Anyone Taking Combined Therapy of Tamsulosin + Finasteride for BPH?

My experience with the two drugs, tamsulosin and finasteride was mixed. I was on them for about 2 years, ostensibly (I don't know for sure if they worked, but I will assume so per my urologist), to decrease prostate size and open the urethra. They did seem to somewhat help in my overall ability to urinate. However, if I did not urinate when I had the urge (e.g. on a road trip without easy access to a bathroom), I still had painful episodes of not being able to urinate until after several (very minimal, drippy at best) tries. Usually, I could almost empty my bladder after an hour or two. However, they caused a troubling decrease in libido, increased ED, and internal ejaculations 100% of the time. What has caused me the worst problems with not being able to urinate due to BPH since 2010 was having surgery with anesthesia. This began with the first hip replacement in 2010, then 2nd in 2011. After my first shoulder joint replacement in 2020, I began taking the 2 meds; meds were increased after 2nd shoulder joint replacement in 2022...after which I was on a catheter for several days. I had a hernia surgery with anesthesia in February 2024, and could not urinate at all afterwards...had to go to the ER to get catheterized a day after hernia surgery. So, prostate surgery was the only answer. I was on a catheter from February 14 to May 16 2024. Horrible. I had Aquablation surgery on 4/29/24...and the results, for me...have been phenomenal. I wish I had had it sooner. All BPH symptoms are gone...I haven't had such a good urine stream in decades. My libido and ED are much improved, and ejaculations, though nothing like when I was younger (I'm 73) are again all external. Aquablation was wonderful for me.

Your story is so encouraging, thank you! I would be very fortunate to have such a positive outcome as yours. I'm 72, and have experienced many of the BPH symptoms, medication results, and side effects as you have since I started taking tamsulosin a year ago, and recently, finasteride via combined therapy. I'm pleased with my current state and have tolerated some of the "weird" side effects you mentioned, but so far, nothing unmanageable.

And I just learned I have an inguinal hernia in my scrotum area of my abdomen, after it was found on my MRI, along with my enlarged prostate but with no cancerous lesions. I've had no visible or painful symptoms yet with my hernia, but the general surgeon I met told me what to expect and do if I experience such symptoms.

If and when my time comes to consider minimally invasive procedures for my BPH, I will absolutely discuss the aquablation option with my urologist. Thanks again, and best wishes to you on your return to all things "normal" :-). Enjoy!

Thanks for your response tgregg99! I wish you all the best. I'm probably repeating myself here, but...again, I want to offer caution, based on my experience with BPH: If you have to undergo any surgery that requires anesthesia, beware. BPH was manageable, especially with the meds, until I had any anesthesia. Anesthesia always caused my prostate to shut down completely; several times I needed a catheter for a while after anesthesia. In my most recent case, even though the hernia surgeon and my (former) urologist thought the relatively local anesthesia wouldn't cause a problem, prostate surgery was my only alternative to get rid of the catheter. I was catheterized from the day after the first hernia surgery (2/14/24) until 2 1/2 weeks after aquablation (on 4/29/24), and a week after 2nd hernia surgery (on 5/9/24)...until 5/16/24. That was per the aquablation urologist's recommendation to let the hernia surgery heal somewhat to make sure I'd be able to urinate on my own. Again, best of luck to you!