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Benign prostatic hyperplasia (BPH) Surgery Options
Men's Health | Last Active: 7 hours ago | Replies (279)Comment receiving replies
I am 42 and had been on meds for bph for past 3 years. Taking tamsulosin 0.4 mg x 2 and Finasteride. I have been trying to avoid the surgery but had an episode of acute urinary retention and infection 3 weeks back. Had to go to the ER twice and bladder scan showed 700ml of retention. Had to be catherized. Off the catheter now.
Have contacted my urologist and thinking about scheduling the holep procedure.
Replies to "I am 42 and had been on meds for bph for past 3 years. Taking tamsulosin..."
@mandarin007
I just had a highly successful Holep on 19 June. Totally painless and uneventful recovery in my 6th week. But I would NOT recommend Holep for a 42YO because men at this age would still be likely be fathering children. Holep is best for those who are past fathering children because male fertility is 99% compromised. There is a modified Holep called “Part Holep” where the bladder neck tissue is left intact, to reduce the occurrence of retrograde ejaculation.
For a young man your age, I would recommend in this order:
1. P.A.E. (Prostate Artery Embolization - no prostate tissue removed, no risk of fertility loss from retrograde ejaculation
2. Aquablattion
Discuss with your urologist these 2 procedures. There is another new procedure (OPTILUME BPH) I came across today that is guaranteed NOT to compromise male fertility.: https://www.gaurology.com/optilume-bph/
@mandarin007 I’m sorry for your issues. Any info as to why the Finasteride and tamsulosin weren't effective?
I ask because I’m 74, and my prostate is 124/133 grams. I’ve been on first Tamsulosin and now Alfuzosin for about four years. All was going well until I had general anesthesia during a routine outpatient surgery three months ago, which caused (post-operative) urinary retention.
I was too big a weenie to do self-catheterization, so instead had an indwelling catheter. After eight (yes) weeks of voiding trials (catheter out, catheter in), my doctor recommended HoLEP. Since I couldn’t get an appointment with the recommended surgeon for over a month, and I thought I was feeling some bladder sensation, I requested one more voiding trial. The following week, my bladder voided, with minimal retention.
I scheduled an appointment for a “second opinion” with another surgeon (who was able to see me sooner), & he endorsed a trial of finasteride, with no surgery unless & until I had another episode of retention.
Your situation at 42 might be completely different, but FWIW, I thought I’d share my experience. Good luck!
Did the urologist confirm you have BPH (enlarged prostate) that is causing blockage to urination? 42 is too young to be suffering BPH, and highly unusual. Bladder blockage and weak stream is not necessarily caused by enlarged prostate. It can be cause by narrowing of the urethra. There is a specific medical prostate to treat this condition - Optilume balloon therapy. Although it was originally aim at constricture of the URETHRA, it has also been modified to treat BPH. So it can be deployed to treat narrowing of the urethra and also enlarged prostate.
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@mandarin007 My advice is to make sure you get a second opinion. Also, there are usually more than one option for you, so do your homework and research your options. There are many Urologist out there willing to operate on you with some procedure, it’s really important to read, study, and be ready with questions. Write things down. There are many men in this Mayo Connect Group that have faced this exact problem. Go back and read their experiences and results.