BPH and Avodart

[Poundkey]

Well, after recurring bouts with prostatitis my doctor has now diagnosed me with BPH (enlarged prostate) and has prescribed Avodart. Has anyone used this medication? Just wondering how well it worked and what, if any, side affects you may have had.
Before today he had me on Uroxartol which is a different sort of drug and gave no results. My PSA normally tests around 0.8, but was a 1.2 during today's visit. My urine test did show some infection so was also prescribed Levaquin which knocks the infection down, however the prostatitis seems to show back up within a year.
Any feedback would be greatly appreciated.

[Rich_by_the_Bay]

Quote:

Originally Posted by Poundkey Well, after recurring bouts with prostatitis my doctor has now diagnosed me with BPH (enlarged prostate) and has prescribed Avodart. Has anyone used this medication? Just wondering how well it worked and what, if any, side affects you may have had.

Pound,

Symptoms from a benign enlarged prostate come in two types: those due to the physical pressure of the enlarged gland pushing on the surrounding organs and tubes, and those due to the fact that the involuntary muscles around and in the prostate and bladder can get "twitchy" which makes them clamp down during urination.

The "-sin" drugs like tamsulosin, alfuzosin (uroxatral) and doxazasin work against the latter. They truly do work with about a 60-70% reduction in symptoms (like urinary hesitancy, frequency, urgency). Side effects are minimal other than wooziness when you stand up quickly, especially shortly after taking them. That's why they are often given at bedtime.

Finasteride and dutasteride ("Avodart") work by messing with the effects of testosterone on the gland. After about 6 months it shrinks the gland. Decreased libido and ED are among the possible side effects. The increase hair growth for a lucky few. They also work with about a 20% improvement in symptoms on average. Their effects on the incidence of prostate cancer are under study - it is possible that they decrease the incidence but that those which break through are more aggressive.

It's also important to know that given anough time, about 50% of men with flare ups of prostate symptoms get better on their own with no treatment.

I'm pretty conservative with patients whose symptoms are mild, use the "-sin" drugs if necessary, and reserve the hormone manipulating drugs for more persistent or severe symptoms. If serious blockage, kidney problems or recurrent/severe infections arise, it's time to consider surgery. That seems to be less and less the case recently.

Hope this is helpful. Now read my signature line .

[FinallyRetired]

I'm surprised you have an enlarged prostate with a PSA of only 1.2. Guess it shows that PSA can be difficult to figure. Mine has been on a yo yo in the high 2's and low 3s for a couple of years. Good luck with your meds.

[Poundkey]

Thanks very much for the replies. Rich, you sound like my doctor as far as starting with the least aggressive approach first. My symptoms were never what my doctor or I considered severe although we were both surprised when they returned so soon. I believe it was the persistence that made him opt to try Avodart. I would say "twitchy" best describes my problem along with urgency and a lingering burning sensation after urination. I have been on the uroxatral for about 7 months after an initial round of Levaquin. I will admit to missing a dose of Uroxatrol occasionally due to forgetfulness. I also experienced some wooziness as you described, but not enough to worry about.

Interesting that many men get better with no treatment. Are there treatments involved (as in diet, heat, ice packs etc)?.......or is it more a matter of just toughing it out?

Thank you again

[SecondCor521]

TMI alert.

I had CBP for about a decade, and would just encourage you to be persistent in treating the infection. Good urologists (I had a couple of bad ones before I found a good one) will tell you that prostate infections are very difficult to get rid of. I was on long term antibiotics (years and years, including many different antibiotics, including Levaquin). Pure cranberry juice (no sugar, no other juices mixed in) helps. Prostatic massage (Google this) will also help.

I don't know anything about BPH and PSA, but it sounds like you're not really getting rid of the infection, which can be, as I'm sure you know, very annoying.

2Cor521

[Rich_by_the_Bay]

Quote:

Originally Posted by SecondCor521 ...would just encourage you to be persistent in treating the infection ...Pure cranberry juice ... helps. Prostatic massage (Google this) will also help...like you're not really getting rid of the infection

Glad you found something that worked for you, 2Cor, but be careful with your well-meaning advice.

There are several different conditions potentially being alluded to here, each with a different set of causes, treatment and diagnosis alternatives - Acute prostatitis, Chronic bacterial prostatitis, Chronic prostatitis/pelvic pain syndrome, inflammatory, chronic prostatitis/pelvic pain syndrome, noninflammatory, and Asymptomatic inflammatory prostatitis. Your kind suggestions may not be appropriate or accurate for everyone.

I'm sure Pound will sort this out with his doctor - each situation is different.

[SecondCor521]

RIT,

Yes, thank you. I understand that but my post did not make that clear.

To be clear to Poundkey, my entire post should just be understood to be my personal experience and to encourage you to be persistent with addressing the infection, which is just part of the picture. I would also encourage you to work with your "in real life" doctor as Rich suggests.

2Cor521

[Poundkey]

2Cor521..... I understand that this is your personal experience..... and it's other peoples experiences (like yours) that I'm interested in to try to better understand my own situation.
Rich's list of the many (7?) variations/possibilities is something I need to discuss with my doctor on my follow up in 4 weeks. He hasn't yet made a call (although he's prescribing meds for BPH) on one particular diagnosis. Reading through Rich's list I would be inclined to think Chronic bacterial prostatitis in my case as it always seems to start as an infection, coupled with enlargment, and followed by antibiotics. I've never had pelvic pain with this.
My doctor does what I would consider a very mild form of Prostatic massage before I go to the lab for urinalysis which, according to him would help any infection show up on the test.

Thanks again for the replies

[Animorph]

I'm taking Flomax and Avodart. My PSA was more like 10. Avodart eased my symptoms and shrunk my prostate by 1/3 or so after a year, and my PSA was down to 4 or so. That's pretty much as promised. But I still need to take Flomax 3 times a week (down from once a day).

Unfortunately that high PSA was my first test, so I didn't have a baseline. I did have a biopsy. The first in-office one hurt like heck and they LOST THE SAMPLES!! No result from that one. I got a second biopsy with full anesthesia after that. They didn't lose anything, but I did have to go to the emergency room for a catheter after those two sodas they wanted me to drink wouldn't come back out. That was fun too. But no cancer at least. I hope they won't insist on doing biopsies once a year or something!

I got tinitus soon after the biopsies. Levaquin, which I had both times, has a bad rep on the internet. That was the only possible side effect I noticed from all of these drugs.

Dan

[Poundkey]

Thanks for sharing your experience Dan. Gosh, sounds like you had a miserable time with the procedures. I think I'd be a wreck after going through what you did.
I've had no side effects with Levaquin. My doc asked me to take the full dose of Levaquin (21 days) plus one per day of both uroxatral and avodart until my follow up. It's been less that a week now and I already notice a change for the better. Probably the antibiotic knocking the infection down.
Thanks again...... hope you are feeling better.

[Corporateburnout]

I have been on Proscar which is another brand similar to Avodart for about three months now. I was on uroxatral for a few months before but discontinued it due to decreased libido and mild ED. These side effects are all gone since I stopped the uroxatral (DW doesn't seem to mind).

According to my physician I had a benign prostate enlargement which was causing frequent urinations but no pain or burning sensation and my PSA tests for the last five years have been normal.

My symptoms have improved but I have to keep a close eye on it since my older brother had his prostate surgically removed last November due to cancer.

[Poundkey]

Quote:

Originally Posted by Corporateburnout I have been on Proscar which is another brand similar to Avodart for about three months now. I was on uroxatral for a few months before but discontinued it due to decreased libido and mild ED. These side effects are all gone since I stopped the uroxatral (DW doesn't seem to mind). According to my physician I had a benign prostate enlargement which was causing frequent urinations but no pain or burning sensation and my PSA tests for the last five years have been normal. My symptoms have improved but I have to keep a close eye on it since my older brother had his prostate surgically removed last November due to cancer.

Interesting how these drugs effect people in different ways. At my age (59 tomorrow) decreased libido and mild ED may be somewhat normal. I didn't notice any marked difference in libido after 7 months of uroxatral.....although, as I said earlier, I would forget a dose here and there.
Actually my doctor said it would be the Avodart that would likely cause ED and libido problems.

Thanks for your reply

[Poundkey]

Just wanted to post a follow up about my one month check up with my doctor. I took the Levequin for the first 21 days, and have been on Uroxatral and Avodart for about a month. My urine test showed no infection at all.....doc used the words "clear as water". My PSA which had gone from my normal 0.8 to 1.2 has now dropped down to 0.6. Doc says my prostate is reduced in size by about 10% so far, but is now firm and not "mushy" (again, his words). So....things look good. No side affects from the meds yet, but he wants me to stay on both uroxatral and avodart for a full 6 months then check back....so we'll see.
Thanks again for all the input