Kupelian PA, Katcher J, Levin HS, Klein EA. However, most patients experience durable improvement after surgical intervention forBPH without need for subsequent medical or surgical intervention, the authors concluded intheir study. PMID: 9475762. The muscles relax and urine flows more freely. Can't wait until my doctor removing it in 1 wk after surgery. Tagged BPH, laser surgery, medications, surgery, TURP. Thanks for sharing your experiences henrya. Is this normal? It takes 3-6 months to see the benefits of using finasteride. This study was based on a database of commercially insured patients (Truven Health Analytics MarketScan Commercial Claims Database) and did not include men above 65 years of age or assessment of medication use for longer periods that one year prior to surgery. Int J Radiat Oncol Biol Phys. Their names have been changed, but all other details are accurate (see Jack Muriel and Henry Banks below). The combination therapy is effective in decreasing the irritative and obstructive symptoms in patients with BPE than monotherapy. Finally, the surgeon will insert a long plastic tube called a catheter into the urethra and flush destroyed prostate tissues into the bladder where they are excreted through urine. Post-TURP, he told me I could drop the FLOMAX but stay on the Finasteride. Free PSA 0.20. In the long-term, the MTOPS and Combination of dutasteride (Avodart) and Tamsulosin study (CombAT) 5-ARI monotherapy arms demonstrate 30% decrease in IPSS and 20% urinary flow at 4-year mark . This Canadian database study determined the frequency and incidence of bladder and prostate medication use following transurethral prostatectomy (TURP). After a person reaches the age of 40 years old, cells in the prostate gland can sometimes begin to multiply. Just talking about what I went through for comparison-sake. As with any medical procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications. A retrospective analysis was performed of patients who underwent TURPs between July- December 2019 within the University Hospitals of Leicester NHS trust to assess if patients preexisting medications used for the treatment of LUTS were discontinued post operatively. Advertisement intended for healthcare professionals, University Hospitals of Leicester, Leicester, United Kingdom. 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. appropriate medical assistance immediately. Levels of DHT fall precipitously after several weeks of taking a 5alpha-reductase inhibitor, but it may take at least three to six months, and perhaps even longer, before you notice any improvement in urine flow. Keywords: We want the forums to be a useful resource for our users but it is important to remember that the forums are After what I went through I really don't want to do that. Posted 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. By blocking the action of the chief male hormone responsible for growth of the prostate, these drugs eventually cause the prostate to shrink. Existing evidence and emerging benefits. Comparison of efficacy between Tamsulosin and Finasteride on symptomatic Benign Prostatic Hyperplasia. Health Alerts from Harvard Medical School. Choi, S. B., Zhao, C., & Park, J. K. (2010, August 18). B. Alpha-1 blockers attach to certain receptors in the muscle walls much as a key fits into a lock. The reduction in local and distant recurrences in the finasteride group suggests that the effect on PSA reflects a direct effect on tumor growth without affecting the initial response to subsequent hormonal therapy. The authors evaluated data from over 58,000 men undergoing TURP between 2003 and 2016. Part II: Treatment of advanced, relapsing, and castration-resistant prostate cancer. Similarly, because of these side effects, the nonselective alpha-1 blockers may not be the best choice for you if your blood pressure is already on the low side. Every man is different. Probably you'll just have to see how good your, ) as needed. Tamsulosin may cause serious side effects. Common side effects of TURP surgeries include: The minor side effects associated with TURP surgeries usually go away as the urethra and prostate tissues become less inflamed, usually within a few weeks. Before So whats going on? But today a man considering surgery has many more options [see "TURP use declines," below]. In the past, patients really had only two options when it came to surgery for BPH. We use cookies to help provide and enhance our service and tailor content and ads. The TUIP procedure is used in cases where the prostate is fairly small, but urethral constriction is severe. Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate. I REALLY HOPE your situation improves quickly! If you develop problems with ejaculation during sex, the solution depends on what medication you are taking. Suddenly tonight I am just passing a lot of blood and urination is very painful. But, now I dribble when I run water for dishes or brushing my teeth. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Finasteride is used to treat men who have symptoms of benign prostatic hyperplasia (BPH) and male pattern hair loss, also called androgenetic alopecia. Obviously the decision about whether to make some change in your medication regimen for BPH whether it involves changing the dose or switching medications is a complex one. If the men responded to tamsulosin, they were randomized to one of three groups. Results: Journal of Endocrinological Investigation , 36 (11), 1094-1098 https://link . Originally published Jan. 1, 2007; last reviewed April 22, 2011. Early signs of post-TURP syndrome include: Signs of severe post-TURP syndrome include: Though rare, post-TURP syndrome can be fatal if it is not treated early enough. 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. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. TURP then LRP in 2009/2010. No apparent effect on the PVR or large doses of tamsulosin (2x0.4mg) and prostate too small for finasteride/dutasteride. 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. I am a healthy 74 year old man with a rising PSA which is now over 10. Can diet help improve depression symptoms? I had radical Turp surgery 11/08/2016. 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. It seems every place is different. Surgical intervention by Transurethral Resection of the Prostate (TURP) and laser therapy provide symptomatic relief in over 70% of men. and transmitted securely. You notice side effects that werent affecting you before. and transmitted securely. If you want to limit the number of different medications you are taking, ask your doctor whether using a nonselective alpha-1 blocker might enable you to control both your BPH and your blood pressure and then monitor both your urinary symptoms and your blood pressure to make sure the medicine is really working for you. The .gov means its official. thxs for the reply i p**s like a race horse since the TURP , im stopping talking the flowmax . official website and that any information you provide is encrypted government site. Just because I was taken off the FLOMAX, doesn't mean it is right or wrong for you. Hormonal manipulation for rising PSA after radical prostatectomy. 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. Unauthorized use of these marks is strictly prohibited. Does it help? It can reduce the risk of urinary retention (not being able to empty the bladder) and the need for surgery. National Library of Medicine a painful erection that lasts 4 hours or longer. Dosing is simpler for the selective alpha-1 blockers. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. 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. Your BPH symptoms worsen, even though you are taking your current medication. Of which, 47 patients received combination therapy with Tamsulosin plus Finasteride and 45 patients received monotherapy with Tamsulosin once daily at bed time. and Privacy Policy and steps will be taken to remove posts identified Fewer recurrences were observed in the finasteride group, but these differences were not statistically significant. Because prostate tissue sometimes grows back and again blocks the urethra AFTER TURP, I am wondering if I should ask my Urologist if my continuing to TAKE Finasteride might help REDUCE the chance of recurrence of urinary retention in the future. After a long recovery about 6 months I was doing well for almost two years. Chances are, you'll do fine. I have rare bleeding episodes nowadays. But if it should double over the course of a year, say from 1.5 back to 3, talk with your doctor about whether to have a prostate biopsy. Post-TURP, he told me I could drop the FLOMAX but stay on the Finasteride. Stop taking it and see what happens. The two classes of drugs currently approved to treat BPH alpha-1 blockers and 5alpha-reductase inhibitors work in entirely different ways, and therefore raise different types of issues. Most people also feel very weak and tire easily for several weeks. The ONLY THING I KNOW FOR SURE is that I don't want to have another one UNLESS i really have to! The nonselective agents, doxazosin (Cardura, generic) and terazosin (Hytrin, generic), affect both the urinary tract and other tissues elsewhere in the body. The selective alpha-1 blockers, alfuzosin, silodosin, and tamsulosin, have less of an impact on blood pressure, so they may be good alternatives in these situations. During the procedure, surgeons remove the excess prostate tissue through the urethra. Transurethral Resection of the Prostate (TURP) The most commonly employed surgical procedure for BPH, TURP reduces symptoms in 88 percent of patients. 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. As instructed by the radiology department, Henry drank large quantities of water before the procedure. In general, 5alpha-reductase inhibitors tend to reduce PSA levels by about 50%, although the actual reduction varies from man to man. In some cases, a separate device will be used to flush sterile fluid through the surgical site. what was the reasoning of the urologist when you asked him why he recommends taking Flomax after surgery? Absolutely ask your doctor. BPH patients can develop urinary tract symptoms including urinary retention, urinary tract infections and even kidney damage. TURP (bipolar) done 19 days ago Main reason: huge PVR and potential complications. 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. [Combined treatment of BPS with tamsulosin and finasteride : Literature review and prescription data]. 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. 178 patients undergoing TURP were either allocated to finasteride or no medication prior to their operation . Youll need to figure this new baseline into your calculations as you monitor your PSA in the future. PMC The 5alpha-reductase inhibitors, which include dutasteride (Avodart) and finasteride (Proscar, generic), act directly on the prostate. Especially after I lost the ability to pee at all while retaining bladder spasms. 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