For about 15 years I have had symptoms off and on (long duration mild burning post ejaculate mainly) which my previous urologist chalked up to chronic non bacterial prostatitis. We'd use bactrim and an NSAID and the problem would maybe go away on its own maybe not over the years. I started TRT 5 years ago and seemed like my symptoms were completely cured until about 6 months ago - after a self prostate massage ( I have done this before over the years but may have been too aggressive this time).
I had some further testing done and have BPH. I'm 44 years old and my prostate measured 51 grams on an ultrasound (which is pretty enlarged for my age or any age). I had a cystoscopy yesterday and my bladder has developed against the pressure of obstruction from the prostate to the point where I retain about 200mL of urine every time. I've been on Alfuzosin and it isn't doing anything. My flow test showed 3.6 average flow which is terrible. I double/triple pee, have urgency (which is new since the prostate massage), and my frequency is off the charts. I do not have nocturia.
My urologist told me not to stop TRT when I asked. I thought about just going hypogonadal for 3-6 months to see if this fixes the issue but based on what I have been reading about saturation theory and prostate, it probably wouldn't matter. This combined with the previous flare that I had before this 5+ years ago was BEFORE I began TRT and was hypogonadal. I'm just throwing another round of bactrim and an NSAID at it along with beginning pelvic floor therapy but the urologist is hinting at the eventual need for surgery although he says I'm a bit young for it whatever that means. I'm also taking pygeum and saw palmetto but they don't seem to help either and have been on 5mg of cialis for years. He offered finasteride but I declined. Any ideas?
Also my PSA has remained stable over the last 5 years on TRT at 1.7 - 2 and my DRE was normal outside of enlargement and some tenderness.
I had some further testing done and have BPH. I'm 44 years old and my prostate measured 51 grams on an ultrasound (which is pretty enlarged for my age or any age). I had a cystoscopy yesterday and my bladder has developed against the pressure of obstruction from the prostate to the point where I retain about 200mL of urine every time. I've been on Alfuzosin and it isn't doing anything. My flow test showed 3.6 average flow which is terrible. I double/triple pee, have urgency (which is new since the prostate massage), and my frequency is off the charts. I do not have nocturia.
My urologist told me not to stop TRT when I asked. I thought about just going hypogonadal for 3-6 months to see if this fixes the issue but based on what I have been reading about saturation theory and prostate, it probably wouldn't matter. This combined with the previous flare that I had before this 5+ years ago was BEFORE I began TRT and was hypogonadal. I'm just throwing another round of bactrim and an NSAID at it along with beginning pelvic floor therapy but the urologist is hinting at the eventual need for surgery although he says I'm a bit young for it whatever that means. I'm also taking pygeum and saw palmetto but they don't seem to help either and have been on 5mg of cialis for years. He offered finasteride but I declined. Any ideas?
Also my PSA has remained stable over the last 5 years on TRT at 1.7 - 2 and my DRE was normal outside of enlargement and some tenderness.
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