Prostate - Avodart and Uroxatral

Author

Avodart and Uroxatral

John Bishop

2004-10-04, 2:21 am

I have been reading posts from your newsgroup for several weeks. I am 60 and
have suffered from BPH for at least 20 years.

Tuesday, my urologist did a cystoscopy (I had one done about ten years
ago) and declared that my prostate was probably about 35cc in size, was not
growing into my bladder, no stricture observed, my bladder was fine (no
lesions, growths or other
abnormalities) and that we should continue to treat my condition medically.
I brought up Avodart and he recommended Uroxatral, and that the two could be
used in tandem.

(Had a urodynamics test about a year and half ago, and it indicated that my
bladder
function was good.)

I have tried Hytrin (5mg, no effect) and FloMax (had some relief but could
not tolerate the side effects). Have never tried Proscar. In short, I was
glad that he was not recommending surgery (he said that if my prostate were
his, he definitely would not), but have mixed feelings about a continued
drug regimen: cautiously optimistic, you might say

My problem is getting up five or more times a night. It is something I have
lived with, tolerated for all these years but find that my limit has been
reached. I am in reasonably good physical condition. Was running for about
25 to 30 minutes in the morning (to avoid the heat in Savannah) but stopped
last month when I was waking up tired and running was the last thing I'd
want to do. I miss it, but now that the weather is cooler, plan to start
again in the late afternoon.

I enjoy two beers and a glass of wine in the evening. Is that an excessive
fluid intake before bed?

Look forward to reading your responses.

Thanks.

JBB

Spread deMocracy

2004-10-04, 7:10 pm

Go see a therapist. If you meant that as a regular practice, 2 beers plus a
glass of wine EVERY night, then you meet the definition of an alcoholic.
Also, any alcohol or caffeine aggravates a prostate.

"John Bishop" <jbbishop@bellsouth.net> wrote in message
news:s6T6d.78777$as2.61047@bignews3.bellsouth.net...
>I have been reading posts from your newsgroup for several weeks. I am 60
>and
> have suffered from BPH for at least 20 years.
>
> Tuesday, my urologist did a cystoscopy (I had one done about ten years
> ago) and declared that my prostate was probably about 35cc in size, was
> not
> growing into my bladder, no stricture observed, my bladder was fine (no
> lesions, growths or other
> abnormalities) and that we should continue to treat my condition
> medically.
> I brought up Avodart and he recommended Uroxatral, and that the two could
> be
> used in tandem.
>
> (Had a urodynamics test about a year and half ago, and it indicated that
> my
> bladder
> function was good.)
>
> I have tried Hytrin (5mg, no effect) and FloMax (had some relief but could
> not tolerate the side effects). Have never tried Proscar. In short, I was
> glad that he was not recommending surgery (he said that if my prostate
> were
> his, he definitely would not), but have mixed feelings about a continued
> drug regimen: cautiously optimistic, you might say
>
> My problem is getting up five or more times a night. It is something I
> have
> lived with, tolerated for all these years but find that my limit has been
> reached. I am in reasonably good physical condition. Was running for about
> 25 to 30 minutes in the morning (to avoid the heat in Savannah) but
> stopped
> last month when I was waking up tired and running was the last thing I'd
> want to do. I miss it, but now that the weather is cooler, plan to start
> again in the late afternoon.
>
> I enjoy two beers and a glass of wine in the evening. Is that an excessive
> fluid intake before bed?
>
> Look forward to reading your responses.
>
> Thanks.
>
> JBB
>
>

Peter

2004-10-07, 7:10 pm

You shooting from the hip...
Two bears and a glass of wine does not mean by any standard that the person
is an alcoholic.
SEE http://alcoholism.about.com/cs/homework/a/blwhatis1.htm for more info
on the subject.
Peter

"Spread deMocracy" <Spread_deMocracy@hotmail.com> wrote in message
news:NnJ7d.29785$MD5.1611706@news20.bellglobal.com...
> Not god, just going by the info he provided. If you did any reading about
> alcoholism you may understand.

Roger

2004-10-12, 7:11 pm

rubbish

"Spread deMocracy" <Spread_deMocracy@hotmail.com> wrote in message
news:NnJ7d.29785$MD5.1611706@news20.bellglobal.com...
> Not god, just going by the info he provided. If you did any reading about
> alcoholism you may understand.

RUBBISH - and why hide behind a nonsense username like that?

>
>
> "redbeard" <redbeard419@msn.com> wrote in message
> news:8c6b2898.0410021537.702faeaa@posting.google.com...
>

John Bishop

2004-10-13, 11:10 am

OK. For the sake of eliciting some useful information (that's why I posted
originally), let's assume I am an alcoholic, currently in rehab (AA, that
is, gingerly doing the twelve step) and am off the booze. Would anyone care
to respond with their experience taking Avodart and Uroxatral?

Like most newsgroups, boards, etc., there resides here the usual mix of
humanity: from the humane to the insane.

JBB

"Roger" <rickgall@igs.net> wrote in message
news:bd-dnaO6fdY_zPHcRVn-jw@igs.net...
> rubbish
>
>
>
> "Spread deMocracy" <Spread_deMocracy@hotmail.com> wrote in message
> news:NnJ7d.29785$MD5.1611706@news20.bellglobal.com...
about[vbcol=seagreen]
>
> RUBBISH - and why hide behind a nonsense username like that?
>
>
>

XS11E

2004-10-13, 7:11 pm

"John Bishop" <jbbishop@bellsouth.net> wrote in
news:sKbbd.78701$yp.3440@bignews1.bellsouth.net:

> OK. For the sake of eliciting some useful information (that's why
> I posted originally), let's assume I am an alcoholic, currently in
> rehab (AA, that is, gingerly doing the twelve step) and am off the
> booze. Would anyone care to respond with their experience taking
> Avodart and Uroxatral?

I know nothing about them but doing a Google search it appears they are
almost the same as Proscar and Hytrin? FWIW I am taking those...

John Bishop

2004-10-13, 7:11 pm

Hytrin didn't work for me, and I've never tried Proscar. After only two
weeks, I can say that I'm seeing some relief.

What's your experience been?

JBB

"XS11E" <xs11eNO@SPAMyahoo.com> wrote in message
news:Xns95818121117EFxs11eyahoocom@68.6.19.6...
> "John Bishop" <jbbishop@bellsouth.net> wrote in
> news:sKbbd.78701$yp.3440@bignews1.bellsouth.net:
>
>
> I know nothing about them but doing a Google search it appears they are
> almost the same as Proscar and Hytrin? FWIW I am taking those...
>

Roger

2004-10-14, 10:09 pm

John Bishop

2004-10-15, 10:08 pm

Spread deMocracy

2004-10-17, 11:08 am

John, my apologies for my previous comment. You do have a solid point: my
comment was an over-reaction, insensitive and quite out of line. Since I
appear to be THE inhumane XXXXXXX who caused your postings to have stalled,
let me offer some comments in hopes stimulating others to dump their wisdom
and experiences in hopes of helping to get an answer to your question...

If your frequent visits to the washroom at night is something fairly recent
then my comments below may apply--in my non-medical opinion. I must admit
at the outset that I could not interpret the implications around the size of
your prostate based on the description of 35cc in your post. Much of what I
know of prostate size is based on an estimate of WEIGHT: 20 to 30 grams are
considered in the normal range. But let me continue. There are 4 reasons
for urinary urgency, that I am most aware of: 1-enlarged prostate,
2-obstructive prostate, 3-infection of prostate, or 4- irritation of the
prostate. Let me take these in reverse order:

4- Irritation: Things that MIGHT--in my nonmedical opinion-- irritate
prostate: coffee, hypertension, stress, and high blood glucose. You can
easily rule out blood glucose with a fasting blood test and hypertension
with a quick peek at your blood pressure. If you take blood pressure
readings while on the meds in "A" below, then your blood pressure might read
"normal" so, you have to factor around those meds since they might lower
blood pressure throughout the body and not just in the (lower part of the
body), the urinary tract.

3- Infection: Called PROSTATITIS, symptoms are frequent urination, possible
urinary tract irritation, possible burning on urination, BUT NOT
NECESSARILY. Hard to treat, takes a long time. Course of treatment is by
anti-biotics for both you and your intimate partner. Your uro would have
carefully ruled this out by asking you about the urinary burning and by an
uncomfortable prostate massage to extract prostate fluid to study it under a
microscope while you waited. If white blood cell count is up then he would
have prescribed about a 3 month course of anti-biotics for you and about 6
weeks for your partner...in my non-medical opinion. Since your uro has not
put you on anti-biotics, (not indicated in your post), we can then move on
to possibility number 2.

2- Obstructive prostate. Obstuction the uro looks for is the enlargement of
the median lobe or prostate growing into the bladder. You indicate in your
post that he found no obstructions. You are fortunate. So, the last
possibility would be a possible enlarged prostate, item #1.

1- Enlarged prostates are typically 70 grams or larger and that represents
about double the normal size. But some people do experience BPH symptoms
even if the Prostate has grown a wee bit larger than what they normally had
in the past. If so, then doctors MIGHT consider one of three things: a)-
relax the urinary tract with Alpha Blockers: Flomax, Hytrin, Cardura, or
Xatrol; b)-shrink the prostate with Proscar or Avodart; or c)-Surgery: TURP,
TUMT, or PVP--though they ought to want to consider surgery as a very, very
last resort.

A)- If a doctor thinks a prostate is enlarged, BUT IS NOT GROWING VERY
RAPIDLY then the doctor might offer Alpha Blockers--reduces lower body blood
pressure and allows urinary tract to relax. [By the way, referring to the
side effects you mentioned in your post: I also found that Flomax interfered
with my sports. What's more frustrating is my doctor didn't relate to
"getting my internal energy up to where it was". Merely suggested we switch
to Xatrol. Xatrol got rid of retro-ejactulation, but still, internal energy
is no where near as intense. ] Some guys can stay on Alpha blockers for
quite some time, if their DHT is not that high and therefore if their
prostates are not growing too quickly.

If your doctor felt your prostate was TOO LARGE then several options might
be considered:
B)- The Alpha Blockers to relax the urinary tract to let you have a wiz
while one of the 5-Alpha-Reductase Inhibitors (DHT inhibitor) is considered.
FDA approved DHT inhibitors include: PROSCAR or AVODART. Avodart is the
more recently approved med., but both are approved. DHT inhibitors work
VERY SLOWLY--many months, if they work at all, so some doctors combine the
Alpha Blocker with the DHT inhibitor to buy the patient time while the DHT
slowly kicks in. [I have never seen any publications indicating how long
one has to take the DHT inhibitors. I am assuming it has to be lifetime
since they only treat the symptoms and not the cause of high DHT. If DHT
is high, and one wants to get to the cause of high DHT one may have to do a
complete blood work up--see my posting for blood workup details. Getting at
the cause of high DHT may need a trip to the endocrinologist and about 6
vials of blood for the blood workup.] Studies talk about the efficacy of
this combined med therapy versus any one med alone. It makes sense. But
no longer term results cited if the meds are discontinued.

C)- If the above is not working, or if there is acute symptoms, then surgery
MIGHT be indicated. Like DHT inhibitors, surgery buys you time. If your
DHT is within normal range then, in my non-medical opinion, surgery may
provide long-lasting relief. I can't locate any evidence of the long-term
efficacy of surgery when DHTs are above normal ranges. If DHT is too high,
then likely the prostate will keep on growing and surgery may only provide a
few years of relief? If DHT is above normal high ranges, then maybe an
endocrinologist MIGHT be able to pin down the culprit.

Again, my apologies and I hope this posting gets others to offer you helpful
suggestions. Best of luck to you.

"John Bishop" wrote: I am 60 and have suffered from BPH for at least 20
years. Tuesday, my urologist did a cystoscopy ...prostate was probably
about 35cc in size, was not growing into my bladder, no stricture
observed, my bladder was fine.. tried Hytrin (5mg, no effect) and FloMax
....never tried Proscar. ... I was glad that he was not recommending surgery
....mixed feelings about a continued drug regimen...My problem is getting up
five or more times a night. I am in reasonably good physical condition.
....waking up tired and running was the last thing I'd > want to do.

XS11E

2004-10-17, 7:11 pm

"John Bishop" <jbbishop@bellsouth.net> wrote in
news:8Tgbd.3$rl3.2@bignews4.bellsouth.net:

> Hytrin didn't work for me, and I've never tried Proscar. After
> only two weeks, I can say that I'm seeing some relief.
>
> What's your experience been?

Hytrin = wonderful! It keeps me able to urinate at night. I can't
take much (5mg/day, 10mg works better but I had fainting spells and
hurt myself badly once) as it drops my BP too much (I'm taking it
primarily as a BP medicine).

Proscar = Good news, it shrank my prostate. Bad news, it didn't shrink
it much. Good news, it keeps it from growing more. Bad news, it's
already WAY too big.... :-(

Spread deMocracy

2004-10-19, 7:20 pm

John Bishop

2004-10-19, 10:10 pm

XS11E

2004-10-20, 2:08 am

XS11E

2004-10-20, 11:12 am

John McNerney

2004-10-23, 10:08 pm

On Thu, 30 Sep 2004 08:38:48 -0400, "John Bishop"
<jbbishop@bellsouth.net> wrote:

>
>I enjoy two beers and a glass of wine in the evening. Is that an excessive
>fluid intake before bed?
>
>Look forward to reading your responses.
>
>Thanks.
>
>JBB
>

I am a certified drug and alcoholism counselor. Consistency does not
define alcoholism; it is about behavior. In my working definiition, if
a person continuously behaves in a specific manner that (s)he knows is
harmful, that is addictive behavior. Vis, alcohol, drugs, gambling,
sex, whatever. Enough said about that.

I take both Hytrin 10mg and Avodart 0.5mg daily. I started the Hytrin
about 6 years ago at onset of symptoms, I'm 53. It provided wonderful
relief, and had little or no side effects, until about 18 months ago,
when it stopped being quite so effective. My Doc put me on Avodart. I
was expecting some effect within 6 to 12 months, but like you, in just
two weeks I did notice some effect.

My annual follow up showed a reduced prostate, from about 75g to about
50g. Not great - but good enough that I sleep all night... IF I do not
take coffee or caffeinated beverages after about 4pm or 5pm.

My response to John is this: Knowing that this alcohol *might* be
causing some of your discomfort - and not knowing any other alcohol
related behaviors - why don't you try an experiment. Don't drink any
alcohol for two weeks, see if in fact it might be at least partially
responsible. If so, then to continue your nightly constitutional would
meet my working definition, see 1st paragraph.

Recently, my Doc has suggested we stop the Hytrin. Brother, I got a
formula that is working, I don't want to mess with it. But maybe I
will try reducing the dosage at my next annual follow up. Avodart is
working for me - although I have developed a slight case of man boobs,
which I am working on at the spa. They are not pronounced enough to
cause me great concern... Yet. And it seems their development has
slowed or stopped after the initial growth spurt of about 3 to 6
months after starting the Avodart. So I'm hopeful. -John-

Spread deMocracy

2004-10-24, 2:09 am

John McNerney

2004-10-29, 7:16 pm