Told I need Urolift!

Not a great advice Lester. Actually, a bad one.Finesteride and especially dutasteride kill libido in most ageing men and in many causes impotence. Well documented. In most results are permanent even after terminating the drug. Research the publications yourself. It took me 6 months to return to normal after two weeks on dutasteride.

Putting up with PVR,dribbling is even worse than impotence. It either leads to an enlarged bladder that is not able to contract and requires Self-cath for life + ensuing infection of LUT or contraction of the bladder and super-sensitivity due to the thickening of the bladder walls. As a result, the number of night and day trips to the loo will multiply to unbearable. The earlier you do something to decrease the obstruction created by the BPH the better for your bladder, kidneys and quality of life. Sexual life as well... Period.

Good luck to everybody. Everybody is different but not when it comes to obstruction of the bladder neck. Pretty much the same for all men suffering from long time BPH. It won't dissolve itself... Don't bet on it. It will grow and grow.

Up for a pee break right now at 4 a.m. I might disagree -- for, as you say, we are all different.

I am age 73. My first BPH symptoms developed around age 40. I visit the uro once per year. I have the urine retention test each visit. Thus far, I continue to void 90% + and have been prescribed the lone therapy of alfuzosin and 5mg generic Cialis once daily. I assume from this that my condition has not worsened and that my bladder is not any worse for wear.

Maybe - or maybe not? But you have to listen to your body. I have avoided more invasive procedures (for some of the sadder stories I have read here and elsewhere) preferring to put up with what are now moderately frequent toilet visits. Night time frequency was recently reduced to 2x (from 3 or 4 times) by addition of the daily cialis with the alfuzosin. I live with the pee frequency figuring life could be a lot worse with prostate cancer, etc. Though I do miss the now ancient experience of sleeping through the night.

But it's all obviously one's very personal decision.

Clarifying: I have been on alfuzosin for perhaps ten years. Cialis was a recent addition.

Owen,

Thank you for sharing your wisdom with us. Let me doubt that you had a BPH at age 40, by all means the peak of man's sexual health. Bu your own admission on this forum a year ago, you Doc after performing routine DRE told you that your prostate is not enlarged. Am I right? You never had an MRI or TRUS , or CT scan. Most likely you have "irritated bladder"syndrome, maybe some urodynamics problems and possibly a "normal" ageing man BPH with relatively small prostate, slow growth, and maybe slightly enlarged median lobe, but not even close to obstruction of the bladder neck and retention. I don't think that you situation qualifies you for giving advice to men with severe BPH symptoms and almost inevitable retention at the age when surgery becomes questionable or impossible.

You are lucky (like other 30% of men your age, 100%-age) who have only a mild BPH and relatively slow DHDT metabolism and growth rate. Us, the less lucky majority of 70+ men (I'm 72) should be more decisive in the world, where people often live in their 90th. My Dad passed away in November 2019 at age 102 from BPH complications. He didn't go beyond alfuzosin and avodart and suffered dearly from BPH, while not having much of other problems. He suffered from bPH since his mid-50s and always rejected an idea of any invasive surgery. For me he was a visual example of how wrong is "wait and do nothing" approach.

Best of luck.

Hi Gene -- 2nd time in two years or so for me being corrected in these dialogs by you (or perhaps someone else.) Let me assure that there is no intention at this end to "give advice" to anyone. I thought we were sharing experiences and suggesting possible pathways/questions forward for our respective clinicians. Multiple uros over the years have had me medicated with, oddly, BPH the official assessment. Yes, puzzling that my prostate was not said to be "enlarged" on the outside so much as growing with inward pressure on the inside --pressure on the pipeline, so to speak. Hence the less drastic drug therapy that has been my experience through my 40s to now age 73. Perhaps your contrasting diagnosis is the correct one, but you may appreciate lthat -- short of the often burdening invasive options often chronicled here -- we are commonly slave to our own doc's best guess. May the record stand corrected if it can be determined that yours is indeed the more accurate perspective.

Paul: They should be willing to schedule you for a transrectal ultrasound (TRUS). It is the most accurate ultrasound method available for the prostate, and it is fairly accurate (almost as accurate as 3T MRI). For purposes of sizing the prostate, TRUS is accurate enough. 3T MRI has the advantages of also being able to evaluate the prostate for prostate cancer (using PIRADS) and provides nice pictures of what the prostate actually looks like. But if your PSA test and DRE exams are normal and you have no other reason to suspect cancer, TRUS should work well for providing an accurate prostate size.

Now, I don't know about how well TRUS works for evaluating a possible median lobe. 3T MRI will show the median lobe in nice detail. I believe that uros can diagnose a median lobe via cystoscopy, but am not sure. Perhaps some other posters will chime in on this.

One other thing about TRUS. Based on personal experience, the upper limit for measuring the prostate size using TRUS is around 120 grams or so. I was at that upper limit and my TRUS pictures required some guessing by the uro as to where the end points for measurement were. Just keep that in mind if TRUS comes back with a number of around 120 gms or so. But either way, you will know that it is at least that large and that you probably need to do something. If you get a TRUS, ask the uro what the measurement size limit is. Size may be an issue with certain prostate procedures that have size limits (although those limits are being expanded upon with new studies).