Prostate problem in younger age

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I am 22 years old male and diagnosed with prostate enlargemnt. I had my first UTI when i was 15 years old. After that i had UTI once or twice the year till i was 20. Two years ago i started facing frequent utis and continous irritation in penis. Main problem was pain in ejaculation and irritation in penis anytime. One year ago the doctor (urologist) asked me to undergo cystoscopy, at that time my full bladder volume was around 300ml and pastvoid above 100ml. Peak flow rate of urine was 13.7ml/s. After the cystoscopy i was told that i have a bladder like of a 50 years old man. I was prescribed tamsulosin for 6 months and a follow up after that. After 6 months of tamsulosin my full bladder volume was around 470ml and pastvoid below 40ml. And peak flow rate was still 13.7ml/s so i was again prescribed tamsulosin for 3 months. Today it has been 9 months since i m taking tamsulosin and now my prevoid and pastvoid is still around 470 and 40. But peak flow rate is decreased to 12.7ml/s. I have follow up with my doctor next week. I am very worried about my future and marrital life. I am still suffering from painfull ejaculation but i dont feel irritation in my penis anytime now. I dont want to undergo any surgery whose side effects can affect my sex life.

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  • Posted

    Was there any mention of prostatitis? Sound like it to me but there will be others along that are way smarter than me. Your uro didn't prescribe antibiotics of any kind?

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  • Posted

    Hi Dan,

    Yes, do not get talked into any surgery or procedure that will effect your sex life. TURP, along with it's variations often cause permanent retrograde ejaculation (dry orgasms) as well as the risk of other sexual problems. You do not want this, especially at your age both because of your sex life and the fact that it may mean you won't be able to, or at least it will be more difficult to have children.

    One suggestion is that you try a trial switch from Tamsulosin to Daily 5 Mg Cialis. Studies show similar results but the Cialis can actually enhance your sex life while Tamsulosin often has the opposite effect. 

    So, you know, there are newer procedures coming out now that can help men with BPH/LUTS without some of the sexual side effects. My recommendation, especially at your age, would be to wait for as long as possible on this, as even better procedures no doubt will be developed. 

    Right now, it seems that Tamsulosin is controlling your symptons and protecting both your bladder and kidneys by keeping total bladder volumes and post void residuals (PVR) in check. Should medictions (Tamsulosin or Cialis) start to become ineffective, as they sometimes do, consider self catherization (CIC) as part of your watch n' wait strategy. It will empty your bladder completely any time you want while protecting your kidneys. 

    Speaking of kidneys, have you had a bladder/kidney ultrasound to check for any kidney damage. How about bloodwork for some kidney function tests? If you haven't had both, it's important you do. 

    Having the symptons you describe at such a young age is both bad news and good news. The bad is that you have to deal with all this at such a young age. The good is that many of us wait many years to deal with the problem, damaging the bladder in the process. By tackling this early on in life, hopefully you will not have to deal with this later in life when it might be more difficult to treat.

    I assume you're seeing a urologist and not a general practioner. That is who you need to see. Just know that many of them are surgery/procedure oriented, and again do not let them talk you into any type of surgery or procedure that will affect your sex life. There are other options for you.

    Jim

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    • Posted

      As "Unckle Fester" mentioned, prostatis is always suspect with urinary issues and sometimes can go hand in hand with other obstructive issues. Again, a good urologist, should be helpful to sort this out. A course of antibiotics might be worthwhile in your case to see if it helps things out, especially that pain you describe.

      Jim

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    • Posted

      Thankyou Mr jim for the kind response. One thing i forgot to mention that i have only one kidney by birth (the left one). And it is functioning normal. I never had any kidney pain or something. And My urologist told me after cystoscopy that if the tamsulosin wont provide good results then i would need to undergo surgery. He havent mentioned me the name of surgery he just told me that they will remove the part of prostate which is causing complications.
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    • Posted

      Again, don't let any doctor talk you into surgery until you have explored every other option. Given your low retention, your kidney would not appear to be in any danger whatsover. Just keep monitoring it on a reasonable basis via ultrasound and blood work. And even if your kidneys eventually do show some stress, there are strategies other than surgery to help with that. You're just too young to have an invasive operation that can effect both your sex life and the ability to bear children in the future. You have to understand that urologists like to operate. It's what they do. It's how they pay their bills and put their kids through college. Doesn't mean you have to buy into it.

      Jim

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  • Posted

    Better do something, I think a biopsy is call for
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  • Posted

    Did the doctor tell you why this is happing.  There has to be a reason.  He must be having retro with the med your on.  There are other pills you can take so you wont have retroand help your bladder.  Please at your young age d on't let them touch your prostate.  You need that for a long timesometime we have to deal with the pain

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    • Posted

      He said this is happening because the prostate is disturbing the bladder and affecting the flow of urine. I am very worried about what would i do if he ask me to undergo surgery and there is no other option left now. The hospital where my treatment is going on is one of best hospitals of our country. 
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    • Posted

      First of all you stay away form prostate surgery.  At 22 the doctor should know better.  You need your prostate.  If you want kids one day.  I still would like to know why this is happing to you at 22.  The only procedure I would even tell you to do is Urolift.  It would open up your prostate and help the flow.  What they do is go in and put implants on the prostate to keep it open.  There are no side effects.  I have mone done 2 1/2 years ago Look into it.  Like I said before is get off the flomax there are a few more that can help relax everything in that area.  Take it easy  If you need to talk just send me a PM I will answer any questions you have  Ken
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    • Posted

      You just tell him no way.  There is other ways to open up the prostate without cutting away at it.. It's your body and you have to deal with the side effects and at 22 you should not have to  Ken

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