I am 22 years old male and diagnosed with prostate enlargemnt. I had my first UTI when i was 15 years old. After that i had UTI once or twice the year till i was 20. Two years ago i started facing frequent utis and continous irritation in penis. Main problem was pain in ejaculation and irritation in penis anytime. One year ago the doctor (urologist) asked me to undergo cystoscopy, at that time my full bladder volume was around 300ml and pastvoid above 100ml. Peak flow rate of urine was 13.7ml/s. After the cystoscopy i was told that i have a bladder like of a 50 years old man. I was prescribed tamsulosin for 6 months and a follow up after that. After 6 months of tamsulosin my full bladder volume was around 470ml and pastvoid below 40ml. And peak flow rate was still 13.7ml/s so i was again prescribed tamsulosin for 3 months. Today it has been 9 months since i m taking tamsulosin and now my prevoid and pastvoid is still around 470 and 40. But peak flow rate is decreased to 12.7ml/s. I have follow up with my doctor next week. I am very worried about my future and marrital life. I am still suffering from painfull ejaculation but i dont feel irritation in my penis anytime now. I dont want to undergo any surgery whose side effects can affect my sex life.
Was there any mention of prostatitis? Sound like it to me but there will be others along that are way smarter than me. Your uro didn't prescribe antibiotics of any kind?
Hi Dan,
Yes, do not get talked into any surgery or procedure that will effect your sex life. TURP, along with it's variations often cause permanent retrograde ejaculation (dry orgasms) as well as the risk of other sexual problems. You do not want this, especially at your age both because of your sex life and the fact that it may mean you won't be able to, or at least it will be more difficult to have children.
One suggestion is that you try a trial switch from Tamsulosin to Daily 5 Mg Cialis. Studies show similar results but the Cialis can actually enhance your sex life while Tamsulosin often has the opposite effect.
So, you know, there are newer procedures coming out now that can help men with BPH/LUTS without some of the sexual side effects. My recommendation, especially at your age, would be to wait for as long as possible on this, as even better procedures no doubt will be developed.
Right now, it seems that Tamsulosin is controlling your symptons and protecting both your bladder and kidneys by keeping total bladder volumes and post void residuals (PVR) in check. Should medictions (Tamsulosin or Cialis) start to become ineffective, as they sometimes do, consider self catherization (CIC) as part of your watch n' wait strategy. It will empty your bladder completely any time you want while protecting your kidneys.
Speaking of kidneys, have you had a bladder/kidney ultrasound to check for any kidney damage. How about bloodwork for some kidney function tests? If you haven't had both, it's important you do.
Having the symptons you describe at such a young age is both bad news and good news. The bad is that you have to deal with all this at such a young age. The good is that many of us wait many years to deal with the problem, damaging the bladder in the process. By tackling this early on in life, hopefully you will not have to deal with this later in life when it might be more difficult to treat.
I assume you're seeing a urologist and not a general practioner. That is who you need to see. Just know that many of them are surgery/procedure oriented, and again do not let them talk you into any type of surgery or procedure that will affect your sex life. There are other options for you.
Jim
As "Unckle Fester" mentioned, prostatis is always suspect with urinary issues and sometimes can go hand in hand with other obstructive issues. Again, a good urologist, should be helpful to sort this out. A course of antibiotics might be worthwhile in your case to see if it helps things out, especially that pain you describe.
Jim
Better do something, I think a biopsy is call for
Did the doctor tell you why this is happing. There has to be a reason. He must be having retro with the med your on. There are other pills you can take so you wont have retroand help your bladder. Please at your young age d on't let them touch your prostate. You need that for a long timesometime we have to deal with the pain
As jimjames said look into dailey cialis. Of course at your young age it might give you the dreaded 4 hr ecection. Sound funny but it not. I've been dailey cialis for a couple months I think. Its not quite as good as Flowmax but my sex life has improved somewhat. Flowmax can beat the heck out of your sex life. Also what jimjame and ken have said any type of surgery is only a last resort. There are surgeries that probably will save your sex life but nothing is for sure. Good luck.
No mention of prostatitis. I was prescribed antibiotics when i had uti before undergoing cystoscopy.
Thankyou Mr jim for the kind response. One thing i forgot to mention that i have only one kidney by birth (the left one). And it is functioning normal. I never had any kidney pain or something. And My urologist told me after cystoscopy that if the tamsulosin wont provide good results then i would need to undergo surgery. He havent mentioned me the name of surgery he just told me that they will remove the part of prostate which is causing complications.
He said this is happening because the prostate is disturbing the bladder and affecting the flow of urine. I am very worried about what would i do if he ask me to undergo surgery and there is no other option left now. The hospital where my treatment is going on is one of best hospitals of our country.
My urologist didnt give me any options. He just said if tamsulosin doesnt work good enough we will have to undergo surgery and remove the part of prostate which is causing complications. Let see what he say in the follow up next week.
I can't imagine having problems at a young age, my heart and prayers are with you. mind started at 44 several years after my vasectomy. If I knew then what I now. I schedule a HOLEP at Mayo Phoenix, Dr Humphrey, The drugs I've taken over 20 years ,failed Urolift, just wish Had HOLEP around then, I've already experienced retro on difference meds. I a pipefitter
Thankyou thankyou very much for the kind words Sir. I dont really know anything about HOLEP, urolift and other treatment like these. I will now search about them to increase options for myself. May God cure us all.
One of the most important numbers to know about your prostate, especially
with what is going on here is ..what is the size of your prostate.?.It is a simple quesion, however if it is slightly enlarged then lets go from their. One way to get the true number is a Sonagram.This is also very helpful as a future reference point. DRE 's are not that reliable .Also not that you can take it to the bank, but what is your PSA number..this may indicate infection or something else..but it MUST be stated that PSA numbers can be very confusing to interpret. Also at YOUR AGE a lower fat diet..steering away from dairy and eating more fish & milled flaxseed along with ODERLESS AGED garlic tablets will naturally lower your trigylcerides & control, not stop future UTI's. As state on this forum many times, supplements have received poor reviews, however a lower fat diet can hinder the development.
Good luck dan
Reading these things for the first time. Flowmax holep cialis, gonna search and learn about them to increase options for me.
so, what country are you in?
Bay and Danya,
He's too young for a PSA test. Size is important, but the functional tests more important. Studies suggest that prostate size does not necessarily corrolate with BPH/LUTS.
Jim
Pakistan. At Ziauddin Hospital.
I could use one of those dreaded "4 hour erections" But seriously, at a 5mg daily dose which is equal to only a single 8mg dose, priapism would be a rarity and should not dissuade him or anyone for what could be a superior treatment.
Jim
Again, don't let any doctor talk you into surgery until you have explored every other option. Given your low retention, your kidney would not appear to be in any danger whatsover. Just keep monitoring it on a reasonable basis via ultrasound and blood work. And even if your kidneys eventually do show some stress, there are strategies other than surgery to help with that. You're just too young to have an invasive operation that can effect both your sex life and the ability to bear children in the future. You have to understand that urologists like to operate. It's what they do. It's how they pay their bills and put their kids through college. Doesn't mean you have to buy into it.
Jim