Anyone Taking Combined Therapy of Tamsulosin + Finasteride for BPH?

Hi Terry, I'm also on that same medication regiment for a few years now and I was like you 3-5 trips per night and now I could set a watch to the 1 time per night. I haven't had any side effects either. Sleep is a wonderful thing.

I have been taking tamsulosin (flowmax) and dutasteride (avodart) for 20+ years. During this time I have had two PVP laser surgeries and one water vapor (Rezume) procedure. I feel the dutasteride (similar to finasteride) has reduced the growth rate of my prostate. The tamsulosin has helped make it easier to go. While my prostate has not grown out very much (intruding further on my bladder), it keeps growing in on my urethra. This is why I keep having surgeries. But, I am tired of these more short term fixes and am at Mayo Clinic now for HOLEP surgery, which I feel will be much longer lasting. Long story short, as long as you and your urologist feel the finasteride and flowmax are helping I would keep taking them. They may not prevent surgery but can help delay it and make things more tolerable while you see what is needed in the future. Good luck!

I was originally just on tamsulosin and the urologist added Finasteride for my BPH symptoms. He did a urine flow and retention test before adding the finasteride. Six months later, he did another test, which showed zero improvement. My prostate was not overly large, but we decided to do aquablation, which I had done in Northern Virginia on March 20, 2024. I'm glad I went through the procedure and am now off both medicines. Even with the drug combo I was getting up 2-3 times a night; now I'm pretty much down to once per evening.

@kayak461 Can I ask what test did you have confirm the need for surgery? My dad is almost the same as far as medicine goes . He been on catheter for about a year. Did you have a catheter too? His doctor was ready for TURP then he decided to refer him to other doctor to do HOLEP instead.

I knew that I had an enlarged prostate because my Urologist had done the once a year “Finger Wave” and told me I had an enlarged prostate. It wasn't until my Urologist was not available….that a Nurse Practitioner did a simple test to see how well my bladder was emptying after I had urinated. She said to me…..you need to have a Cystoscopy. This is where they insert an instrument into and up the penis, it has a camera, and they can see up the Urethra, into the bladder! I had a lobe of my prostate growing into my bladder….and was told I needed to have my prostate removed. The Urologist who performed the Cystoscopy is a VA Urologist…..he told me to do my homework on options for Prostate removal. He also ordered an MRI to determine the size of my prostate. I did what research I could online…and sought a second opinion. I believe in second opinions. I say it again….I believe in second opinions. That’s the first thing your Dad should do. I settled on HOLEP. Then I sought a third opinion.. That Urologist said….i do all these different prostate procedures…but the one you need….I don’t do. YouTube taught me about HOLEP, Doctor Dora at the Mayo in Jacksonville had done a video on the procedure. I looked online, found the contact details for his office….called the office, sent my MRI images and the Images from the Cystoscopy…..and ended up with and appointment. I feel like the luckiest man on earth to have Dr. Dora’s skill as he performed HOLEP on me. It was the absolute best procedure….I have no regrets. Hope this helps!

Hi Dana,

Yes, I agree, sleep is good! I'm crossing my fingers for both of us. Good luck!

Thanks for your helpful feedbacksl and encouragement. Best of luck with your surgery and outcome!

I'm very happy for you and for sharing your journey, gives me hope, thank you!

Whew! You're very fortunate, thanks for sharing the details and the good doctor too! I'll keep it all in mind as i go forward. Best wishes!

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.