel type of device that measured rate of flow and starting/stopping.  The report was that I have a weak stream and start and stop a lot.  

    Doc wants me on medication, does not want to do surgery.  Is medication my only choice? Which meds are best?   And what about the Beer/alcohol thing? 

    Report / Delete Reply
    • Posted

      Hi Bob,

      If you're emptying is "good", there's the possibility you may have overactive bladder syndrome (OAB) as opposed to BPH/LUTS. Symptoms are overlapping which so one can easily be mistaken for the other without proper testing. OAB could also account for your prostatitis like symptoms after drinking beer.

      Treatment for OAB  can be quite different from treatment for BPH/LUTS, and usually doesn't require surgery, so it's important you get a proper diagnosis. 

      As mentioned before, a 24 void and intake log is a very valuable diagnostic tool and something you can do yourself. Urodynamic testing, by measuring bladder pressures, may also be used to help differentiate BPH/LUTS from OAB. 

      If your doctor is not onboard with further testing, a second opinion is always a good route, preferably with a voiding specialist in a major teaching hospital who does routine urodynamic testing, preferably video urodynamics. 

      It's important to note that OAB and BPH/LUTS can coexist, so unfortunately some uro's will just go ahead and treat for BPH/LUTS without finding out if OAB is the primary cause of the symptoms. So, again, very important you get a proper diagnosis before trying to solve the problem.

      Jim

       

      Report / Delete Reply
  • Posted

    Hello  Bob, and welcome to the forum. You sound almsot identical to my situation, only I am 54, but also very active, work out, lift etc.

    I also have had a real battle with prostatitis and also BPH. 

    I had a PAE procedure back in Jan 2016, that did nothing for me, except cause the worst case of prostatitis I have ever had. My Doc almost put me in the hospital for IV antibiotics. And the Doc who done my procedure actually suggested I may need to have my prostate removed. That was my last conversation with him!

    Then I read here on the forum about a new procedure called FLA, which you can search for here on the forum, and read about. The Doc who done mine 2 weeks ago is in Houston TX and he not only done the FLA procedure, but he also done a rigorous, detailed regimen to attempt to cure the prostatitis hopefully forever.

    There is a new DNA test where they can test to see exactly whst bacteria you have, and what antibiotics to treat it with.

    You can do a search here on the forum, where I went into the details of exactly what he done, and the meds used. 

    Or if you have any questions feel free to pm me.

    It has been just over 2 weeks, and I can already see a difference in my urination, and ejaculation. And for the first time in years I do not constantly feel my prostate. That probably sounds funny, but when you have prostatitis it feels like you are sitting on a golf ball all of the time.

    The procedure is very expensive, and the Dr does not take insurance, however he will give you the documentation to submit it yourself. My insurance gave me a pre approval, but it remains to be seen if they send me any money back. But either way it is totally worth it.

    Do you know how large your prostate is?

    Joe

     

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up