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My Second Attempt Here. My Prostrate Is Enlarged. I Have

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Posted on Sun, 19 Apr 2020
Question: My second attempt here.

My prostrate is enlarged.

I have been taking Duodart 500/400 for ten years.

In the last two years my ability to get an erection has almost gone.

My ability to pee standing up is gone.

Obviously my Duodart is not a desirable medication for me.

Would any of these other medications, or any others at all, help my conditions?



Alfuzosin (Uroxatral)

Doxazosin (Cardura)

Prazosin (Minipress)

Silodosin (Rapaflo)

Tamsulosin (Flomax)

Terazosin (Hytrin)

I guess the medical world has not made any, or much, progress in the last ten years. As pervasive as an enlarged prostate problem is I am surprised with the amount of progress in solving the problem.

I am very doubtful that I can wisely select the brand and the dosage of a different med. Apparently you feel the same.

So I'll wait until the virus lockdown is over and try to find a Filipino doctor that I can rely on.

Thanks.
doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
Please provide few more details

Detailed Answer:
Hello
Thanks for query ,

I shall be happy if you can post me more details to help me in making precise comments
1) What is your age ?
2) Do you have other health issues like cardiac problem ,hypertension,Diabetes etc?
3) What is the frequency of urination in a day time and at night ?
4) Is there urgency or hesitancy for urination ?
5) Have you recently done Ultrasound Scanning of abdomen if so what is the size of Prostate and Post Void Residual Urine volume (PVR)
6) Have you done Renal Function tests and Serum PSA test very recently if so what the results ?

Based on the facts that you have been diagnosed to have Enlarged Prostate and have been taking medicine (Duodart) which is a combination of Dutasteride and Tomsulosin ,Both these drugs are routinely prescribed as a first line of treatment which helps to improve the urine flow and to reduce the further growth of prostate .

However it is known fact that these drugs are ineffective when taken for a longer period of time say more than 3-4 years

As regards your query about switching over to other drugs The list of the drugs that you have mentioned I would say that all these drugs belong to same group of drugs like lik

They all belong to same family of drug of Duodart like alpha adrenergic receptor blockers and 5 alha reductse inhibitor,Hence switching over to other drugs will not serve any purpose or give you relief from symptoms.

In a given situation you have to consult qualified Urologist to reassess and investigate on following lines
1) Urine routine and Urine Culture
2) Ultrasound Scanning of abdomen to know the size and confederation of prostate
3) To know the Post Void Residual Volume of Urine (PVR)
4) Uroflowmetry .
5) Renal function tests

He will be the best judge to decide about the further modality of treatment depending upon the results of these tests and quality of your life and other co morbid conditions that you may have .

However in most of the cases particularly in patients who have been taking medication and do not have satisfactory results ,it is a normal protocol to go for surgical treatment of Endoscopic Resection (removing) of Enlarged prostate where the source of energy to do the the procedure varies from either using electric energy or laser energy .This help to remover the obstruction to urine flow caused by enlarged prostate and gives permanent results in terms of symptoms and improves quality of life .

The loss of Erection and libido i due to side effect of Duodart .

I ould suggest you to continue with the same drugs till you consult Urologist .

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.



Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10591 Questions

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My Second Attempt Here. My Prostrate Is Enlarged. I Have

Brief Answer: Please provide few more details Detailed Answer: Hello Thanks for query , I shall be happy if you can post me more details to help me in making precise comments 1) What is your age ? 2) Do you have other health issues like cardiac problem ,hypertension,Diabetes etc? 3) What is the frequency of urination in a day time and at night ? 4) Is there urgency or hesitancy for urination ? 5) Have you recently done Ultrasound Scanning of abdomen if so what is the size of Prostate and Post Void Residual Urine volume (PVR) 6) Have you done Renal Function tests and Serum PSA test very recently if so what the results ? Based on the facts that you have been diagnosed to have Enlarged Prostate and have been taking medicine (Duodart) which is a combination of Dutasteride and Tomsulosin ,Both these drugs are routinely prescribed as a first line of treatment which helps to improve the urine flow and to reduce the further growth of prostate . However it is known fact that these drugs are ineffective when taken for a longer period of time say more than 3-4 years As regards your query about switching over to other drugs The list of the drugs that you have mentioned I would say that all these drugs belong to same group of drugs like lik They all belong to same family of drug of Duodart like alpha adrenergic receptor blockers and 5 alha reductse inhibitor,Hence switching over to other drugs will not serve any purpose or give you relief from symptoms. In a given situation you have to consult qualified Urologist to reassess and investigate on following lines 1) Urine routine and Urine Culture 2) Ultrasound Scanning of abdomen to know the size and confederation of prostate 3) To know the Post Void Residual Volume of Urine (PVR) 4) Uroflowmetry . 5) Renal function tests He will be the best judge to decide about the further modality of treatment depending upon the results of these tests and quality of your life and other co morbid conditions that you may have . However in most of the cases particularly in patients who have been taking medication and do not have satisfactory results ,it is a normal protocol to go for surgical treatment of Endoscopic Resection (removing) of Enlarged prostate where the source of energy to do the the procedure varies from either using electric energy or laser energy .This help to remover the obstruction to urine flow caused by enlarged prostate and gives permanent results in terms of symptoms and improves quality of life . The loss of Erection and libido i due to side effect of Duodart . I ould suggest you to continue with the same drugs till you consult Urologist . Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you Thanks and Regards. Dr.Patil.