It is important to obtain a baseline PSA value before beginning treatment with one of these medications, and then have another after 612 months, to see how much the PSA has gone down after treatment. Get answers from Pharmacologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Being honest I thought the drug was a godsend. I didn't know if coming off it was part of the healing process. Watch your intake of fluids, especially if you will be unable to urinate for a while (such as when youre at a sporting event or on a long airplane trip). Of the 89 men, only 46 were given a clear instruction to stop these drugs on discharge. I had the same surgery and from what I understood 9 out of 10 have regrowth of the prostate within 7 to 10 yrs. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Our results show a need for effective patient counseling about continued or new use ofmedical therapy after laser and TURP procedures. The objective of this study was to evaluate the effect of finasteride (10 mg/d) or placebo on serum prostate-specific antigen (PSA) and recurrence rates in men with detectable PSA levels after radical prostatectomy. New England Journal of Medicine 2003;349:238798. When it comes to BPH, are two drugs better than one? Benign prostatic hyperplasia (BPH) patients often regard surgical intervention as a definitive therapy for urinary complications allowing them to eliminate medication and its inherent expenses. McConnell JD, Roehrborn CG, Bautista OM, et al. They found that surgery is successful in eliminating the need for medical therapy in over 75% of patients who use medication prior to surgery. These drugs shrink the prostate by reducing levels of the male hormone dihydrotestosterone (DHT), which promotes prostate growth. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. [No dentures yet] Very annoying and I resorted to wearing male guards in my briefs. It is important that the long-term safety and efficacy of drugs intended for chronic administration in men . 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. New England Journal of Medicine 1998;338:55763. I had high PSA about 10 years ago and had a prostrate TURP operation and it was clear. I was OK after that, but I sometimes would have minor bleeding. The alpha-1 blockers are classed into two groups. They may also include frequent urination and incomplete bladder emptying. Out of these, 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and finasteride. Video chat with a U.S. board-certified doctor 24/7 in a minute. As instructed by the radiology department, Henry drank large quantities of water before the procedure. I should have started Finasteride long ago; maybe I wouldn't have needed the TURP. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. 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. A doctor who specializes in the urinary tract does most TURP surgeries. Search for other works by this author on: The Author(s) 2021. Using tamsulosin only, want to avoid finas/dutas altogether. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. You can learn more about how we ensure our content is accurate and current by reading our. 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. I have been taking finesteride for some time now 3 or 4 yrs prior to surgery and have been taking it since the surgery, which has been 2 months out now I have been struggling with having to pee in an instant and have about 5 to 8 secounds to get to the John or I'm done for. I am a healthy 74 year old man with a rising PSA which is now over 10. Casab A, Roehrborn CG, Da Pozzo LF, Zepeda S, Henderson RJ, Sorsaburu S, Henneges C, Wong DG, Viktrup L. J Urol. From MEDLINE/PubMed, a database of the U.S. National Library of Medicine. 4 years ago, Alfuzosin is a time-release formulation, so a single 10-mg tablet is taken once a day immediately after a meal. Finasteride does shrink the prostate, however it takes 2-6 months to be effective, and yes, to prevent the prostate from growing again and it will, you must stay on it most likely the rest of your life.As far as awful side effects; whenever you start a new drug there will be side effects as your body has to get used to it, I have been on both Flomax and Finasteride for 6 months now both pre Op and post op, very little if any side effects. as being in breach of those terms. TURP surgery or transurethral resection of the prostate, is the most effective surgical procedure for people with enlarged prostate. 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. https://patient.info/forums/discuss/flomax-after-turp-734861. So whats going on? Maybe we don't need anything? government site. TURP then LRP in 2009/2010. Overall, the risk of serious complications after TURP surgery is quite low. Some men experience complications after TURP surgery. Investigators have discovered in the past few years that more than half of men with BPH also suffer from overactive bladder, and that this may further exacerbate urinary difficulties. 6 users are following. During TUIP procedures, the surgeon will insert a cystoscope into the urethra and widen the urethra by making tiny cuts in the prostate, and the area where the urethra connects to the bladder. No apparent effect on the PVR or large doses of tamsulosin (2x0.4mg) and prostate too small for finasteride/dutasteride. Read our editorial policy. Intermittent Tamsulosin Therapy in Men with Lower Urinary Tract Symptoms. Created for people with ongoing healthcare needs but benefits everyone. TURP syndrome and severe hyponatremia under general anaesthesia. 2023 by The President and Fellows of Harvard College, Do not sell my personal information | Privacy Policy. However, if you are currently using, or considering, an alpha-1 blocker, you may want to take some precautions when adding one of the PDE-5 inhibitors. In Jacks case, the problem was mixing a BPH medication with one for erectile dysfunction. BPH patients can develop urinary tract symptoms including urinary retention, urinary tract infections and even kidney damage. Clipboard, Search History, and several other advanced features are temporarily unavailable. These medications are used to quiet overactive bladder muscles, which can lead to urinary incontinence. Bookshelf The prostate is a walnut-sized reproductive gland responsible for producing some of the fluid components of semen. An official website of the United States government. OK, but I would suggest obtaining a new urologist if necessary. Second, although the MTOPS study found that side effects were similar whether men took one drug or the combination, many experts feel differently, based on the patients they see. The https:// ensures that you are connecting to the respect of any healthcare matters. This not only impedes urinary tract functioning, but also reduces the volume of urine the bladder can hold. 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). Just talking about what I went through for comparison-sake. I REALLY HOPE your situation improves quickly! National Library of Medicine With the triple port, your hours in the recovery room there is constant irrigation going on. start alpha blocker (Tamsulosin or Alfuzosin) for at least 48hrs prior to TWOC and finasteride if large prostate (bigger than a plum/30cc). Symptoms of BPE may vary between the patients. Unauthorized use of these marks is strictly prohibited. Out of these, 89 men were already on 5-alpha reductase inhibitors and/or alpha blocker, predominantly tamsulosin and finasteride. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Stage T1-2 prostate cancer: a multivariate analysis of factors affecting biochemical and clinical failures after radical prostatectomy. 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. Especially after I lost the ability to pee at all while retaining bladder spasms. 2017 May;56(5):645-653. doi: 10.1007/s00120-016-0296-x. During the procedure, surgeons remove the excess prostate tissue through the urethra. Try our Symptom Checker Got any other symptoms? Please enable it to take advantage of the complete set of features! Use of the forums is subject to our Terms of Use As a consequence, they require longer hospital stays and rehabilitation than most procedures used to treat BPH. BPH is caused by an enlarged prostate. Please enable it to take advantage of the complete set of features! Urologist recommends another run at the turp surgery. Many of the side effects, complications, and risks associated with TUIP are similar to those of TURP. i thought the surgery was suppose to cure everything ? 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. Most men see an improvement within six months of starting treatment. Chances are, you'll do fine. Hi, I see that this was three years ago, but I have been taking Finasteride 5 mg since 2009 after the surgery. Stop taking it and see what happens. While these agents are usually not the first choice for blood pressure control, they may be a good choice for men who have both BPH and high blood pressure. Thanks o.b it's been 2 months now. Publication types Clinical Trial Randomized Controlled Trial MeSH terms Dr. Bennett Machanic and 2 doctors agree Dr. Birendra Tandan answered Urology 36 years experience After a good TURP you should not need Flomax. Each day, we'll check to see if new items have been published to the topics you're subscribed to, and we'll send you one email with all of the new items from that day. Even so, the information in this table, and in the rest of this article, may help you clearly evaluate your medication options. Thanks for sharing your experiences henrya. Advertisement intended for healthcare professionals, University Hospitals of Leicester, Leicester, United Kingdom. (2012, January-June). Question about TURP prostate operation. Even though a value of 3 is considered normal in men not taking a 5alpha-reductase inhibitor, a PSA value that doubles within a year of beginning one of these medications could indicate that cancer is present. Before TURP After TURP Transurethral Resection of the Prostate (TURP) During TUNA procedures the urethra is protected from the radio waves with a shield. 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. Does anyone out there have experience with taking Finasteride AFTER a TURP? Thanks for visiting. Post-TURP, he told me I could drop the FLOMAX but stay on the Finasteride. I'm 65 years old and I had TURP surgery 6 days ago. Those drugs can have awful side effects that can be permanent. He had many a patient, but now he has left the area. Use of the forums is subject to our Terms of Use Favilla, V., Cimino, S., Salamone, C., Fragal, E., Madonia, M., Condorelli, R., Morgia, G. (2013, December). Medical therapy is an effective alternative, however, new studies are showing that there may be more side effects than previously realized in the elderly male. What foods are good for an enlarged prostate? The other alpha-1 blockers may cause less of this problem. 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). 2005 Aug;48(2):269-76. doi: 10.1016/j.eururo.2005.03.029. So its important to understand these differences as you evaluate which medications might be right for you. Source: McConnell JD, Bruskewitz R, Walsh P, et al. Patients treated with finasteride had a delayed increase in serum PSA compared with placebo of approximately 9 months in the first year and 14 months by the end of the second year. Unable to load your collection due to an error, Unable to load your delegates due to an error. Typically the urgency goes away after 1-3 months and if everything else seems to be OK, you probably will too. After what I went through I really don't want to do that. Doctors usually start with 1 milligram (mg) at bedtime, then gradually increase it as needed to a maximum of 10 mg of terazosin or 8 mg of doxazosin. Try our Symptom Checker Got any other symptoms? All rights reserved. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in Certainly some type of adverse event, such as these men experienced, might make you wonder if its time to adjust the dose of your medication or perhaps even change medications. 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?. Careers. By using our website, you consent to our use of cookies. (n.d.). Living on the pills unless it gets much worst. Youll need to figure this new baseline into your calculations as you monitor your PSA in the future. There was a statistically significant reduction in the residual urine volume with combination therapy (p<0.0001) than in patients with monotherapy (p= 0.1271). 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. It is not related to cancer and is usually harmless, though it can cause unpleasant symptoms. Many doctors, surgeons and urologists are trained in United States, Canada, United Kingdom, etc. The Medical Therapy of Prostatic Symptoms (MTOPS) study indicated that the answer may be yes at least for some men. Considering collagen drinks and supplements? Judging by the pain I had with a 24, I can imagine what a 26 is like. However, our panel of Harvard experts think the concerns are overblown. 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. A 26 is like to be OK, you probably will too infections and even kidney damage,! 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Prostatic Symptoms ( MTOPS ) study indicated that the long-term safety and efficacy drugs... Database of the complete set of features evaluate which medications might be for... Administration in men with Lower urinary tract does most TURP surgeries away after 1-3 months and everything... Most effective surgical procedure for people with enlarged prostate Privacy Policy ongoing healthcare needs but everyone. With TUIP are similar to those of TURP ofmedical Therapy after laser and TURP.! Reproductive gland responsible for producing some of the prostate by reducing levels of the prostate a. Text answers on HealthTap are not intended for individual diagnosis, treatment or prescription components of.... Usually harmless, though it can cause unpleasant Symptoms, University Hospitals Leicester. 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