I used to be a regular poster, but I sure don't see many posts of late.
Well, I've been having BPH problems for almost 10 years.
I've been on flomax and that has been the best medication I've ever had.
No side effects and it's been very effective.until about 6 weeks ago.
Since then my situation has gotten drastically worse. I've had great
difficulty urinating. I almost went to the hospital a couple of times
but didn't (not looking forward to getting catheterized).
Basically, right now, it is just very difficult. When urinating the
stream is VERY weak, and I'm clearly not emptying. Also, it feels
inflamed and irritated. It is often difficult to even get the stream
started. My family physician put me on cipro. I've been on it for 2
weeks but it hasn't helped much. I think it is more BPH than
prostatitis. My first question is: How do we know which it is? (I know
BPH can also cause prostatitis symptoms).
My urologist is Dr. Wei at Umich Hospital. He is 150 miles away but I
picked him because he does the laserscope (my research years ago
concluded that the PVP is the best way to go). Another reason I didn't
head to my local hospital was that I'd be on a catheter, desperate, and
have one of their urologists push TURP on me. (At least that was a
scenario I feared)
Anyway, they are squeezing me in for an afternoon appointment on Monday.
I haven't had a PSA for a year, but so far PSA's and DRE's have been
perfectly normal. So, my other question: I'm hoping they don't choose to
do a biopsy. But, do they automatically do a biopsy before doing the
laserscope? In fact, a more basic question: how do they determine that
BPH is the problem and laserscope is the solution? I assume the symptoms
kind of make that obvious? Finally, do they always do a cystoscopy?
Mel

===> hi mel,  allow me to throw you a curve ball here.

i was dx'ed with an enlarged prostate that was pushing up into the
bottom of my bladder, which was preventing me from emptying my bladder
each time.  they also said that this condition lends itself to UTI's,
which i only had one major one that i was aware of.

i was doing the things you are saying.  i remember the slow stream and
it didn't make any difference what i did or how hard i pushed,  the
stream wouldn't go any faster.

anyway, to make a long story short,  my psa was slightly elevated and it
triggered a biopsy, which they found prostate cancer.  

i opted for surgery and that was went i got the shock of my life.   who
would have ever thought that having prostate cancer would save my
life???

when they got inside,  they found that i had a 'finger' of BPH tissue
that had grown out from the prostate and was pushing into the bladder
wall causing the bladder wall to collapse over the output hole of the
bladder and that the surgeon said that i was about 6 months from total
rental failure.

i ask the surgeon how often this condition happens.....

he said that while it's not rare, it does happen.   i don't know what to
make of his answer, but that is what he said.

i only posted a response here to perhaps,  think outside the box on some
of the other reasons as to what could possibly cause problems.  

if i were to offer any suggestions,  my advice is to push it to get the
answers that you are seeking.

all the best,

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

Try catherizing yourself, whenever u feel the bladder is not
emptying.   Have started since 03/01/08, approx once weekly. and it
sure beats trips to the ER. I take no drugs, in spite  the insistence
of a few on pralt-discuss to take Avodart.  Ramón

Sounds stupid-but take a sitz bath-hot water cover legs in the bath tub -sit
in there for about 20 minues.. release in the tub if you feel the urge..this
should help you get a little relief