If you dont want to stop using a nonselective alpha-1 blocker for your BPH, you can make sure you take the PDE-5 inhibitor at different times of the day (take one medication after lunch, say, and the other in the evening) to avoid problems. Second, although the MTOPS study found that side effects were similar whether men took one drug or the combination, many experts feel differently, based on the patients they see. Blood loss was significantly elevated in . Accessibility Ive heard of two operations called TURP and tuip. In the remainingpatients, pre-surgical use of antispasmodics was associated with the highest risk of medication use at 4 months after surgery compared to patients who did not take any medication prior to surgery. HoLEP: The gold standard for the surgical management of BPH in the 21stCentury. Posted Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. These data require confirmation by studies that are longer and larger, focused on demonstrating significant differences in progression rates and survival before the use of finasteride can be considered as an option for men with detectable PSA levels after radical prostatectomy. The catheter is usually kept in place for 2 to 3 days after TURP surgeries and removed when the bladder has been completely flushed. Laser prostatectomy techniques include holmium laser enucleation of prostate (HoLEP) or photoselective vaporization (PVP). Initially, the urethra and surrounding area will be inflamed, and it will be difficult to urinate. His doctor suggested he try lowering his dose of Viagra in the future, to 25 mg (from the 100200 mg hed been taking), because that would lessen the chance of dizziness if he took it along with the Flomax. Get answers from Pharmacologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. He felt as if he were about to faint. Sudden episodes of low blood pressure can be dangerous if you already have some type of vascular disease, because it increases your risk of suffering a heart attack or stroke. The catheter and flushing process can also be uncomfortable and cause bladder cramping. All rights reserved. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer. If you are taking a 5alpha-reductase inhibitor, the only way to resolve the ejaculation difficulties is to stop taking the BPH medication, so you may need to decide on another medication (or surgery) to deal with your urinary difficulties. Use of the forums is subject to our Terms of Use You start taking a drug for erectile dysfunction. Does it help? Results: I made them check me for a UTI after a couple weeks and I was clean as I was in the middle of a CIPRO course right about then. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. During the procedure, surgeons remove the excess prostate tissue through the urethra. Try our Symptom Checker Got any other symptoms? Montorsi F, Alcaraz A, Desgrandchamps F, Hammerer P, Schrder F, Castro R. Prostate. Epub 2013 Nov 12. Please enable it to take advantage of the complete set of features! If you are considering an erectile dysfunction medication, you dont have to worry if you are also on one of the 5alpha-reductase inhibitors for your BPH: The drugs can be taken together without adverse effects. For potential or actual medical emergencies, immediately call 911 or your local emergency service. I didn't know if coming off it was part of the healing process. i pee like a race horse after the TURP , i just do t understand why she has me on flomax for 2 yeats now . Urologe A. PracticeUpdate is a registered trademark of Elsevier Inc. Many HoLEP surgeries also only require one night of hospitalization and catheter use. Lots of leakage but PSA < 0.1 AMS-800 Artificial Sphincter activated 2015. My guess is that by then there will be many far less invasive ways to do the same thing - I think there are now and the options will only get better. The objective of this study was to evaluate the effect of finasteride (10 mg/d) or placebo on serum prostate-specific antigen (PSA) and recurrence rates in men with detectable PSA levels after radical prostatectomy. Investigators have discovered in the past few years that more than half of men with BPH also suffer from overactive bladder, and that this may further exacerbate urinary difficulties. OK, but I would suggest obtaining a new urologist if necessary. 6 users are following. Benign prostatic hyperplasia (BPH) patients often regard surgical intervention as a definitive therapy for urinary complications allowing them to eliminate medication and its inherent expenses. These complications may include persistent bleeding, persistent urinary retention, urethral strictures, and urinary incontinence. Results: Would you like email updates of new search results? Each day, we'll check to see if new items have been published to the topics you're subscribed to, and we'll send you one email with all of the new items from that day. A clinical trial involving more than 3,000 men, comparing finasteride (Proscar) with placebo, found that only 3% of men taking finasteride developed acute urinary retention (versus 7% taking placebo), and 5% eventually required surgery (versus 10% taking placebo). During TUNA procedures the urethra is protected from the radio waves with a shield. When it comes to BPH, are two drugs better than one? 4 years ago, Stop taking it and see what happens. My question is who is right? The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia. Some men with large prostates try combination therapy to get fast relief for their symptoms from the alpha-1 blockers. Choi, S. B., Zhao, C., & Park, J. K. (2010, August 18). Just letting you know what my urologist did. By continuing you agree to the use of cookies. Can't wait until my doctor removing it in 1 wk after surgery. Federal government websites often end in .gov or .mil. Come to think of it, the pretty nurses at the ER and other staff. If you have to pay for medications on your own, or if your insurance company requires some type of co-pay, you may want to figure cost into the equation. Medication is one of the most common treatment options. I don't think my flow is as good as it was just a week or two after the procedure. Table 2 summarizes the salient information by drug and suggests the type of men who might want to consider taking one drug rather than another. There are several ways to reduce the risk of complications after TURP surgery. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. But to prevent problems, he needed to make sure that he took it at least four hours before (or after) he took the Flomax. It shrinks (over a period of 6 months) the prostate by 20 to 25%. Absolutely ask your doctor. These procedures are similar to TURP except they use a laser to destroy or vaporize prostate tissues instead of cutting them away with an electrical wire. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Unable to load your collection due to an error, Unable to load your delegates due to an error. A man who has developed acute urinary retention may need to consider surgical options to alleviate his symptoms. MeSH Then they insert a large Foley into you. Helping children who are neurodiverse build friendships, Preventable liver disease is rising: What you eat and avoid counts, Easy ways to shop for healthful, cost-conscious foods. Pay attention to PSA levels. The reduction in flow seems a bit odd, after all, the whole purpose of a TURP is to drill a great big hole through your prostate. It is not related to cancer and is usually harmless, though it can cause unpleasant symptoms. Of course this may also depend on what type of drug coverage is included in your health insurance plan, and how much of a co-pay you need to contribute. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. That is what Jack Muriel eventually decided to do. One evening, while driving home to meet his wife for dinner, Jack suddenly became lightheaded. During the TUMT procedure, a urologist inserts a catheter with an attached microwave generator through the urethra and into the prostate. I am a healthy 74 year old man with a rising PSA which is now over 10. Hasan M, Parveen F, Shamsuzzaman AK, Kibria MD. The muscles relax and urine flows more freely. PMID: 9475762. The common medications for enlarged prostate are Flomax or alpha-1A reductase inhibitors such as Proscar and Avodart. PMID: 14681504. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Now PSA going up. The continuation of pharmacological therapy post operatively is redundant, however it was noted that several patients remained on these medications post TURP. After suffering an infection after turp surgery I am unable to urinate. TURP is considered a fairly safe, effective procedure for treating BPH. We avoid using tertiary references. Last medically reviewed on March 12, 2018. In six months or so, when the 5alpha-reductase inhibitors begin taking effect, these men may stop taking the alpha-1 blockers. Finasteride (Proscar) is an Effective Treatment for BPH Symptoms Proscar, generically known as finasteride, shrinks the prostate by as much as 50%, which helps to improve urinary symptoms in men. Intermittent Tamsulosin Therapy in Men with Lower Urinary Tract Symptoms. However, if you are taking tamsulosin, you may be able to alleviate ejaculation problems by taking the drug every other day (see Alternate days, below). I was OK after that, but I sometimes would have minor bleeding. I'm 65 years old and I had TURP surgery 6 days ago. I got a TURP operation weeks ago, but I am feeling tired and feeling down, has anyone had this? New England Journal of Medicine 1998;338:55763. What should I do? Upgrade to Patient Pro Medical Professional? Roehrborn, C. G. (2005). Youll need to figure this new baseline into your calculations as you monitor your PSA in the future. NCI CPTC Antibody Characterization Program. Some men experience complications after TURP surgery. Eur Urol. The costs below are based on average wholesale prices to pharmacists and the lowest dosage; costs to patients may be more. MNT is the registered trade mark of Healthline Media. Erectile dysfunction is treatable with three medications, and it is generally safe to take these drugs when you are taking your BPH medication, whether it is an alpha-1 blocker or a 5alpha-reductase inhibitor; however, we offer some important cautionary advice. The urologist said he only had two like me in his practice at that point. Surgeon very well experimented and cautious (2000+ interventions) Chances are, you'll do fine. No apparent effect on the PVR or large doses of tamsulosin (2x0.4mg) and prostate too small for finasteride/dutasteride. 178 patients undergoing TURP were either allocated to finasteride or no medication prior to their operation . (2012, January-June). I REALLY HOPE your situation improves quickly! The email address you provided during registration, Social Determinants of Health Affect Racial Disparity in Prostate Cancer Mortality, Overall Cancer Mortality Continued to Decline From 2019 to 2020, UGN-101 Reviewed in Real-World Upper Tract Urothelial Cancer Setting, Low-Value Prostate Cancer Screening Common in Primary Care, Symptoms in Late Reproductive Years Similar to Menopause. A doctor who specializes in the urinary tract does most TURP surgeries. i thought the surgery was suppose to cure everything ? Doctors usually start with 1 milligram (mg) at bedtime, then gradually increase it as needed to a maximum of 10 mg of terazosin or 8 mg of doxazosin. I should have started Finasteride long ago; maybe I wouldn't have needed the TURP. You notice side effects that werent affecting you before. With mine, the flow was constantly good after TURP, right up to the point where I lost my prostate. In severe cases of BPH usually those that do not respond to any other type of treatment the prostate may be partially or entirely removed. Does less TV time lower your risk for dementia? respect of any healthcare matters. Finasteride does shrink the prostate, however it takes 2-6 months to be effective, and yes, to prevent the prostate from growing again and it will, you must stay on it most likely the rest of your life.As far as awful side effects; whenever you start a new drug there will be side effects as your body has to get used to it, I have been on both Flomax and Finasteride for 6 months now both pre Op and post op, very little if any side effects. It might be worth checking with your consultant whether there could still be some debris, or the odd clot . In the study, 3,047 men with BPH were randomly assigned to take doxazosin (Cardura), finasteride (Proscar), a combination of the two, or a placebo. In fact, when I ran out of that last bottle of FLOMAX, I contacted the urologist to re-confirm that he preferred me to be off of it. Probably you'll just have to see how good your, ) as needed. But there are other considerations as well. Should I have a prostrate biopsy? In 7-10 years these newer procedures may prove to be effective, we shall see. Watch your intake of fluids, especially if you will be unable to urinate for a while (such as when youre at a sporting event or on a long airplane trip). Most are fine with no help. My PSA was as high as 16 but there wasn't any cancer. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Researchers at Washington University addressed this issue in a cohort study entitled Use of Medical Therapy and Success of Laser Surgery and TURP for BPH and published in the journal Urology. This study showed that BPH is a progressive condition that can lead to a worsening of symptoms, acute urinary . All rights reserved. Many of the catheters I had placed were done in the emergency room by nurses there. i had a radical TURP 2 years ago and my urologist still has me taking Flomax , is this normal ? Patients with baseline PSA levels less then 1.0 ng/mL had no significant increase in serum PSA during the 2 years of treatment. Always speak to your doctor before acting and in cases of emergency seek [No dentures yet] Very annoying and I resorted to wearing male guards in my briefs. Possible but rare risks associated with TURP procedures include: In rare cases, post-TURP syndrome occurs. In minor cases of BPH, prostatic devices may be inserted into the prostate that helps lift it away from the urethra, reducing urethral pressure and constriction. Because these medications reduce the size of the prostate and thus ease constriction of the urethra, they also reduce the risk of developing acute urinary retention and having to undergo surgery (see Two additional benefits, below). If medical therapy fails, then the next step may be surgery. Out of these, 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and finasteride. The Effect of Finasteride on the Risk of Acute Urinary Retention and the Need for Surgical Treatment Among Men with Benign Prostatic Hyperplasia. This not only impedes urinary tract functioning, but also reduces the volume of urine the bladder can hold. Ornstein DK, Rao GS, Johnson B, Charlton ET, Andriole GL. Every year, doctors perform it on around 150,000 American men. Just because I was taken off the FLOMAX, doesn't mean it is right or wrong for you. Learn about how benign prostatic hyperplasia can affect sexual function. He went straight to the TURP and made out very well. Out of these, 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and finasteride. i loom back on it and really dont know how i did it . Still carry the 3-way foley catheter and is experiencing horrible bladder spasm whenever I have an urge to urinate. The decrease in the total American Urological Association symptom score was statistically significant in the combination group (p<0.0001) as compared to monotherapy (p=0.0715) respectively. Unauthorized use of these marks is strictly prohibited. Thanks for sharing your experiences henrya. During TUIP procedures, the surgeon will insert a cystoscope into the urethra and widen the urethra by making tiny cuts in the prostate, and the area where the urethra connects to the bladder. I hope. Finasteride (Proscar) Summary Prescription only Tamsulosin (Flomax) is a commonly prescribed oral medication used to treat benign prostatic hyperplasia (BPH), also known as an enlarged prostate. Created for people with ongoing healthcare needs but benefits everyone. Much less invasive than the "Turp" and all the other much more "radical . Transurethral Resection of the Prostate (TURP) The most commonly employed surgical procedure for BPH, TURP reduces symptoms in 88 percent of patients. For it to work properly, you have to take it 30 minutes after the same meal each day. Fewer recurrences were observed in the finasteride group, but these differences were not statistically significant. The PCPT study has generated heated discussion, and one leading theory is that because finasteride shrank the prostate gland, doctors had a smaller target to sample, and were therefore more likely to find cancer. Common Flomax side effects may include: abnormal ejaculation, decreased amount of semen; dizziness, drowsiness, weakness; For tamsulosin, you take 0.4 mg or 0.8 mg half an hour after dinner. As with any medical procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications. The nonselective alpha-1 blockers block alpha receptors in the heart and blood vessels as well as in the prostate, lowering blood pressure in the process. The combination created the dizziness that caused him nearly to run off the road. Favilla, V., Cimino, S., Salamone, C., Fragal, E., Madonia, M., Condorelli, R., Morgia, G. (2013, December). There are no guarantees. Bethesda, MD 20894, Web Policies Health Alerts from Harvard Medical School. In general, 5alpha-reductase inhibitors tend to reduce PSA levels by about 50%, although the actual reduction varies from man to man. If you need another procedure in 7-10 years, it won't be a TURP. and Privacy Policy and steps will be taken to remove posts identified The nonselective agents, doxazosin (Cardura, generic) and terazosin (Hytrin, generic), affect both the urinary tract and other tissues elsewhere in the body. However, if you are currently using, or considering, an alpha-1 blocker, you may want to take some precautions when adding one of the PDE-5 inhibitors. Even though a value of 3 is considered normal in men not taking a 5alpha-reductase inhibitor, a PSA value that doubles within a year of beginning one of these medications could indicate that cancer is present. 2007 Jan;29(1):17-25. doi: 10.1016/j.clinthera.2007.01.018. Can diet help improve depression symptoms? options: 1: TURP if fit enough2: Long term catheter3: Intermittent self catheterisation. Relax smooth muscles in the urinary tract, allowing urine to flow more freely, Also affect other smooth muscles throughout the body, Dizziness, headache, and fatigue (most common), Nasal congestion, dry mouth, and swelling in the ankles (occasional), Retrograde ejaculation and other ejaculatory problems (occasional), Hypotension (low blood pressure); may pose a danger for some men (rare), You have a normal to moderately enlarged prostate (under 35 grams), Cost is a consideration (these drugs are available in generic forms), You want something with a proven track record that works within weeks, You have mild hypertension and want to reduce blood pressure while also treating BPH, You suffer frequent urinary tract infections, You have hypertension or heart disease (check with your doctor about mixing medications), Act more selectively on muscles in the urinary tract than elsewhere, Retrograde ejaculation (may occur with tamsulosin; less likely with alfuzosin), Erectile dysfunction (possible but less likely than with 5alpha-reductase inhibitors), You are taking a medication for hypertension and want to use an alpha-1 blocker, You are concerned about diminished ejaculation (less likely with alfuzosin), Reduce the size of the prostate, easing pressure on the urethra and allowing greater urine flow, Prevent the conversion of testosterone into dihydrotestosterone (DHT), which stimulates prostate growth, Decreased volume of ejaculate (occasional), You have a large prostate (more than 55 grams), You want to avoid surgery (these drugs reduce the likelihood), You are patient (the drugs may take at least six months to act, and up to two years to show full benefits), You want to reduce your overall risk of prostate cancer (but see caveat, next column), You are concerned about your risk for aggressive prostate cancer (finasteride may increase this risk), Cost is a consideration (both drugs are expensive and not yet available as generics). One group continued taking the medication daily, the second took the same dose every other day, and the third stopped taking the drug. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Alternatively, they use spinal anesthesia, where a needle is placed in the spine to stop any sensation below the waist. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Living on the pills unless it gets much worst. Although a panel of Harvard experts thought the risk of hypotension was minimal, its still worth knowing about. They found that surgery is successful in eliminating the need for medical therapy in over 75% of patients who use medication prior to surgery. Post-TURP, he told me I could drop the FLOMAX but stay on the Finasteride. I don't have a problem with it. We'll keep all topic alert notifications available on your dashboard for 30 days, to make sure you don't miss anything. All rights reserved. We have detected that you are using an Ad Blocker. Could these medications, already approved to treat erectile dysfunction, also alleviate BPH symptoms? Ultimately, of course, you are the authority when it comes to your own body, and different people metabolize drugs in different ways, so these general guidelines should be viewed as just that general. The baseline demographic variables were comparable in both groups. If your doctor recommends a medical test that requires you to drink fluids ahead of time, as Henry did, mention that you are taking a BPH medication and ask what your doctor advises. A significant proportion of men suffer from lower urinary tract symptoms (LUTS) secondary to prostatic enlargement. Maybe we don't need anything? government site. You can learn more about how we ensure our content is accurate and current by reading our. I guess the balloon at the end of the catheter irritates my bladder. At one point, after Henry experienced a bout of unexplained abdominal pain, his internist ordered an abdominal CT scan to determine the problem. Sometimes a man can be weaned from the catheter and return to taking a BPH medication, but not always. 1996 Dec;48(6):901-5. doi: 10.1016/s0090-4295(96)00315-9. The effect of transurethral resection of the prostate on erectile function in patients with benign prostatic hyperplasia. 26!?! Finasteride doesn't shrink the prostate permanently - it can shrink it for as long as you take it, but once you stop it reverts. It seems every place is different. If the patient had a reasonable-sized prostate, he could undergo a TURP, and if he had an especially large prostate, then perhaps an open prostatectomy. The benefits of Proscar are not immediate. The first question has largely been answered by a 4-year trial with finasteride. For now, check with your own urologist for advice about what you should do. If you are like many of the 14 million men in the United States who have been diagnosed with benign prostatic hyperplasia (BPH), youve probably been taking the same medication, at the same dose, for years. Keywords: Typically the urgency goes away after 1-3 months and if everything else seems to be OK, you probably will too. I just had TURP surgery done 3 days ago. Once the surgeon has positioned the resectoscope, they will use it to cut away abnormal prostate tissues and seal broken blood vessels. The selective agents, alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax, generic), work primarily on the tissues of the urinary tract. Question about TURP prostate operation. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in as being in breach of those terms. Before the TURP, I was on both FLOMAX and Finasteride. You should always compliment your urologist as they have your entire life in their hands. 5. Always speak to your doctor before acting and in cases of emergency seek Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight lossfrom exercises to build a stronger core to advice on treating cataracts.
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