I’m 44 and have been having urgency issues for about 6 months and a history of on and off prostatitis (or was it early onset BPH?) for 15 years. I went on a diet for a physique contest (1st one ever - bucket list thing) and was waking up to pee 5-6x per night for 3 months straight due to glycogen/carbohydrate storage issues. I went to my urologist and he did a retention test and I was retaining 250mL. The ultrasound said 28cc prostate so he assumed it was prostatitis flare and put me on Alfusozin, Bactrim, Naproxen. Fast forward, contest is over and I’m eating normally and pee 0 - 1 time per night and thought I was cured so I go back for a follow-up thinking I’m cured and we do another retention test and I’m still 200+ mL.
My wife is a high level admin at a hospital system and suggests that I see her co-worker there who is the urology chair for a second opinion. I do 2 more voiding tests both at 200mL and additionally another prostate ultrasound (pelvic) that shows 51cc prostate size… not 28 like the one I had a month earlier. Also had a DRE and he estimated 50-60cc before the test. Also did a flow test and the average was 3.6 which indicates an obstruction. Had a cystoscopy and my bladder has over-developed due to the obstruction and part of my prostate is pressing into the bladder. He wrote a script for Celebrex, finasteride, and pelvic floor PT for me but we discussed the severe cons of finasteride and are delaying it. Additionally I have been on testosterone therapy for 5 years. Has anyone with BPH issues who is also on testosterone, come off of testosterone and shrunken or fixed their LUTS symptoms? I didn’t have a single prostatitis/LUTS flare during the 5 years on testosterone until now. I literally thought that it cured my prostate issues and now here I am worse than ever. My PSA is 2 and was 1.7 5 years ago before I began TRT. The latest research seems to indicate that the prostate is saturated with really low levels of DHT so going above that (ie TRT) won’t cause extra growth but I’m wondering if this is in fact a contributing factor.