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Enlarge Prostate-Finasteride

I have enlarged prostate 144-160ml (size at first (2/11/2011)and second biopsy in March 2013.   I know very large prostate.

Elevated PSA but two biopsy negative.
BPH (urinary problems) resolved with 5mg tadalafil daily.

Should I take finasteride to reduce the size of the prostate.

Have been reluctant because of side effects and urinary symptoms
to the extent they exist don't brother me, but also don't want to end up
requiring surgery a few years down the road.

Your opinion would be appreciated.
4 Responses
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351246 tn?1379682132
MEDICAL PROFESSIONAL
Hi!

Well, with two negative biopsies, chances are that the elevated PSA levels are due to benign prostatic hyperplasia. The urinary symptoms are often unrelated to size of the prostate gland. Even a much smaller prostate gland can cause severe urinary symptoms, while larger glands, as in your case, often do not show much symptoms.

In general, enlarged prostate gland that does not cause symptoms that affect a person’s life drastically are managed through a ‘wait and watch’ policy. You will need annual follow-ups to see how the gland is behaving. Drugs like finasteride are usually helpful in those individuals who have severe urinary symptoms. They do help in reducing the size of gland, but as I said earlier, the urinary symptoms due to prostate gland are not entirely dependent on size of the gland. So, the drug may not produce any appreciable benefit in your case.

In your case, just elevated PSA levels are not important. Indications of a more aggressive management would be:

• Rapidly increasing prostate size
• Increasing PSA levels
• Increasing urinary symptoms
• Positive biopsy

So, you can take a call regarding finasteride, and start it at  a later date as well (especially if the urinary symptoms worsen). Please, however, discuss in detail with your urologist. You can also take a second opinion from another urologist, who can perform a digital rectal examination to assess the contour of the gland and neighboring structures. Good Luck and take care!
Helpful - 1
Avatar universal
A related discussion, swelling above right scrotum was started.
Helpful - 0
Avatar universal
A related discussion, Prostatits or something else. was started.
Helpful - 0
Avatar universal

I think the size of the prostate is measured with ultrasound,

but how accurate +- is the measurement?  In other words what

would be considered a significant increase bases on the accuracy

of the measurement?
Helpful - 0

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