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Medical Forum / Diseases and Disorders / Prostate BPH / January 2006Avodart vs. PVP
I am 57, Type 2 Diabetic, on Hytrin for about 4 years for BPH, now on Avodart for 3 months. My Doc tells me the Avodart is supposed to shrink my prostate within 6 months, by which time I might be able to get off the Hytrin (which makes me lethargic and fuzzy-headed). The Avodart immediately knocked out my sex drive COMPLETELY. I'm not totally impotent, but it's irrelevant because I have no libido whatsoever. I hoped this would be temporary, but it doesn't seem to be. Now I'm wondering if it's worth waiting the rest of the six months to see if the stuff works, especially after reading that controversial post that said the side effects could be permanent. So far, my BPH symptoms haven't improved a bit. If I try to go off the Hytrin for even a day, it takes me five minutes to pee. The point of all of this is, if I have only partial relief and 100% chance of sexual and other side effects by staying on the meds the rest of my life, wouldn't I be better off with the 20% to 40% chance of retrograde from a PVP, and at least get off the damn pills? Any issues with Insurance that anyone is aware of for the PVP? Hi Temujin, I don't want to discourage you from getting PVP. If my own BPH worsens, I may have the PVP procedure myself rather than suffer the side effects of Flomax or other medications. (I'm currently successfully treating myself with diet and supplements.) However, where are you getting the 20% to 40% figure from? Dr. Sancha, a frequent contributor to this newsgroup, says (in the "PVP Setback" thread): "I believe patients fare better when you are aggressive with PVP, and my patients have a high percentage of retrogade ejaculation, about 60-70%." Dr. Reiter at UCLA gave me the same figure. Bruce Bruce, Thanks for your input. I guess the percentage depends on who you talk to. I've seen an article by a guy from Mayo Clinic (don't remember the name) who claims good results and 20% to 40% retro, which is in line with Laserscope's literature. I did see Dr. Sancha's post estimating 60% to 70%, which is a little discouraging. In the end, though, I think you have to make the decision based on the assumption that it is 100%. Even 20% ain't very good odds if the outcome is totally unacceptable. The question is, would retrograde ejaculation be worse than the symptoms I am experiencing right now, with or without meds? The answer is, I don't know, never having experienced retro. I do know I am very unhappy with my current situation, which seems likely only to get worse. Anyone out there with retro who can provide some input? > Hi Temujin, > [quoted text clipped - 9 lines] > > Bruce Temujin, I am about your age and had med of Cardura or Flomax and Proscar for 6 years. Just like you, if I got off Flomax one day, it took me one minute to pee especially at night. My prostate size was 100 mg with median lobe. Prior to my August-05 PVP, I alraedy had somewhat retro and loss of libido. Now I am a happy camper of PVP without taking any med and any syptom of BPH but 100% retro. With help of Viagra sometimes, I could not ask any more. My peak flow is 30+ cc/sec vs. less than 5 before pvp, mean flow is around 16 cc/s. You can buy an urinal to measure the mean flow with a stop watch. Four months after my surgery, my 80-year-old father-in-law had a successful pvp too. Best wish to you. >Bruce, I don't know, never having experienced retro. I do know >I am very unhappy with my current situation, which seems likely only to >get worse. Anyone out there with retro who can provide some input? Temujin: ..curiosity questions...If you are diabetic, why the heck are you letting the docs turn you into a chemical cocktail? Other question, did you check with appropriate experts to learn if a PVP will exacerbate healing problems since you are diabetic, (though the laser ought to cauterize somewhat as it zaps the channel and prostate)? Do you know the cause of your enlarged prostate? Insulin spikes tend to cause some prostate responsivenes, that turns into BPH symptoms...is that the case with yours? Did the docs do a thorough blood test to factually determine if your insulin spikes are driving your BPH or if DHT is? (See posts by Spread guy..he made lots of sense and I had to confront my doc to follow what spread guy said...my doc didn't want to do blood tests) If DHT is not the culprit you may want to have a chat with your urologist for blindly recommending DHT inhibtors if your problem is driven by other causal factors. Another question. Did the doctor appropriately advise you that not all guys' prostates respond to DHT inhibitors? Oh, yeah, and did he appropriately tell you that it may be as much as 12 to 18 months before you notice any shrinkage, and not just 6 mos? And, oh, your comments about retro...so what if your trade offs becomes retro? Lots of us PVPers have retro but I bet their sex lives are as exciting as mine. It's a blast. More action and less mess. Screw the stats about 20% to 40% retro...it is likely more like 100% chance. So, if that's stopping you, then my gawd watch out that retro don't get you! But so what? Sensation is ALMOST the same except your sex partner may appreciate the fact there is less mess after a good screw. You talk as though it s a some gawd awful thing. I'd think it would not even be a factor in deciding...if you can get zapped due to medical condition. You may not be able to be zapped? >I am 57, Type 2 Diabetic, on Hytrin for about 4 years for BPH, now on > Avodart for 3 months. My Doc tells me the Avodart is supposed to [quoted text clipped - 14 lines] > retrograde from a PVP, and at least get off the damn pills? Any issues > with Insurance that anyone is aware of for the PVP? Bong, Thanks for your helpful input. I'm afraid I'm at the lower end of the learning curve on all of this. I'm a new member of this group, and am just starting to learn about PVP. I have not seen a urologist about my BPH, just sort of blindly followed my GP's recommendations, assuming that was what was best. I have never been happy with the side effects of Hytrin or Flomax, and was offered Avodart as an alternative. It sounded great, but caused immediate sexual side effects, which I put up with in hopes that they were temporary. When it became clear that they were not, I Googled "Avodart side effects", and saw a news group post suggesting PVP as clearly superior to meds in general. I had no idea what PVP was, and my research on it led me to this news group. My point in this story is that I have none of the benefit of the apparently long history of posts about the benefits of PVP and the "trivial" nature of retro. I'm still trying to figure out what's going on, so be gentle. I am now off the Avodart and in communication with a PVP urologist who wants to do a urodynamics test to see if my bladder has been damaged by my diabetes. He will also do a cystoscopy, then decide if I am a good candidate for the procedure. Per your suggestion, I will ask him about blood tests to see if insulin spikes are driving my BPH. Regarding retro, I can only assume that your blithe dismissal of my concerns are based on experience and not on your prior knowledge. Can you honestly say that you were completely unconcerned about retro before your PVP? Comforting as it is to hear from people with retro who are not bothered by it, I still think it is a normal and reasonable worry. Thanks again for all your good information, but I have to say that your caustic belittlement and sarcasm (seen more in other posts than in this one) detract from your helpfulness Point taken. And...apologies to go with that. Frustrating to see all the work done, and nobody reading the historical postings. Guys like Spread, Pete, Chockman, dr.Sanchez, Michael...took lots of their personal time to put up their posts. As well, all the internet stuff and good blogs out there such as http://bph-prostate-enlarged.blogspot.com/ (I see guys like Spread have checked out...likely out of frustration with the spin and lack of progress on this newsgroup!!) Hence my unforgiveable lack of patience. I'd like to see the above guys and newsgroup go way beyond simply answering the same old, same old. Those guys have the smarts, but are in a spin cycle answering questions answered a thousand times before. Again my apologies. ..Answer to your question...I said to hell with it once the meds started interfering with my lifestyle. I acknowledged possibility of retro was more important to be able to take a leak and to maintain a lifestyle than to wasted by the meds. Checked out a few sites on TURP and PVP and went looking for a PVP guy. > Bong, [SNIP]...but I have to say that your caustic belittlement and sarcasm (seen more in other posts than in this one) detract from your helpfulness Bong, Your point is taken as well. It's got to be frustrating to put a lot of time, effort, and emotional capital into a group and then have to deal with the same questions over and over from new guys. I'll check historical posts in the future. I've reached the same point you were at before your PVP -- I've had it with the meds, and a normal life is more important than worries about retro. I'm working on getting the PVP now. To Derek F - I am taking saw palmetto, and it helps some. I've been able to cut back, but not eliminate the Hytrin. And at their best, any of the pills offer only partial relief. I still have weak stream, occasional retention, and a good night is one where I only get up once to pee. Speaking of which, somebody (don't remember who) had a post on ibuprofin reducing urine output. I've tried one ibuprofin the last few nights and averaged a 4:00AM wakeup instead of my normal 2:30 or 3:00. I worry about the long term effects of the Ibu, but hope a PVP will make it unnecessary. Have you tried Saw Palmetto yet? It held my symptoms at bay for 10 years waiting for a miracle procedure (PVP) to replace TURP. I had my PVP in July of last year, gradual rather than instant benefit but now no urgency, decent flow, no retention and hours between voids. Have a browse here for historical NG postings on PVP http://tinyurl.com/7vnmx Derek. > Bong, > Thanks for your helpful input. I'm afraid I'm at the lower end of the [quoted text clipped - 25 lines] > sarcasm (seen more in other posts than in this one) detract from your > helpfulness |
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