Hi Doc, I have previously written to you and need some furher advice. This was my question: "I am a 32 year old male and have been diagnosed with Bladder Neck stenosis/hypertrophy. I use Detrunorm,which do help but not 100%. What is my long term solution to this?Is surgery safe" and part of your answer:
"Surgery would be the definitive step to correct this.
You can try different medications that have been shown to be effective in small studies. Alpha blockers as well as alpha-reductase inhibitors (i.e. finasteride) may help"
I intend to see my urologist again as I need to map out some strategies for dealing with this more effectively. The medication, similar as to what you suggested (local brand is called "Detrunorm") does work to a degree, but there are times when the discomfort gets to be too much. I need to improve my quality of life and therefore I am considering doing the surgery, BUT, I need to know what exactly the negatives/side-effects are for a young, unmarried guy like me.
I.E, what types of surgeries are available and which of those are the most succesful? I understand that, in general, surgery is very succesful, but that it might cause retrograde ejaculation and/or infertility as it might damage the Protrate. Is this true?
What other side-effects might it cause: Could it worsen the condition or cause erection or related problems? As a young guy that intends marrying and having kids one day I need to make a well educated decision and you advice is well appreciated.
I am not a urologist - so this answer may not be as comprehensive as your personal urologist's.
In general, incisions to relieve the bladder neck obstruction have a good success rate. Of course, there is always the possibility that surgery will not work. Erectile dysfunction may be a side effect. Although possible, I am not aware of infertility being a common side effect.
If surgery isn't feasible, there are some other modalities for treatment. This can include laser therapy, as well as collagen injections into the bladder neck. Smaller studies suggest some efficacy with these methods.
These options can be discussed with your urologist - or in conjunction with another opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
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