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Hi all. I live in the U.K. am 62 years of age and have been treated for BPH with Doxozasin and Finesteride, I have have the usual DRE and PSA checks over the years and no alarm bells have been flagged but the DRE confirms I have an enlarged prostate. 

I have been on the Finesteride for over a year now and over the last 3 months my sex drive has dropped off dramatically and feel what I can only describe as desensitised down below. My flow is not great and I'm up a couple of times through the night. My doc, on the last visit says I am on the best combination ot drugs but I seem to despair at their lack of expertise and am sure if I go back and mention my decline, he will say it is a pay off to keep the prostate in check, another PSA check DRE. 

I know things are advancing with procedures to treat BHP and hope  I could delay things until a safe less evasive procedure was available. The word TURP puts the fear of God in me. My friend suffered after one a few years ago. 

In anyone's opinion am I on the Finesteride for too long and could the doc give me an option. The Doxozasin was prescribed due to my high blood pressure and is a tablet that they say, if can be tolerated is ideal for my prostate also. 

Any info. about good urologists, drugs or the way forward would be much appreciated from you guys, and all the best!

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  • Posted

    Graham The 2 drugs you are on are going to stop your libido.  There are some other med's you can try that do not have the side effects of the 2 your are taking.  Talk with your doctor to see if he will change them if not get another doctor that will.  And do not be force into any procedure that you are not ready for.  Myrbetriq & Cialis are a couple  Ken  

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  • Posted

    Cialis (10-mg or 20mg) will revive your erections.  But from what you describe, you may want to explore a non-invasive intervention.   PAE and REZUM have this year been approved by NICE as cost effective for financing under our NHS.   I am 76 and this year had PAE.  It is relatively new in the UK and you might need to search a bit for someone who has done it often enough.  I went to Poland and paid at a private clinic c £2500 + fares. Two months on, my prostate has shrunk c 10% and vascular surgeon says he expects that to reduce further. Sexual function unchanged.  An MRI to detect the size of your prostate seems desirable; a DRE can provide only a rough estimate.

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  • Posted

    You should stop Finasteride immediately or risk going impotent, just google it you'll see what others say about it. Doxozosin if it is the same as Alfuzosin, Prazosin helps with BPH but there are others that are more specific for BPH, like Flomax (Tamsulosin) and Rapaflo (silodosin) - those are USA names I don't know about UK.

    If you need it for blood pressure anyway I suppose Doxozasin should help and you can't take that together with Flomax as far as I know.

    So bottom line if the drugs are not enough, I don't know what is available in UK or if you can afford to travel and or pay out of pocket, but there are alternatives to Turp. They are all scary in their own way, you can read about most of them on patient.info but I think the fear of the very idea is worse than the actual pain. If you have surgery to reduce size of prostate there is not guarantee you won't still get up twice a night or more, the bladder gets out shape and many even who don't have BPH get up anyway to pee. If you feel the flow is getting worse to the point where you might get blocked up it's time to act. Learn how to do CIC (self catheter) so you don't have to be rushed to emergency room etc. Then look at options and decide what is for you. Your Urologist may not do that procedure.

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  • Posted

    Graham  If you do need a procedure try Urolift.  I know they do them in the UK.  That would open you up and it has so side effects.  Have a good day  Kene
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  • Posted

    Graham, I believe in the UK and have been put on a waiting list for a Urolift by my urologist... I have both but additionally suffer from a low capacity/overactive bladder... I wake up every hour in the night to pee..

    Apparently he is going to do the Urolift in his clinic and said it will take no longer than 10 minute under local anesthetic, and it is also a very quick recovery period..Youll need a cystoscopy to determine whether you are a good candidate for the procedure but I suggest talking to your Urologist about it..

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    • Posted

      I don'y know if the doctor you are going to see is Neil Barber but he said it was a very good procedure if you have sexual concerns 100 %   Ken

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    • Posted

      No, not Neil Barber... But yes, it is the least invasive surgical intervention... I also have a high bladder neck apparently, so of the Urolift is not successful, he has suggested that he does surgery to correct that too.. but I am very hopeful the Urolift will produce positive results... I have a very poor flow rate but at least I manage to empty my bladder currently.
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    • Posted

      Please what ever you do do not let them do both at the same time.  Have the Urolift first.  It will take the pressure of the bladder.  If they touch your bladder neck it will not close right and you will end up with retro ejaculation.  Make sure that is the only thing you sign and give permission for.  Ken.  
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    • Posted

      Thanks Ken... We are only doing the urolift first.. and then evaluating the results after 8 weeks...

      If it is not as successful as I hope, then we will discuss further options... he did say, that if he does do the bladder neck, he would only do half, so whilst I would have reduced ejaculation, it would not be full retrograde ejaculation... however, Urolift first ... hoping for positive results

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    • Posted

      That is good but I never heard of reduced ejaculation.  I think you need to read up on bladder neck incision.  Anytime they touch the bladder next you can end up with retro.  The bladder neck will not close and everything will go up instead of down.  Good luck  Did he tell you haw many clips he is going to be putting in.  I have 4 clips been 3 1/2 years still wide open.  And no side effects  Ken. 
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    • Posted

      No, he hasn't mention the number of clips to me.. 

      I am sincerely hoping the Urolift is all I am going to need, I declined a TURP previously with my previous urologist... this one agrees that a TURP would be too extreme, especially since I am still relatively young (I'm 49)... he says he is going to be as least invasive as he possibly can be...

      The hospital has just confirmed the date of the procedure as 19th of October...

       

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    • Posted

      That is good .  Just be careful when you go in for you post up and sign paper work that it tells you Urolift only. Nothing else.  At 49  I don't thing you want any side effects.  You should be fine.  Did he say how big your prostate was  Ken. 

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    • Posted

      Thanks Alan.. I think the Urolift procedure has only become available on the NHS recently... My previous Urologist (2 years ago) suggested a TURP which I declined
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    • Posted

      There are now so many procedures but urologists stick with ones that they are happy with or that the NHS area health authority accountants will give funding for.    
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