Prostate problems

@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.
Martin

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

My ex-boyfriend had the Rezum procedure, which is a water vapor treatment to reduce the size of the prostate. It was very successful for him.

Hi I had rezume procedure done Nov, 2022. And now I feel the prostate is acting up again, the stream is not as good as it was before and this has not been even a year yet. Does anyone else has the same experience ?. Also retro has been the issue ever since. Thanks

Ronplo1, keep in mind that finasteride, it is my understanding, is supposed to reduce the size of your prostrate, while tamsulosin relaxes your urinary tract, making it easier for you to urinate, at least that is my understanding. One thing to know, if you are having problems emptying your bladder, you should make sure your urologist is doing bladder scans to make sure you are emptying properly. Otherwise, if your bladder is filling with urine it could back up into your kidneys and cause kidney disease, which can lead to dialysis and renal failure, which is a much worse problem than not being able to urinate.

1. I have Prostatitis, but no pain behind the testicles. My main problem is no control when I feel the need to urinate - which can be every 1 to 2 hours. Note that I drink water constantly throughout the day.
2. I am taking finasteride as well as tamsulosin.
3. When I get up in the morning and take a shower, I start it on cool or cold and then change it to hot - then back and forth for the duration of the shower, the reason being that it actually causes me to (eventually) empty my bladder. Note: toilet right next to the shower. Hope this is of help.

@paul55 I had a biopsy last mid October; the urologist said it went well, but he prescribed me the antibiotic CEFDINIR: 3x100 mg per day. I had the biopsy on a Tuesday evening, staying the night in the hospital. I was give a chart to record my liquid intake and urine passing - from after the biopsy till when I was discharged around late morning. Jump to Friday: I had extreme difficulty passing urine on the Friday; on the Saturday, it was even worse. I was thinking of going to the hospital to request a catheter, but was not in a fit state to go out, so I went online and checked out this (above) antibiotic. I came across various reports by patients that this antibiotic was basically useless for post biopsy treatment. Furthermore, I found out that the recommended dosage was in fact 600mg twice a day - twice what I had been prescribed, so I immediately doubled the dosage - Saturday afternoon. Within hours, I was actually able to urinate again. I continued with the "double dosage" until I saw the urologist on my followup appointment on the Tuesday (one week after my biopsy). I had recorded a daily record of my condition for the week, mentioning that I had doubled the dosage on the Saturday. The (only) reply from the urologist was "I am sorry"! So, after the biopsy until last Saturday, I have been suffering with (on and off) prostatitis and Bacterial prostatitis. I have been self medicating - totally given up on this useless urologist - with UROFLOW (Tamsulosin) and FIRIDE one per day of each, plus NOROFLOXACIN 400 mg twice a day. Last Saturday, I woke up and couldn't urinate at all, so my wife took me to the "senior" partner hospital of my previous hospital. I saw the senior urologist and we both immediately agreed that I needed a catheter inserted. Almost immediately, the urine started to drain out, with the urologist pressing (albeit a bit hard) on my abdomen. I informed the urologist of the 3 medications I was on and he said to continue taking them. I had a followup with a different urologist last Tuesday and have another appointment on Monday. In conclusion, I feel much better; I am able to manage living with the catheter inserted, I feel my prostate is no longer taking over the whole area behind where it would normally be located, I don't have to get up 3 times a night to urinate and I no longer have difficulty in passing a stool. The urologist mentioned "2 months" for the duration of my having the catheter, so I guess I will have to wait and see.

@solar I had Rezum therapy performed under GA since my prostate was over 100ml. Doc said according to the flow meters, etc. that it improved me, but I did not think there was much improvment and now a year or two later it is just as bad as ever. I did not get retro out of it, thankfully, but I did have retro when I would double the flomax dose though, pre-rezum. Currently I get up a lot during the night. I am tired of it. No force behind the stream either, it is all gravity. I am thinking maybe should check out the HoLep?

I had holep done 6 monts ago. I feel great, and pee great. My prostate was 134 g. I highly recommend the procedure.

@wally920 Sexual repercussions? RE or ED?