Posted by ronpol1 @ronpol1, Jul 20, 2016

Several times a day I have an urgent need to urinate. I barely make it to the toilet in time. My urologist recently put me on FINASTERIDE 5MG. I was already taking TAMSULOSIN HCL 0.4MG. He said to wait a month before contacting him. I know I have an enlarged prostate. Any suggestions? Thanks.

@ronpol1, I’m glad you found Mayo Connect and dropped in for an exchange of information on the problem. Your recent experience with an enlarged prostate is like a recording of my own experience. Urgent need to urinate, even while on the National Mall in Washington DC with friends. A nearby bush gave me concealment at just the right time.

I had been on both Finasteride and Tamsulosin one time or another over several years, and it made life possible until 6 years ago when a new urologist at my HMO advised it was time to deal with the problem. Benign prostatic hypertrophy (BPH) is in my genes; my father had a tennis-ball size prostate removed surgically. My urologist recommended a transurethral resection of prostate tissue (TURP) in which he inserted a special cystoscope through my penis into my bladder and, for almost an hour, snipped away a fairly significant portion of prostate tissue.

All of the pieces were recovered and placed under a microscope to check for cancer; gratefully, no malignant cells were found in my prostate. However, removal of the prostate tissue revealed a small tumor hidden underneath on the lining of the bladder; he removed that as well and it was found to be malignant but, thankfully, attached superficially to the bladder’s lining. Over the next three months, it was treated with a biological agent; periodic cystoscope examinations have found no new tumors for five years.

A number of procedures are available to remove excess prostate tissue. The TURP was a good choice for me. It’s no surprise that your urologist wants to wait a month after prescribing the two medications; that will allow the prostate to settle down as much as possible before talking about next steps. You will want a good detailed discussion with your urologist about the diagnostic procedures, what might possibly be found, what steps to take with each possibility, when, and with what procedure.

Have you had a PSA test to see whether the prostate specific antigen has emerged into your blood? The antigen’s presence results from five different causes, one of which could be a malignancy. If the PSA shows up, your urologist will tell you what additional procedures would determine whether cancer is present. The only reliable evidence of cancer is microscopic confirmation of malignant tissue. Keep us posted on your experience so we know what other information would be helpful, and feel free to contact us any time.


I’ll discuss this with my urologist next month. Thanks for your suggestions and your advice.

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