Trying to get my sex life back AND control BPH

Thanks very much for the comments, all very helpful.  

Arlington, I'll take yours as a positive vote for the Alfuzosin since you experienced no negative sexual side effects from it.  I'm curious.   Did you replace the Alfuzosin with another alpha blocker?  If so, is whatever that is working for you?

Jim and CMDR, my previous urologist suggested daily low dose Cialis before I started on alpha blockers.  This was in the days when that regimen cost about $150./month and my insurance wouldn't cover it.   I recall I tried low dose C for about two months and had only so-so results on the BPH.  It turned out that Cialis just isn't an effective ED drug for me for whatever reasons.  Although I got a lot of nocturnal erections while taking it low dose, even full strength Cialis didn't give me reliable erections for sex.  Perhaps for whatever reason it doesn't cause the required degree of relaxation in the prostate and bladder neck to affect the BPH symptoms enough.

Levitra, on the other hand, works beautifully, even with lower doses, so I'm guessing I'd have better results using it low dose daily for BPH than the Cialis gave me.  I'll check with my insurer this week to see if they'll cover any of the cost now that the FDA has approved Cialis for BPH and find out the recommended "low dose" for Levitra.

 

Kinau,

Another option is Clean Intermittent Self Catherization (CIC). The advantage here is no drugs to take and therefore no side effects of any kind. It is also more effective than any drug in terms of dealing with retention and the related symptons of bph, as it allows you to empty your bladder completely any time you want. 

Many people have an initial negative knee jerk reaction to CIC. I certainly did. But after a relatively short learning curve, it won me over, as it has a number of people posting here. Not only did it offer me a non surgical, non drug way to deal with bhp, but it has also rehabilitated my bladder to the extent that I am able to stop CIC for significant periods of time. Since I've started CIC, my IPSS (International Prostate Sympton Score) has dropped from the "severe" to "mild" category. According to my urologist, my results are better than many who have had successfl surgeries!

If interested, lots of information on CIC both here and elsewhere on the web. Just don't let some of the problematic posts give you pause. Some people adjust right away, but for others there can be a difficult initial period of several weeks as the body adjusts. (After that, it gradually becomes a quick, easy and painless procedure that I have compared to brushing my teeth in terms of lifestyle adjustment, although brushing my teeth takes considerbly longer!

Jim

 

Yowza!

That cracking sound you're hearing, Jim, is both my knees jerking.    Maybe I can avoid the CIC for now?  Each time I've been catherized in a hospital I've has serious pain afterward when urinating.  Are these people using lube, or no?

I've had a sonogram which showed that my bladder does void well when I pee.  There's little difficulty during waking hours, only at night with bathroom trips.  The Tamsulosin does a pretty good job with that part.  I'm down an acceptable number of bathroom trips during sleeping hours.  It's the negative sexual side effects of this drug which are unacceptable to me.

 

When you say your sonogra shows your bladde voids well, is that while you're taking Tamsulosin? Or are you saying that your bladder voids well without drugs but only during the day and that Tamsulosin helps with that?

Because if it's the latter, then you may have what is termed nocturnal polyuria, or excessive urine production at night. If so, it's possible the Tamusolin may help some, but there are a number of non-drug interventions that also can help nocturnal polyuria. They range from fluid management, to salt (sodium) managment, to compression stockings, to even treating sleep apnea, a condition that can cause nocturnal polyuria that most people don't even realize they have. 

So I have nocturnal polyuria to a degree myself. In fact, as we get older most people start producing more urine at night then they did when they were younger.

I have taken both Tamusolin and Urexal, and both left me with retrograde ejaculation so I stopped. 

So, if you don't want the sexual side effects of those drugs, then you could try the daily Levitra, or one of the other strategies mentioned. And then there's CIC. Sounds like you had a bad inittial experience. So did I. 

If someone offered you an operation right now that would get your bladder working 100% with zero chance of sexual side effects, would you take it? The caveat is that there would be a one-time healing process of 2-3 weeks where you might experience some pain, urgency, bleeding, etc. 

Well, CIC is like that except there is no operation. In most cases at worst it's 2-3 weeks of discomfort. Down the road about as painful as brushing your teeth but doesn't take as much time. I timed it the other day. Maybe takes 30 seconds longer than an natural void, but since the urine comes out so much faster, you gain back the thirty seconds!

Jim

"When you say your sonogra shows your bladde voids well, is that while you're taking Tamsulosin? Or are you saying that your bladder voids well without drugs but only during the day and that Tamsulosin helps with that?"

I was not on Tamsulosin at the time of the sonogram, but one of the other a-blockers.  Doc suspected my bladder was not emptying when I voided.  I was told to drink a lot of water, waited some period of time, peed, then had the sonogram when it was determined that my bladder was not retaining fluid inappropriately.  "Keep taking the (whatever it was I was on at the time)."

I generally pee fine in the daytime, sometimes weak-streamed, but I pee and am not much inconvenienced.  No pain ever.  I manage evening fluid intake regularly and use little salt in foods.  Sleeping time is the problem.  Before the a-blockers I'd have to get up as many as 7 times during the night, nor was there much urine volume when I did pee.  Now maybe three x-night, which is acceptable.  I'd rather not take up CIC at this point because I don't mind popping a pill to avoid 7 bathroom visits a night.  I'm just hoping for a pill that allows me to ejaculate and have normal orgasms.  

 

I'm going to start low-dose Levitra as soon as I have a replacement a-blocker for the Tamsulosin; I asked my doctor to send a pre-approval request to my ins company.  It refuses to cover any of the ED drugs, calling them "recreational," but maybe his stipulating BPH treatment will sway them.  Otherwise the Levitra will cost me around $40 per pill.  (The ED drug companies are gouging us full-throttle before their patents run out in a couple years.)  According to what I've read, 5mg/day is the right dose, but a good idea, they say, to have a 6hr time difference between taking the Levitra and taking the a-blocker.

Kinau,

Daily Cialis cost around $100 month with Medicare picking up the rest and that's with an rx for bph. But you have pay out of pocket for daily Levitra, best bet is to get the 20mg pill and cut it four ways. 

Jim

That does save.  I do that already, only needing 10 mg for a good sexual run.

So how does 10mg Levitra compare say to 10mg Viagra, if you've tried it? Also, if you do try daily Levitra (5mg/day) do report back on not only how it affected your bph but how it compared to on-demand 10mg Levitra for sex. I've been thinking of going back on daily Cialis but I might try daily Levitra instead as the principle should be the same.

Jim

Jim;

I've used Viagra for some years and still do occasionally.  At first it was a little iffy.  It gave me a slight headache, facial flushing, and that blue visual halo they talk about (hence the color of the V. Tablets?). My stomach had to be completely empty for the best result and I did have a bit of stomach discomfort at first. If I dissolved it prior, it took effect in 20 - 25 min., otherwise up to an hour.  Solid erections, but the best part is that it delays orgasm for me so I can last longer before I cum.  Interestingly, over weeks of use, the negative side effects gradually disappeared - except for the blue halo.  I use either 25 or 50 mg of the V.

Tried Levitra when it first came out and have stayed with it pretty much except for when I was doing daily low-dose Cialis. Started on 20 mg but that was a bit much.  10 mg was better.  Erections are as hard as with V.  It takes effect faster than V does with few worries about food interfering.  No headache, no halo, and only mild and brief flushing for me, but we're all different.  Bayer also makes Vardenafil (Levitra) in a lozenge which you dissolve under your tongue.  Forget the name.   (Staxyn?) I haven't tried it but would like to.  If anyone here has, let me know what you think of it.

Cialis is not a real effective ED drug for me, even full strength.

I'll certainly let you guys know how the low-dose Levitra regimen goes.  If I stick to the 6 hr separation of the a-blocker and the Levitra, I'll have to figure out how much L to take for sex, unless the daily low-dose also makes sex possible whenever.

 

Kinau: I'll have to figure out how much L to take for sex, unless the daily low-dose also makes sex possible whenever.

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With a little research and math, you can figure out the amount of Levitra in your blood at any one time on a daily 5mg dose. 

With Cialis, for example, the mutliplier if I remember correctly is about 1.5  That means if you take 5mg of Daily Cialis, it's the same at any point in time if you took 7.5 mg of Cialis on demand. With Levitra, the number may be differrent because the computation has to do with the half life. 

That said, there were some studies that showed that 5mg daily Cialis had an equal or more positive impact on sex than I believe 10 or even 20mg on-demand Cialis. So, it might be more than just the numbers.

If you go for the daily Levitra, I guess you will know soon enough if it is better, equal or less adequate than the 10mg doses you now take. 

Jim

If you do go the surgery route, pick a surgeon with a lot of experience in whatever procedure.