Guys,

What a great resource! Most guys here seem more knowledgeable than the doc's I've dealt with.

-I'm 30 yrs old, progressively worse "classic" BPH symptoms since 26. IE Nocturia (2-3 times a night), frequency, difficulty starting, weak flow, reduced capacity (usually when I go it's only 100-150 cc)
-psa .4
-Urine tests neg for infection
-Cystoscopy normal, no blockage observed
-kidney ultrasound normal
-urologist says prostate not enlarged.
-High sexual function. Have not been tested but could this indicate high DHT?
-Have done 1 short course of cipro (15 days) to no effect.

Saw one urologist, he did the cysto and after observing no objective evidence for any of this he is diagnosing interstitial cycstitis and BPH, even after saying my prostate was normal and not seeing anything on the cycsto. He gave me urotraxal but I can't take it as it will remove me from flight status.

Any ideas much appreciated!

Whidbey

Whidbey, in the absence of infection, obstruction or prostate enlargement it sounds like a bladder neck contracture, where the passage between the bladder and prostate is restricted and fails to open properly for voiding. It's like a tight rubber band that will not stretch. If that is the problem, the only solution of which I'm aware is a fairly simple surgery to slice the bladder neck and let it grow back correctly. I had this procedure done about three years ago at age 57 and have had zero problems since. The procedure will take you off flight status for a couple of weeks, but not long-term like the drugs will.

BTW, if your Docs prescribe Avodart or Flomax, be prepared for some serious sinus problems and having to clean a lot of snot off your O2 mask. Another likely med will be Pyridium (pyridoxine), a mild analgesic that turns your urine bright orange and causes staining that WILL NOT come out of any fabric. In that case, swallow your pride and either use panty liners or Depends (adult diapers) while you are taking the stuff.

Please let us know how it goes, eh?

Aardvark,

Did you have the bladdder neck contracture after another procedure? Everything I could find online listed it as a side effect of prostatectomy. By no problems after the procedure, do you mean you got back to 100%? Or was it a smaller improvement in your urinary function? Is there a typically high success rate and minimal risk with the procedure? IE I'm not ready at 30 to start strapping on the depends for the rest of my life if something like this went awry.

Sounds interesting- you know a symptom of mine I havn't thought to tell the docs about is that it feels like those muscles will sort of spaz out and contract on their own. My symptoms are worse after sexual activity, it really feels like those muscles that tighten up when you have intercourse just won't let go for some time.

Any other info or ideas would be much appreciated!

Whidbey

W --

Yes, the bladder neck contracture was about 10 months after a transurethral resection of the prostate (TURP) for BPH. My prostate was reduced in size from the inside, i.e. hollowed out somewhat, but not removed. And yes again, urinary function returned to 100%. Just two nights ago I slept for nine hours straight. How many 60-year-old men can say that? Probably I would sleep that long every night if my six cats would let me.

If performed by an experienced Urologist the risk is minimal to non-existent. Should you be anywhere near Bethesda I can vouch for the Navy Surgeons there who repaired an inguinal hernia for me. Not to be disloyal to my former service, but given the choice you're far better off with the Navy medical system than with the guys in the green suits.

My reference to Depends was only for the few days following surgery, while the pyridium is in your system. If that stuff gets on your shorts or dress whites, you might as well toss them overboard, because the orange stain WILL NOT come out. Otherwise, everything should be back to normal within a couple of weeks -- ejaculatory function even sooner, because the bladder is not involved in orgasmic prostatic spasms.

BTW, I conferred this morning with my Urologist, who concurs that some sort of stricture must be involved in your case, and at your age the most likely location is the bladder neck. Just in case your Navy Docs question why the cystoscope passed through, sometimes the bladder neck will relax on its own and sometimes it won't. If you recall any resistance at all when the scope was passing through either the prostate or bladder neck, then one or the other -- or both -- are constricted. It was also suggested that you have an ultrasound done on your prostate, because irregular prostate enlargement from BPH may be undetectable via either urethral or digital examination. Better indicators are the actual size and weight of the prostate.

One more suggestion -- since sphincters are muscles and you might just be having a "cramping" problem, try taking magnesium and calcium supplements (1 mg of magnesium for every 2 mg of calcium) for a week or so and see if your voiding frequency returns to normal. Try about 500 mg of magnesium and 1,000 mg of calcium twice daily to start out. If simple cramping is the cause of stricture, you'll recognize the improvement within a few days. A quicker way to find out whether cramping is the culprit is to drink a couple of gin & tonics every night (or when off-duty) for a few days. Either the quinine in the tonic water will provide relief almost immediately or it won't. Of course, you might also skip the gin if you (or your Skipper) prefer.

Go get 'em, Tiger.

Aardvark,

Great gouge. Please check your PM's.

Whidbey

Done. Reply enroute.

Hi Whidbey, are you stationed at Whidbey Island? I'm an old Marine pilot. I've had some of your problems but they now seem to be under control. I never had the Nocturia but I did have the other symptoms. My prostate is enlarged, but that's to be expected at my age, 69 in a few weeks. What seems to really have helped me is Terazosin (Hytrin). It has the added benefit of making me sleep like a baby.

I've also started taking Ultra Natural Prostate with 5-LOXIN and Standardized Lignans, from Life Extension Foundation. Best price at HealthMegaMall.

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