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Medical Forum / Diseases and Disorders / Prostate BPH / December 2003

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BPH Quest's.  Also re Doxazosin

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Robert11 - 27 Dec 2003 15:25 GMT
Hello:

Have recently been diognosed as having bph.
Very confused about it, and if anyone might have a spare minute or so, would
be most appreciative for any clarifications, etc.

Am very confused over what bph is, and isn't.

My problem is the fairly typical one of having to urinate several
times during the night.  My doctor says I have a "slightly" enlarged
prostate.

   My only problem is the nightly frequency.
  (amount, total emptying of, stream, etc. seem fine)

So, let me please ask the following.

a.  Is my condition bph, or is bph when you have trouble emptying bladder,
poor stream, etc.

b.  is doxazosin or Proscar possibly indicated for me ?

    One of the medical web sites has the following for doxazosin:
           indicated for the treatment  of both the urinary outflow
obstruction and obstructive and
           irritative  symptoms associated with BPH: obstructive symptoms
(hesitation,
           intermittency, dribbling, weak  urinary stream, incomplete
emptying of the bladder) and
           irritative symptoms (nocturia, daytime frequency, urgency,
burning)"

What confuses me is their definition of bph.  Can I have bph, and still not
have outlow type
problems ?  It's only the nightly freq. that i seem to have (so far)

c.  Told me to take Saw Palmetto.  Seem worthless, at least for me.
     Have others had good results with ?
     Is it supposed to actuall shrink prostate; how does it work ?

Much thanks,
Bob
bnd777 - 27 Dec 2003 19:54 GMT
> Hello:
>
[quoted text clipped - 40 lines]
>
> Would suggest your problem is fairly early on and yes Saw Palmetto or a
really good Homeopath should be able to restore status quo
If things get worse and go down full BPH route then probably nothing will
work and you will need to consider PVP
Richard Hughes, M.D. - 27 Dec 2003 21:38 GMT
> Hello:
>
[quoted text clipped - 38 lines]
> Much thanks,
> Bob

Dear Bob,

When I refer to bph, I describe it as either symptomatic or
asymptomatic. A significant percentage of men with enlarged prostates
are asymptomatic. On the other hand, many men with severe voiding
dysfunction can have normal or small prostates.  Urology residents
learn this fact early on. Symptomatic bph patients can have either
obstructive symptoms (slow stream, hesistancy, sensation of incomplete
emptying,...) or irritative symptoms (frequency, urgency,
nocturia,...).  Obstructive symptoms result from the prostate blocking
urine flow, while irritative symptoms result from the secondary
effects of blockage on the bladder--a thickened bladder that becomes
overactive.  Every patient presents differently.

You only complain of nightime frequency (nocturia); is it in small
volumes?, are you having any trouble voiding?  As people age nocturia
becomes more common in men and women. Nocturia is often a normal part
of aging and not related to bph.

You may well have symptomatic bph, but I would first do a uroflow and
bladder scan for post-void urinary residual.  If you have a good
flow,and empty your bladder, then I wouldn't put you on flomax or
proscar.  On the other hand, if you have a poor flow and increased
residual, I would start you on flomax, and proscar if your prostate
were enlarged.

Sincerely,

Dr. Hughes
 
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