48 year old with Prostate Problems...help appreciated

[richny]

Thanks in advance for responses:
I was recently diagnosed with BPH. I am 48 years old, take care of myself (eating wise) and work out 5 days a week. I am approx. 156lbs and 5'9", non smoker and non drinker.

I did the urine flow test into the funnel and it was pretty pathetic. My stream is extremely weak. When I try to push out more, nothing changes..still the weak stream. Typical issues of waking up several times at night, split stream, etc.  

After the urine flow test my doctor did the test with the camera up my urethra. It clearly shows my prostate is very enlarged and is caused significantly reduced flow.

My doctor prescribed uroxatral which I have been on for about 4 days. I have not seen any improvement at all in my flow...how long does it take for a obvious difference? What if this does not work at all?

He also gave me a booklet on Prostiva RF...which he said might me the next step. He is quite concerned on the size of the prostate as well as the very limited flow that I have.

So my question is...what are next steps if the uroxtral does nothing to improve my condition? Also...should I be concerned that this is occuring while I am relatively young?

Thanks
Rich

[rmprdl1964]

Hi,

I wish that I had known that information when I first came down with problems.

Currently I'm in treatement for a fistula between my prostate and rectum. I have had this for over 2 and a half years now and it has not closed spontanuously. I currently have had a suprapubic in for the last year and a half, a urethral prior to that.

Now it seems that the only option is surgery to close the fistula. The fibrin glue has been tried but did not work at all. Do you have any suggestions? Any suggestions are welcomed and very much appreciated.

[Tobbie59]

Dear Rich:  I hope you did not take the advise of the previous commentor and pursue a TURP.  This is now considered to be a more aggressive treatment for a condition which may be treated without such intervention.  The RVF (Prostiva) therapy has proven to be effective for many men who had minimal efficacy from medication, or for men who do not wish to take medication every day.  I am a licensed nurse practitioner specializing in kidney disease and urology.  Be sure you only follow the advise of licensed professionals. Hope this has been helpful

[rmprdl1964]

Hi,

If your prostate is enlarged, the first thing that thye try to do is to see if medications can solve the problem.

If you allready have had a cystoscopy (long instrument to view the urethra and bladder) it is possible that they have taken a biopsy as well to see if this is beneign. If you did not have this done than a biopsy should be done.

I started having problems at 35 and they prescribed my Flomax. I did not see much of a change for well over 6 months.

In 1995 I had surgery to have a resection of the prostate as well as the bladder neck since it showed some obstruction. This procedure is called a TURP (trans urethral resection of the prostate). This is prety much the same as a cystoscopy but there is a cutting loop on the scope to scrape tisue from the prostatic urethra.

Since you state that your prostate is quite large and the fact that medications don't offer relief, I think that a TURP should be considered.

I suggest that you consult with your doctor. If you have a very difficult time to empty your bladder, it can harm your urinary tract. If any urine remains in the bladder it poses a potential for infection of the urinary tract and even in the kidneys.( quite serious and no fun)
If your doctor can determine by palpation that your bladder does not completely empty, then it might be neccessary to have a catheter placed to ensure that you empty your bladder to avoid infections. This could be an indwelling catheter or they could tell you to use intermittant catherization. The difference between the two is that an indwelling catheter  has a baloon on the end that is filled with sterile water to prevent it from coming back out of your bladder. This is the indwelling (Foley) catheter.

I have been using intermittant catherization for over 10 years now, The catheter differs by not having a balloon on the end of it.You will insert it into the urethra using sterile lubrication, you slowly apply pressure untill the catheter enters your bladder. This allows you to urinate. Once urination stops you remove the catheter.

Given your situation I would assume that an indwelling catheter might be placed untill you can have further medical treatment to decide whether surgery might be of benefit.

I hope that you will receive medical help soon to bring relief.

God bless,

Ron