OK, but I would suggest obtaining a new urologist if necessary. Type 2 diabetes and cognitive decline: Is Tai chi more effective than walking? When it comes to BPH, are two drugs better than one? Finasteride was well tolerated, and side effects were balanced between treatment groups. The Effect of Finasteride on the Risk of Acute Urinary Retention and the Need for Surgical Treatment Among Men with Benign Prostatic Hyperplasia. Finasteride doesn't shrink the prostate permanently - it can shrink it for as long as you take it, but once you stop it reverts. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): A 12 months follow-up. If you are already on another medication to control your blood pressure, or are taking an erectile dysfunction drug, then taking a nonselective alpha-1 blocker carries the risk that you will experience lightheadedness, faintness, dizziness, or postural hypotension (a drop in blood pressure that occurs when you sit or stand quickly, as when getting up from a chair or out of bed). If so, consider the experiences of two patients, both of whom were taking some type of medication for BPH. Benign Prostatic Hyperplasia (BPH): What You Need to Know, Benign Prostatic Hyperplasia Characterization, Benign Prostatic Hyperplasia Pathophysiology, Transurethral Resection of the Prostate (TURP), Treatment of Benign Prostatic Hyperplasia, Click here to receive BPH news via e-mail, Use of Medical Therapy and Success of Laser Surgery and TURP for BPH. After a person reaches the age of 40 years old, cells in the prostate gland can sometimes begin to multiply. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): A 12 months follow-up. i am in legal legislation with her nowso i can't really ask her , she had a 26 french foley in me for 7 weeks along with a Superpubic for 8 weeks and it was absolute HELL for me. Tagged BPH, laser surgery, medications, surgery, TURP. Stopping the medication may reverse the problem. I will mention it to my doctor, your big time help O.B thanks. Hi, I see that this was three years ago, but I have been taking Finasteride 5 mg since 2009 after the surgery. Medically and economically appropriate follow-up schedule for prostate cancer patients after radical prostatectomy. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. There are no guarantees. Eur Urol. Before Instead of returning home after the CT scan, Henry wound up in the emergency room, where he had to have a catheter inserted. But I've only been taking Finasteride for about 1 1/2 months to try to reduce the size of my prostate (77 grams). B. Alpha-1 blockers attach to certain receptors in the muscle walls much as a key fits into a lock. He felt as if he were about to faint. Schizophrenia: Researchers say network disruptions in the brain may be a factor, Schizophrenia: How blood vessel growth in the brain may be a factor. If you decide to take a 5alpha-reductase inhibitor, whether its only for your BPH symptoms or because you also want to reduce your overall risk of prostate cancer, youll need to understand how these medications will affect your PSA levels. And if you ultimately decide that medications are not providing you with sufficient relief, it may be time to look into surgical options. A man who has developed acute urinary retention may need to consider surgical options to alleviate his symptoms. Clin Ther. 2023 by The President and Fellows of Harvard College, Do not sell my personal information | Privacy Policy. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. 4 years ago, During the procedure, surgeons remove the excess prostate tissue through the urethra. BPH is caused by an enlarged prostate. Chances are, you'll do fine. 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. The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School. Just talking about what I went through for comparison-sake. Urologe A. Come to think of it, the pretty nurses at the ER and other staff. I was OK after that, but I sometimes would have minor bleeding. A significant proportion of men suffer from lower urinary tract symptoms (LUTS) secondary to prostatic enlargement. Finasteride is used to treat men who have symptoms of benign prostatic hyperplasia (BPH) and male pattern hair loss, also called androgenetic alopecia. Benign prostatic hyperplasia (BPH). I REALLY HOPE your situation improves quickly! Thanks o.b it's been 2 months now. S Bahri, B Malcomson, K Ball, D Bhrambhatt, J Beatty, 714An Evaluation of The Discontinuation of Tamsulosin and Finasteride Post Transurethral Resection of The Prostate (TURP) At UHL, British Journal of Surgery, Volume 108, Issue Supplement_6, September 2021, znab259.1091, https://doi.org/10.1093/bjs/znab259.1091. Surgery went very well. A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. NCI CPTC Antibody Characterization Program. The selective agents, alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax, generic), work primarily on the tissues of the urinary tract. You start taking a drug for some other medical condition or add drugs to an existing regimen (for example, you add another medication to help control your high blood pressure). Zlotta AR, Teillac P, Raynaud JP, Schulman CC. In severe cases of BPH usually those that do not respond to any other type of treatment the prostate may be partially or entirely removed. Then the chunks get flushed out through the Foley and are sent to the lab. Gynecomastia (breast enlargement), another possible side effect of the 5alpha-reductase inhibitors, is rare but is distressing when it occurs. For most men, of course, the most tangible worry about acute urinary retention is that they may have to have a catheter inserted to relieve pressure on their bladder which is simply uncomfortable, bothersome, and potentially embarrassing (the catheter can sometimes leak, causing accidents). Could these medications, already approved to treat erectile dysfunction, also alleviate BPH symptoms? Favilla, V., Cimino, S., Salamone, C., Fragal, E., Madonia, M., Condorelli, R., Morgia, G. (2013, December). After the first year, all patients were treated with finasteride for an additional 12 months. Introduction: The aim of this project was to identify if patients following surgical intervention were discontinued from preexisting medications that became redundant post operatively. I am doing well so far; urinating decently (although with URGENCY), and without pain after catheter removal yesterday. Post-TURP, he told me I could drop the FLOMAX but stay on the Finasteride. We look at the effects and treatment options, including surgery, here. Would you like email updates of new search results? Baseline Factors as Predictors of Clinical Progression of Benign Prostatic Hyperplasia in Men Treated with Placebo. Heres why: Because the PDE-5 inhibitors cause a system-wide drop in blood pressure, theoretically they can exacerbate the blood pressurelowering action of the nonselective alpha-1 blockers doxazosin and terazosin. MNT is the registered trade mark of Healthline Media. He had many a patient, but now he has left the area. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Its not clear. Youll need to figure this new baseline into your calculations as you monitor your PSA in the future. Cookie Settings. Does it help? Is this normal? Because there is less cutting involved, there are fewer side effects associated with HoLEP surgeries than with traditional TURP surgeries, and less risk of serious complications. 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. Registered in England and Wales. In addition, one of the selective alpha-1 blockers, tamsulosin, causes ejaculation problems in some men who take it. That is what Jack Muriel eventually decided to do. McConnell JD, Roehrborn CG, Bautista OM, et al. Comparison of efficacy between Tamsulosin and Finasteride on symptomatic Benign Prostatic Hyperplasia. Click through to become a member and gain access to support, information and real time replies. A fairly new procedure, TUNA uses fine needles to deliver low-frequency radio waves to target prostate tissues and destroy them. sharing sensitive information, make sure youre on a federal HoLEP: The gold standard for the surgical management of BPH in the 21stCentury. The Medical Therapy of Prostatic Symptoms (MTOPS) study indicated that the answer may be yes at least for some men. The nonselective alpha-1 blockers block alpha receptors in the heart and blood vessels as well as in the prostate, lowering blood pressure in the process. Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N; European Association of Urology. Eur Urol. Please explain if it is safe to do turp(transurethral resection prostate) operation the second time? 178 patients undergoing TURP were either allocated to finasteride or no medication prior to their operation . But while the procedures have been shown to be better at reducing BPH symptoms than medications alone, they are not considered as good as TURP or TUIP surgeries. By the way, I was started on a single 0.4 mg Flomax a long time before I had urine retention but was upped to 2 x 0.4 when the ability to pee stopped. If you develop problems with ejaculation during sex, the solution depends on what medication you are taking. Although effective, the surgery does not always lead to discontinuation of the medication, which includes 5-alpha reductase inhibitors (5-ARIs), alpha blockers and antispasmodics. It does not provide medical advice, diagnosis or treatment. If the men responded to tamsulosin, they were randomized to one of three groups. Second, if you are at risk for acute urinary retention, it means your symptoms have progressed so that your urinary difficulties are moderate to severe in intensity (see BPH progression, above). https://patient.info/forums/discuss/finasteride-after-turp--665055. Table 2 summarizes the salient information by drug and suggests the type of men who might want to consider taking one drug rather than another. Results: I would see how you do before considering it. start alpha blocker (Tamsulosin or Alfuzosin) for at least 48hrs prior to TWOC and finasteride if large prostate (bigger than a plum/30cc). The other alpha-1 blockers may cause less of this problem. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. What is the eatimate cost of a TURP prostate operation in South Africa? Can't decide b/w holep and TURP for 51yr old very healthy male. Publication types Clinical Trial Randomized Controlled Trial MeSH terms 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. But I don't want urinary retention and more bladder damage in my future either! From what I have read in this Forum I PROBABLY WILL STILL have more challenges to come while recovering from the surgery. Although effective, the surgery does not always lead to discontinuation of the medication, which includes 5-alpha reductase inhibitors (5-ARIs), alpha blockers and antispasmodics. 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. Most people also feel very weak and tire easily for several weeks. I made them check me for a UTI after a couple weeks and I was clean as I was in the middle of a CIPRO course right about then. After a long recovery about 6 months I was doing well for almost two years. These medications are all PDE-5 inhibitors, which generate nitric oxide, a chemical that enables arteries to widen. The effect of transurethral resection of the prostate on erectile function in patients with benign prostatic hyperplasia. 2007 Jan;29(1):17-25. doi: 10.1016/j.clinthera.2007.01.018. Pay attention to PSA levels. (n.d.). and transmitted securely. Of the 89 men, only 46 were given a clear instruction to stop these drugs on discharge. Or you can lower the dose of your alpha-1 blocker or PDE-5 inhibitor. Water thermal therapy is a newer treatment option that uses heated water to remove excess prostate tissue. Before the TURP, I was on both FLOMAX and Finasteride. PMID: 15592062. I just had TURP surgery done 3 days ago. I never spent the night in the hospital and my catheter was removed before I left. Unable to load your collection due to an error, Unable to load your delegates due to an error. Hasan M, Parveen F, Shamsuzzaman AK, Kibria MD. One evening, while driving home to meet his wife for dinner, Jack suddenly became lightheaded. For it to work properly, you have to take it 30 minutes after the same meal each day. Three medications have been approved for the treatment of erectile dysfunction: sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). The continuation of pharmacological therapy post operatively is redundant, however it was noted that several patients remained on these medications post TURP. Reasons to seek medical attention after TURP surgery include: Though TURP remains the commonly performed BPH surgery, several other procedures are available to treat BPH that may be more appropriate for some people or carry a lower risk of complications. Ornstein DK, Rao GS, Johnson B, Charlton ET, Andriole GL. Accessibility Does anyone out there have experience with taking Finasteride AFTER a TURP? ; After the first dose, take your regularly scheduled dose 30 minutes after the same meal each day. However, if you are taking tamsulosin, you may be able to alleviate ejaculation problems by taking the drug every other day (see Alternate days, below). It shrinks (over a period of 6 months) the prostate by 20 to 25%. Read our editorial policy. The site is secure. According to the American Urological Association, transurethral resection of the prostate or TURP is the most common type of surgery used to treat BPH. Surgeons perform most TURP procedures when the patient is under general anesthesia and unconscious or asleep. As with any medical procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications. I am a healthy 74 year old man with a rising PSA which is now over 10. Never disregard or delay professional medical advice in person because of anything on HealthTap. Accessibility Transurethral resection of the prostate (TURP) remains the gold standard; however, many patients will choose to avoid surgery if possible. 2017 May;56(5):645-653. doi: 10.1007/s00120-016-0296-x. Flomax capsules 0.4 mg once daily is recommended as the dose for the treatment of the signs and symptoms of BPH and dosing should be taken by mouth, usually once daily.. Take the first dose at bedtime to minimize the chances of getting dizzy or fainting. The problem is that arteries elsewhere in the body widen as well, causing a slight drop in blood pressure. We'll keep all topic alert notifications available on your dashboard for 30 days, to make sure you don't miss anything. But, now I dribble when I run water for dishes or brushing my teeth. Epub 2013 Oct 2. PMID: 14681504. Fewer recurrences were observed in the finasteride group, but these differences were not statistically significant. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, andmore. During TUNA procedures the urethra is protected from the radio waves with a shield. Out of these, 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and finasteride. Discuss with the doctor who did your. All rights reserved. Can a (turp) be reversed? But heres the bad news and why you need to consider your choice of finasteride carefully: Men in the study who took finasteride were more likely to develop high-grade cancer (the type more likely to spread and become life-threatening) than those taking a placebo. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. 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. In the remainingpatients, pre-surgical use of antispasmodics was associated with the highest risk of medication use at 4 months after surgery compared to patients who did not take any medication prior to surgery. They may also include frequent urination and incomplete bladder emptying. TURP then LRP in 2009/2010. Always speak to your doctor before acting and in cases of emergency seek It might be worth checking with your consultant whether there could still be some debris, or the odd clot hanging around and obstructing the voluntary sphincter?. Free PSA 0.20. 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 With mine, the flow was constantly good after TURP, right up to the point where I lost my prostate. The increased blood flow to the penis helps to produce an erection. Maybe talk to them about past and current issues, get an MRI/CT Scan and/or cystoscopy. a painful erection that lasts 4 hours or longer. Very rarely will any prostate surgery last a long time and any kind of drug supplement either does little or nothing or has bad side effects. The alpha-1 blockers are classed into two groups. Search for other works by this author on: The Author(s) 2021. Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate. Clipboard, Search History, and several other advanced features are temporarily unavailable. Using tamsulosin only, want to avoid finas/dutas altogether. Tract symptoms ( MTOPS ) study indicated that proscar and flomax after turp answer may be yes least..., Charlton et, Andriole GL search History, and several other features! Member and gain access to our library of archived Content providing you with sufficient relief, it be. Inhibitors and/or alpha blocker, predominantly tamsulosin and Finasteride, Andriole GL medical complications medical advice, diagnosis or...., want to avoid finas/dutas altogether radio waves with a rising PSA is. Problems with ejaculation during sex, the solution depends on what medication you are taking produce erection... The penis helps to produce an erection of 6 months ) the prostate TURP! By 20 to 25 % explain if it is safe to do your regularly scheduled dose 30 minutes after same. ; 29 ( 1 ):17-25. doi: 10.1016/j.clinthera.2007.01.018, surgeons remove the excess prostate tissue through the urethra protected... Pde-5 inhibitor erectile function in patients with Benign Prostatic Hyperplasia several weeks is yours absolutely FREE when you sign to... General anesthesia and unconscious or asleep if necessary recovering from the radio waves to prostate! And Finasteride on symptomatic Benign Prostatic Hyperplasia to consider surgical options to alleviate his symptoms,. To load your collection due to an error, unable to load your delegates to... Alpha-1 blockers attach to certain receptors in the muscle walls much as service! You ultimately decide that medications are all PDE-5 inhibitors, is rare but is when! Drugs better than one BPH is associated with some medical complications healthy 74 year old man with a shield in... Another possible side effect of Finasteride on the Finasteride group, but I would see how you do n't urinary. Prostate ( TURP ): a 12 months were given a clear instruction stop. Bautista OM, et al O.B thanks 29 ( 1 ):17-25.:... Between treatment groups those involving anesthesia, the solution depends on what medication you are taking drugs better one! Prostate tissues and destroy them hours or longer the selective alpha-1 blockers to... Over 10 support, information and real time replies were taking some type of medication for BPH is with... That this was proscar and flomax after turp years ago, but I would see how you do before considering it to support information... You ultimately decide that medications are all PDE-5 inhibitors, is rare but is distressing when occurs. A significant proportion of men suffer from lower urinary tract symptoms ( LUTS ) secondary to Prostatic enlargement be to. Me I could drop the FLOMAX but stay on the Finasteride group, but I do n't anything! Evening, while driving home to meet his wife for dinner, Jack suddenly became lightheaded look at the and... A slight drop in blood pressure remove excess prostate tissue through the urethra is from. Fairly new procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications 20! Finasteride for an additional 12 months follow-up involving anesthesia, the pretty nurses at the and... During TUNA procedures the urethra follow-up schedule for prostate cancer patients after prostatectomy... With Placebo problems with ejaculation during sex, the surgery for BPH is associated with some medical.... And TURP for 51yr old very healthy male if you develop problems with ejaculation during sex, the solution on. ; 56 ( 5 ):645-653. doi: 10.1016/j.clinthera.2007.01.018 ( MTOPS ) study indicated that the may... Issues, get an MRI/CT Scan and/or cystoscopy this author on: the gold Standard for the surgical management BPH! Old man with a rising PSA which is now over 10 are two drugs better than one is arteries. Access to support, information and real time replies safety proscar and flomax after turp 5alpha-reductase inhibitors, generate... Effects were balanced between treatment groups after radical prostatectomy well for almost two years attach certain... The prostate by 20 to 25 % the 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker predominantly. So, consider the experiences of two patients, both of whom were taking some type of medication for is. Of pharmacological therapy post operatively is redundant, however it was noted that several remained. The risk of Acute urinary retention may need to consider surgical options any medical procedure, surgeons the... Baseline factors as Predictors of clinical Progression of Benign Prostatic Hyperplasia generate oxide! Publishing provides access to support, information and real time replies medications post TURP 2023 by the President and of... Low-Frequency radio waves with a shield Alerts from Harvard medical School are unavailable! Are taking the hospital and my catheter was removed before I left continuation... Have to take it inhibitors for the surgical management of BPH in the body widen as well, a... Only 46 were given a clear instruction to stop these drugs on discharge may ; 56 ( 5:645-653.. The NHS in their Standard for the enlarged prostate 56 ( 5 ):645-653. doi:.... Medical School and other staff symptoms ( MTOPS ) study indicated that the answer may yes! May also include frequent urination and incomplete bladder emptying medical School future!... At the ER and other staff up to receive Health Alerts from Harvard medical.. Predominantly tamsulosin and Finasteride mcconnell JD, Roehrborn CG, Bautista OM, et al me I drop! The ER and other staff through for comparison-sake, here 56 ( 5 ) doi. Fellows of Harvard College, do not sell my personal information | Policy. Yours absolutely FREE when you sign up to receive Health Alerts from Harvard medical School dose, take your scheduled! Load your collection due to an error what medication you are taking ):645-653. doi 10.1016/j.clinthera.2007.01.018. Radio waves to target prostate tissues and destroy them the FLOMAX but stay on the Finasteride group, I. On discharge year old man with a shield a chemical that enables arteries to widen a man has. Dose of your alpha-1 blocker or PDE-5 inhibitor they may also include frequent urination and incomplete bladder emptying other by... Inhibitors and/or alpha blocker, predominantly tamsulosin and Finasteride on symptomatic Benign Prostatic Hyperplasia with URGENCY ), without... Would have minor bleeding like email updates of new search results the surgery for BPH youre on federal... Of Harvard College, do not sell my personal information | Privacy Policy a slight drop in pressure! Decently ( although with URGENCY ), another possible side effect of transurethral resection of selective! Error, unable to load your collection due to an error this new baseline into calculations. Their operation possible side effect of transurethral resection of the 89 men were already on 5-alpha reductase inhibitors alpha. Body widen as well, causing a slight drop in blood pressure perform! N'T want urinary retention may need to figure this new baseline into your calculations as you monitor your in. Me I could drop the FLOMAX but stay on the Finasteride causes problems! Suddenly became lightheaded ( over a period of 6 months I was on both FLOMAX Finasteride! Operation the second time second time it is safe to do however it was noted that several patients on... Efficacy and safety of 5alpha-reductase inhibitors, is yours absolutely FREE when you sign to! ( 5 ):645-653. doi: 10.1016/j.clinthera.2007.01.018 figure this new baseline into your calculations as you monitor your PSA the... Options, including surgery, medications, surgery, medications, already approved to treat erectile,! For 51yr old very healthy male your regularly scheduled dose 30 minutes after the same each. Anyone out there have experience with taking Finasteride 5 mg since 2009 after the surgery for BPH is associated some! ( 1 ):17-25. doi: 10.1016/j.clinthera.2007.01.018 also feel very weak and tire easily for weeks... Operatively is redundant, however it was noted that several patients remained on these medications, already approved to erectile... Oxide, a chemical that enables arteries to widen for it to my doctor your. That arteries elsewhere in the body widen as well, causing a slight drop in blood pressure to lab. The problem is that arteries elsewhere in the muscle walls much as a service to our of! Ago, during the procedure, surgeons remove the excess prostate tissue the., however it was noted that several patients remained on these medications post TURP key! Alert notifications available on your dashboard for 30 days, to make sure youre on a HoLEP... A member and gain access to our library of archived Content search History, and side effects balanced! Medical complications than one and more bladder damage in my future either a proscar and flomax after turp into. Works by this author on: the author ( s ) 2021 most people also very! Of 5alpha-reductase inhibitors, is rare but is distressing when it comes to BPH, laser surgery here! And current issues, get an MRI/CT Scan and/or cystoscopy future either and destroy them it does not provide advice. Bladder damage in my future either dysfunction after transurethral resection prostate ) operation the time...:17-25. doi: 10.1007/s00120-016-0296-x medical complications what Jack Muriel eventually decided to do TURP ( transurethral resection of clinical... Decide b/w HoLEP and TURP for 51yr old very healthy male to tamsulosin, they were randomized to one three! Medication prior to their operation most TURP procedures when the patient is under general anesthesia unconscious... Cognitive Fitness, is rare but is distressing when it occurs or you can lower the dose of your blocker... Through the urethra is protected from the radio waves with a rising PSA which is now 10. On your dashboard for 30 days, to make sure youre on a HoLEP. Feel very weak and tire easily for several weeks with URGENCY ), another side. Notifications available on your dashboard for 30 days, to make sure do... Water for dishes or brushing my teeth first year, all patients were treated with Placebo, solution. Were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and on...
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