As a male turning 60 next year, I’m starting to show signs of an enlarged prostate. I won’t go into the details because IYKYK. My PSA level is fine.
If you’ve had any treatments for a swollen prostate, I’d like to hear what and how effective they were.
I’ve been on the same two medications, at the same dosage, for 20 years. My prostate has somehow managed to not get any worse in that time, much to the surprise of my urologist, who says prostates normally need more aggressive treatment after 5 years or so.
When I first had symptoms, the only two treatments were drugs and the dreaded TURP if the drugs weren’t effective. Now there are other less invasive procedures worth looking into. In my case, since the drugs are still effective, I’m still happy with them.
I’m 68, and a few years ago, I mentioned to my PCP that I was getting up 3-4 times a night to pee, and I sometimes had excruciating urgency. When he asked why I had never mentioned it, I told him I thought it was a normal part of growing old. As I’ve since learned, it isn’t.
I went to a Urologist, who confirmed that my prostate was double the normal size, and I was immediately put on tamsulosin (generic Flomax), and the problem disappeared. My Urologist told me about various other things she could do if the meds didn’t work. Luckily for me, they did, at least for now.
I’ve had BPH for awhile now, PSA 5.2, Biopsy negative. Exam every 6 months now instead of yearly. Not doing anything apart from not taking coffee or tea, cutting back on drinking in the evening kind of stuff. Will only consider TURP as a last resort.
I have symptoms that as a once-upon-a-time LPN nurse trainee I believe to be prostate enlargement related. I haven’t done anything about it. So far it isn’t causing any problems. Oh, I did have an exam to rule out non-benign variant. Other than that, ignoring it for now.
I’ve been down both paths twice. The first time, back in the 1990s, I spent a few years on Flomax, then on Flomax (tamsulosin) and Proscar (finesteride) at the same time. That worked pretty well for a long time, until it wasn’t enough. In 1997, I got a “laser ablation.” Under numbing drugs, my urologist used a sharp probe to heat up the tissue on both sides of the urethra where it passed through the prostate. The heated tissue shrank, and after a few days on a catheter, I no longer needed the drugs.
I was 48 then, and everything worked well for another 15 years or so. Then I went back on the Flomax, and eventually both drugs again. Then, in 2020 I got a TURP. It’s done with lasers now, not the old dreaded “roto-rooter”. I’m doing okay, without any urinary drugs.
By the way, one of those prostate drugs, I don’t remember which one, has a side effect of slowing down, and in some cases stopping, male pattern baldness.
Flomax worked for me, but make sure your physician keeps tabs on your PSA levels regularly and doesn’t just give you Flomax to ease the immediate problem. My prostate cancer might have been caught sooner had my family physician been more proactive.
I’m a 69 year old male and have been on Tamulosin and Finasteride for a few years…
finasteride
I’ve been on finasteride for 20 years. Trust me, that particular side effect does not occur in all patients.
And thanks to 4d3fect mentioning cutting back on caffeine and alcohol. For me it’s no alcohol at all and no caffeine after 6:00 p.m.
I try not to drink anything after lunch other than a few swigs of milk with my supper.
After a few years on Flomax, my urologist performed a TURP.
Trans Urinal Resection Procedure (if I remember correctly).
I had to use a catheter for 5 days, but other than that it wasn’t even uncomfortable.
Great results. I no longer have difficulty urinating, get up once/night, life is much better.
One issue that my doctor didn’t get around to mentioning is that ejaculation is practically impossible.
At my age, that wasn’t a loss. But something to keep in mind.
How could the doc have failed to mention that?
My father told me that he suffered from BPH for several years (maybe 10, if I believe what he said) because he didn’t want to lose sexual function; this was in his 70’s. He said he had to use a catheter sometimes. He had some weird ideas about what comprised his claim to manhood (my poor mother, is all I could think). Anyway, he was 80 when my mother died, and he had the operation then. I assume it was TURP.
My own situation, as I am now 73, is that I get up 3-4 times a night, not because of BPH, but because of sleep apnea, which even with a CPAP means I surface higher from sleep during my sleep cycle, and once I have surfaced and feel the need to pee I can’t go back to sleep until I do. During the day, everything is normal, and my doctor has confirmed that my prostate is not enlarged.
On that point, I have a sad story about a completely unnecessary prostate biopsy that happened because my PSA went up a couple of points, and neither my regular doctor nor the urologist thought to mention that things like recent sexual activity (and aging, and other things) can lead to a higher PSA reading, so I should have abstained for 72 hours before each test. The result of this completely unnecessary biopsy was that, while I can still reach a climax, I no longer have any ejaculate at all (sorry if that is TMI). I was in my mid-60’s when that happened, and I am still angry about it. I only discovered that connection by reading I did for myself online, I think it was the Mayo Clinic website.
That does seem like an awfully big oversight.
I think I could have written this post. Is your AHI well controlled? Mine had been around 5 with the CPAP but I’ve recently lost a fair amount of weight and now it’s around 1.
I don’t know. My last sleep test was around 2007, and in any case they never told me the results. Instead, they made me buy my stuff from one retailer, and they gave them the prescription. That didn’t last long, the retailer was dictatorial and unreasonable so I ditched them. When my last CPAP machine started operating poorly, I managed to find one I could buy online without a prescription, and copied the settings from the old one to the new one. It seems to still work. I’ve been buying my masks and hoses online no problem for years. I doubt, though, that I will be able to find another CPAP machine without a prescription.
I’ve been dreading trying another sleep test, both times I had it, it was the wired up in the sleep lab experience, which is very frustrating for me, and the tests were run by grad students who had very low understanding about how to make people comfortable. I’m hoping next time to have an in-home test. Maybe I’ll go to a private lab instead of the only hospital-connected sleep lab in the area.
(Faithful readers of my posts may detect some dissatisfaction on my part with the medical industry in general, and some doctors in particular. I would just like to state that I don’t think I am prejudiced against or in favor of doctors or their staffs, but I operate with my eyes open. I may go along to get along sometimes, but I also don’t forget much. Sorry if I vent too much about it.)
@Roderick_Femm Sleep studies have come a long ways in 15 years and many (if not most) prescribers offer the “at home” variety. You should look into it.
You might also want to check out this thread that I started a couple of years ago. If you need a new CPAP machine....
In college I made extra money doing sleep studies as a normal control. Full EEG, full EKG, plus a strain gauge for detecting penile tumescence. In one instance I had an intravenous catheter with tubing exiting my room through the wall for overnight blood sampling.
But the room temperature was perfect and a white noise machine buzzed in the background. I slept like a baby. Maybe it was the $$$ awaiting me when I awoke.