Watchful Waiting

barrie62598 Top88 · 2017-12-02T00:25+00:00

I was treated for Benign Prostate Hyperplasia/Hypertrophy (BPH) since 1990. In 2006 I was prescribed Alpha-blockers (Flomaxtra then Prazosin) 4mg a day. They still left some voiding difficulty and overnight necessities. Bladder capacity was shrinking. There was no consideration of the impact 9 years of Alpha altering of bladder neck/urethra muscles and nerves might have if a prostatectomy were to follow. I did not know that since 1995 urologists had known Prazosin would need an increase in its 4mg dosage beyond 2 years. By 2015 still no one had bothered to do the research. Pharmaceutical companies do all the research and they don’t if there’s no billion dollar benefit in it for them. When Prazosin became a little less effective and I requested an increase to 6mg a day Duodart was prescribed March 2013 to March 2014. Gleason Score 3+4=7 and Open Radical Prostatectomy followed in November 2015(at 72 years). A long and hard partial recovery and so far 2 years of incontinence followed. An emergency hospital botched blockage treatment then causing possible permanent bladder neck damage and months of self catheterising. My 25 years of PSAs never went above 3.8 (Apl 2009) and it was 2.41 (f/t38%) in July 2015 long after 5ARI affect on IT had ceased.

Research shortly after RP alerted me to concern that Duodart may increase risk of high-range PCa. My then urologist said this only related to a different 5ARI drug and then only “serious” PCa “which yours isn’t”. It was serious enough for me. I have spent 2 years trying to get some answers. No one can tell me if Gleasons 3+4 progress to 8s and 9s or if they just become more aggressive 7s. If there are 2 different types of BPH with growth in number or size of cells. Duodarts’ Australian supplier discounts any increased risk from pre-release trials as a fault in the study’s design. There has been no attempt to redo the trial without this design fault. Our Commonwealth Ombudsman says only trial adverse side effects need to be recorded as such on information provided to consumers with the drug. Subsequent adverse effects do not have to be advised and therefore Urologists do not complicate their prescribing and cause any problem with sufferers “risk vs benefit” consideration.

The Australian supplier of Duodart has reported 5 suspect “de-identified cases” of Prostate Cancer to our Therapeutic Goods Administration’s (TGA) Database of Adverse Events(DAEN) yet PCa still doesn’t appear in the side effects of Duodart’s Consumer Medicine Information supplied with the drug. TGA says drug suppliers are legally bound to report “serious” adversities to them but allow the company to report them without age, other medications or Gleason Scores. The only distinguishing factors are the company’s notification date. They could be anyone. Urologists are required to prescribe initial doses of the drug and appear to be the only source for any supplier’s fulfilment of their legally required reporting. Many urologists have decided not to let me know their feedback regime. The supplier informed me they reported my adverse reaction but submission dates indicate they did not.

Dutasteride is supposed to mostly reduce prostate size by abnormal manipulation of its cells. My research has indicated that it mostly does this but it appears that when it fails to achieve this reduction it does something else. If the supplier can isolate their 5 mystery, suspected PCa from the rest of their user PCas I hope they didn’t have a way to do this ahead of our drug use. If you are having voiding and size reduction benefit you are likely on a winner others may not be. UK appears to have more locally readily available BPH treatments than Australia. Do the research and communications to ensure you don’t make our mistakes.

Barrie Heslop

Supertractorman Top88 · 2017-12-02T11:58+00:00

It would seem that many TURP Ops in the NHS are given to Senior Registrars to do before their next move up to Consultant and then they sometimes progress to removal etc. It is a small move on from doing Cystoscopy and taking Prostate samples and they take out a round part from the end of the Prostate to make more room for urine to pass through. In my talks with Consultants it is the only part of old men that grows !, but the risks of E/D and Incontinence depends on what is around your Prostate in that area which may get removed. I do wonder if once you have a TURP it allows the Prostate to float about, as late at night after sitting in my chair and getting out of bed in the morning I struggle to pass urine, stop / start and very slow, now I cannot self catheterise at night as can't get past my Prostate yet I can at lunchtime. I am told it is essential when you have a urine infection to have your bladder totally empty when going to sleep as any left behind will multiply the infection. As I have said before for me I don't want another TURP every 2 years, so want it gone.

One question for all is I have noticed when I have a catheter in I often have no infection and once removed infection is found which I presume is coming from the Prostate area as urine passes it. Think initially infection is picked up by catheter passing the Prostate and taking to the bladder. Anyone noticed the same ?.

arlington Top88 · 2017-12-02T22:15+00:00

Top88,

Anyone had experience with Duodart YES - 7 MONTHS - NO IMPROVEMENT AND QUIT

Know many people who have had TURPS with no problem or concern of RE. NO

Is RE 100% outcome for TURPS PROBABLY

I am not sure on TURPS. If I maintain status quo will symptoms worsen. I have read prostate slows down is this correct? I THINK SO - BUT SOME MORE SLOWLY THAN OTHERS

Good luck!

alan1951 Top88 · 2017-12-04T16:35+00:00

I think Kenneth1955 is correct (see below). Stay away from surgery. Duodart seems to be working for you. There are so many pharmacological interventions you can use before you consider surgery. Why fire a cannon, when a BB will do the trick?

Guest Top88 · 2017-12-06T19:50+00:00

My understanding is that RE is virtually 100% certain after a TURP. But it can have its benefits!

Watchful Waiting

Top88

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