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Benign prostatic hyperplasia (BPH) Surgery Options

Men's Health | Last Active: 5 hours ago | Replies (279)

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@amishboy51

Finasteride is only a TEMPORARY solution and it has side effects. Also I learnt something about taking "medication" to solve BPH. Many, later in life, require cataract surgery. This type of medication will complicate (and introduce risks) to cataract surgery if you should need it later in life. I suffered BPH in silence, for years in my 40,s and refused medication only because I am the type who wouldn't even take a Panadol/ aspirin! I was never on medication until I had to take blood thinners since end of 2018. Yes, even having to take only ONE medication daily, is "annoying"! I tell myself - it's unflavored M&M! The term surgery in ROBOTIC surgery (which refers to all these surgeries to reduce the size of over grown prostate) does not refer to "OPEN SURGERY", i.e. cut through flesh. The surgery is done "robotically". A very thin surgical thread goes into tip of penis, through (where urine flows out of bladder), to the prostate. This surgical carries the laser and camera. The surgeon watches on a TV screen what the teeny weeny camera (now inside the prostate)beams out to TV screen, the "landscape" of the patient's prostate. The patient doesn't see anything because he is on full anasthetic.

BUT a couple of years ago, I had a cystoscopy to find out why I had blood in my urine, everytime after running. A cystoscopy requires only LOCAL anaesthetic so the patient is wide awake and can watch the TV screen - a cystocopy carries only the tiny medical camera, but not the laser (like those required to perform Holep etc). The LIVE view of my prostate, on the TV screen, was not pretty - it showed a dark cave full of blood flushed nodules and lobes (legacy of a prostate regrowing after such a procedure as Greenlight). Now, after Holep, such a view would show a clean hollow cavity of the prostate cavity. Nothing in there to impede passing urine! And sure enough, passing urine now is like the NIAGARA FALLS! GUSH!

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Replies to "@amishboy51 Finasteride is only a TEMPORARY solution and it has side effects. Also I learnt something..."

@heath2026 Actually, it’s been reported by the American Academy of Ophthalmology that Finasteride is LESS likely than Tamsulosin to cause complications (“floppy iris syndrome”) during cataract surgery. [also, my surgeon hopes that I’ll be able to stop my Alfuzosin if the Finasteride is successful.]
https://www.aao.org/education/editors-choice/many-factors-can-lead-to-intraoperative-floppy-iri

@heath2026 No guarantees, of course, but at least one prominent study, reported in the New England Journal of Medicine, concluded that Finasteride could have a significant chance of obviating the need for surgery. https://www.nejm.org/doi/full/10.1056/NEJM199802263380901

@heath2026 My surgeon started me on the higher (5 mg) dosage. Per AI, 8.1% of users at this dosage suffer erectile dysfunction, 6.4% suffer decreased sexual drive, and 3.7% suffer decreased ejaculate volume. It’s also reported that, for the vast majority of men who do suffer these side effects, the symptoms improve “over time” (whatever that means).

That said, I’m almost 75, and, frankly, at this point, sexual activity matters a lot less to me than simply being able to pee without difficulty, while also avoiding the need for surgery. But that’s just me.