Yet another prostate question

[cbo111]

In the past few months for some reason, I have gotten into discussions with a couple different neighbor gentlemen about their prostate issues. The topic comes up when we are talking about sleep problems, using CBD for pain, and other things. These gentlemen are just in misery due to enlarged prostates that drive them to wake up 4-5 times a night to pee. Having moderate BHP myself (with no current sleep problem), I have a vested interest in this topic and wonder why these gentlemen don't seek medical intervention. I don't know them that well and didn't want to delve into their medical histories. Are there men out there that are just not good candidates for all the different medical procedures available? Are they afraid to have anything done and are resigned to suffer every night?

 

[erkevin]

I certainly cannot speak to the situation of your neighbors, but my situation is similar. Prostate is not enlarged, but narrowing around the urethra instead. I am up 2-5 times per night with the urge to go. I suspect that my bladder does not completely empty. My next move is Flomax. That was suggested during my prostate check-up last month. I am going to try that for a while before I consider any surgical intervention. To my limited knowledge, there are various treatments that should bring relief to all/most men. Maybe your neighbors are doctor-averse or aren't aware of the treatments available.

 

[nancyfrank232]

Are your friends taking finasteride or some other medication?

 

[Nemo2]

November 7, I go for this:

https://www.uhn.ca/corporate/News/Pages/greenlight_laser.aspx

 

[braumeister]

I wonder about some people too.
On our OAT tour in Ireland last month there was one gentleman who couldn't go much more than an hour between bathroom breaks, so the tour leader had to keep that in mind when we were traveling between towns.

It's not that he was filling his bladder; I never saw him take more than a small glass of water with a meal, and just one cup of coffee in the morning. He made a comment one time about an overgrown prostate, but I never engaged him in conversation about it.

Considering the mental image conjured up by descriptions of the various surgical procedures, it's hardly any wonder that some want to put that off as long as possible.

 

[Nemo2]

....it's hardly any wonder that some want to put that off as long as possible.

I guess I'm a Larry The Cable Guy kinda feller.

 

[Sunset]

Maybe they are afraid of possible side effects of surgery.

Like a fellow I know who had the surgery about 15 years ago, something important is limp afterwards.

 

[MrsHaloFIRE]

Side effects of the drugs can be extreme dizziness, etc Surgery risks and recovery pain and hassle. Sexual dysfunction. Bladder control issues. Lots of angles to this.

 

[bobneardc]

I haven't seen anything on this site about Uroxatral(alfuzosin). It works for me x 15 years. As I recall it took me a little time to get used to it (slight headache, had to take my time when I stood up, take with food). The minor problems went away within a couple of days. YMMV of course. Talk to your medical service provider, etc.

 

[bolt]

Side effects of the drugs can be extreme dizziness, etc Surgery risks and recovery pain and hassle. Sexual dysfunction. Bladder control issues. Lots of angles to this.

The prostrate is one of the most common health conditions effecting men as they get older, noting 50 per cent of men age 50 and 70 per cent of men age 70 will have an enlarged prostate.
Thats a lot of health care treatment ....... The vast majority(70%) of males over 70

Surgery should be a last resort, ..remember "First,.. do no harm" one urologist I know stated.
Appreciate that Toronto medical link Nemo2.

 

[Nemo2]

Surgery should be a last resort, ..remember "First,.. do no harm" one urologist I know stated.
Appreciate that Toronto medical link Nemo2.

I attribute my encounter with sepsis to a urine infection related to retained fluid. Once you've experienced sepsis you do not want to get it again - with luck the Green Light laser will minimize the possibility of a recurrence.

 

[zinger1457]

What medical test (if any) are you guys getting to check for prostate problems during your annual checkup? My doctor stopped requesting PSA test a few years ago, the digital exams stopped soon after. About the only thing we discuss regarding prostate is if there are any issues regarding frequency.

 

[braumeister]

My urologist still likes to see a PSA reading once a year. In my case I think it's because mine is high (I have a very large prostate so it puts out more PSA). As long as it doesn't rise too fast he's OK with it.

He also is diligent about the annual DRE. I've always thought it amusing that they use the term "digital" because there are few things more analog!

(Yes, I know why it's called that.)

I've also had several biopsies over the years, all of which were negative. So that's another indicator he considers.

Anyway, if you're curious you can always schedule your own PSA test. I've done that a few times. Just use requestatest or walkinlab and set it up.

 

[SecondCor521]

What medical test (if any) are you guys getting to check for prostate problems during your annual checkup? My doctor stopped requesting PSA test a few years ago, the digital exams stopped soon after. About the only thing we discuss regarding prostate is if there are any issues regarding frequency.

I'm 50. My primary care doc does annual PSA and annual or biannual DRE.

The only reason I can imagine a doc stopping is if one is old enough that the risk of dying from prostate cancer are low (because you'll die anyway before the PC gets you). Like maybe 70-ish? Not sure what the recommendation is there.

 

[6miths]

The only reason I can imagine a doc stopping is if one is old enough that the risk of dying from prostate cancer are low (because you'll die anyway before the PC gets you). Like maybe 70-ish? Not sure what the recommendation is there.

Or if they were following a recommendation by the most respected body in the US that makes such recommendations - (May 2012 Recommendation). https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prostate-cancer-screening

Or if the patient decided that they didn't want the test (May 2018 Recommendation). https://www.uspreventiveservicestas...UpdateSummaryFinal/prostate-cancer-screening1

 

[zinger1457]

The only reason I can imagine a doc stopping is if one is old enough that the risk of dying from prostate cancer are low (because you'll die anyway before the PC gets you). Like maybe 70-ish? Not sure what the recommendation is there.

I don't think it's so cut and dry regarding PSA testing. Most of the major organizations (National Cancer Institute, American Cancer Society, Mayo Clinic, etc.) are non-committal when it comes to recommending for or against routine PSA testing for those with no prior issues, leaving that decision between the doctor and patient.

 

[Bamaman]

Have you ever seen people, especially men, that avoid all kinds of medical testing and procedures? They're the people that don't get yearly physicals and are not being watched by a physician. They're also the types that put up with back pain and/or other ailments and don't consider getting the problem fixed.

We just found out yesterday that a friend has stage 4 lung cancer. We also lost another friend a year ago with lung cancer. Neither had been going for yearly physicals that include chest x-rays. They were the last of our friends that smoked, and never gave it up. And they would be considered He Men.

Anyone suffering any kind of bladder issues needs to be check closely by a good doctor. There have been a bunch of our college aquantances come down with bladder cancer. I have no desire to be a He Man as I have too much to live for in my retirement years.

 

[Freedom56]

Have you ever seen people, especially men, that avoid all kinds of medical testing and procedures? They're the people that don't get yearly physicals and are not being watched by a physician. They're also the types that put up with back pain and/or other ailments and don't consider getting the problem fixed.

.

You are 100% correct. My doctor told me that only 15% of males over 25 see a doctor for their annual physical and blood work. I know so many that have avoided doctors all their lives until something bad happens like a stroke or colon cancer (both could have been prevented). Then their lives are changed forever. The same can be said about those who avoid seeing dentists. It is one of the dumbest things you can do as a tooth or gum infection can lead to Endocarditis. Also once you lose your teeth and end up with dentures, you start losing you bone mass in your jaws.

 

[marko]

I haven't seen anything on this site about Uroxatral(alfuzosin). It works for me x 15 years. As I recall it took me a little time to get used to it (slight headache, had to take my time when I stood up, take with food). The minor problems went away within a couple of days. YMMV of course. Talk to your medical service provider, etc.

I attribute my encounter with sepsis to a urine infection related to retained fluid. Once you've experienced sepsis you do not want to get it again - with luck the Green Light laser will minimize the possibility of a recurrence.

I take alfuzosin for the past 7-8 years. Seems to work ok.
I did almost die from sepsis after a prostate biopsy five years ago. Never been so scared in my life! A full week in the hospital and a month of antibiotic pills the size of your thumb.

Biopsy was negative, so dying as a result would've been quite ironic.

Some nights I can sleep straight through...a mild sleeping or pain pill helps. Other times, I might get up as often as 6 times; sub-optimal for sure but thankfully I don't need a lot of sleep.

But...what does that green laser do? The article wasn't very specific.

 

[MRG]

I suffered from BPH and the short bathroom cycles. Most PCP should refer to a urologist who has the proper education and equipment to help.

After getting to see one, they started doing flow/empty bladder(ultrasound) testing. My bladder is a mess after years of nonsense from doctors whose ignorance preceded them.

Anyway I'm the proud owner of a new urolift device: http://www.early-retirement.org/forums/showthread.php?t=97350

I'd suggest talking with your doctor about if it's applicable for your situation. It eliminates some of the issues with different alternatives.

 

[RAE]

Side effects of the drugs can be extreme dizziness, etc Surgery risks and recovery pain and hassle. Sexual dysfunction. Bladder control issues. Lots of angles to this.

+1. The drugs they use to treat BPH, including Flomax, have numerous troubling side effects. I have looked into them, and there are none I would want to take unless my BPH was pretty bad. And surgery is even scarier.

 

[razztazz]

+1. The drugs they use to treat BPH, including Flomax, have numerous troubling side effects. I have looked into them, and there are none I would want to take unless my BPH was pretty bad. And surgery is even scarier.

I haven't seen anything on this site about Uroxatral(alfuzosin). It works for me x 15 years. As I recall it took me a little time to get used to it (slight headache, had to take my time when I stood up, take with food). The minor problems went away within a couple of days. YMMV of course. Talk to your medical service provider, etc.

Seconded on the Uroxatral. I've been taking it for a while.. ehh, 2 1/2 years...?. The side effects were minor and went away after a few days and it works at least as good as the other stuff. A very well targeted drug but different people have different receptors that react variably. That's why there's more than one drug even tho they seem to be "Me Too" drugs and the highly variable effects positive and negative , from different people.

Are there men out there that are just not good candidates for all the different medical procedures available? Are they afraid to have anything done and are resigned to suffer every night?

Yes, some people will be better candidates for different procedures. The green light laser, simple, effective, and low-risk as it may be is still surgery. And it relies on the amount of hemoglobin in the blood to work. I don't know how they test your prostate hemoglobin first to see if it'll work.

If the prostate is less than 80 to 100 grams there are the new non-surgical procedures too, like Rezum and Urolift, and one or two in the bullpen.

 

[Nemo2]

But...what does that green laser do? The article wasn't very specific.

As I understand it, basically it 'shaves' the prostate, and thus opens the passage to allow a greater flow of urine, which reduces retention. (And hopefully eliminates or reduces the possibility of bladder infection.)

Currently I take one Rapaflo (Silodosin) every evening - this should eliminate the need for the drug.

Fingers crossed.

 

[donheff]

I used Flomax for a while about 15 years ago. It worked pretty well but started causing fainting after long bike rides so I dropped it. Other drugs were not much help and I was up to 3-4 trips to the john at night. Xrays after I busted a hip disclosed a big bladder stone that was contributing to the issue. Since they were going to be up there pulverizing the stone anyway, I elected to get a laser TERP at the same time. The results were excellent. I still get up once in the night but that is a major improvement. I was one of the lucky ones who didn't get negative functional deficits from the TERP. The blood flow plumbing activity has actually improved although I get retrograde ejaculations which is a little disconcerting. TMI? .

 

[Chuckanut]

Other drugs were not much help and I was up to 3-4 trips to the john at night.

I found a direct link between eating out, especially fast foods, and the number of trips I make to the lavatory each night. One fast-food meal (pizza or burgers and fries) equals four trips. Even a good meal at a good restaurant will trigger at least two to three trips. My home cooking is zero to one trip.

I assume its the salt and perhaps other additives my body is purging.