May be the end of the line on gear for me. Having LUTS saw the urologist and he said my prostate is enormous.

[eryximachus]

So I had my ultrasound done and my prostate is not enlarged. It's 28cc. I don't know wtf is going on. No infection either. He's prescribing an alpha blocker.

Be very careful. Flomax is proven to cause cognitive decline. It was a contributing factor for my father experiencing mild cognitive impairment in his 70s. The technical definition is not what most people think as "mild". It's 1 full standard deviation below the mean for general intelligence.

It ultimately destroyed his quality of life and caused him to make some profoundly stupid decisions.

 

[readalot]

Be very careful. Flomax is proven to cause cognitive decline. It was a contributing factor for my father experiencing mild cognitive impairment in his 70s. The technical definition is not what most people think as "mild". It's 1 full standard deviation below the mean for general intelligence.

It ultimately destroyed his quality of life and caused him to make some profoundly stupid decisions.

My read was alfuzosin a better choice. Still, long term you are probably screwed with alpha blocker and finasteride. Dose response, etc. I understand.

Sorry about your Dad.

 

[Tonythelip]

Be very careful. Flomax is proven to cause cognitive decline. It was a contributing factor for my father experiencing mild cognitive impairment in his 70s. The technical definition is not what most people think as "mild". It's 1 full standard deviation below the mean for general intelligence.

It ultimately destroyed his quality of life and caused him to make some profoundly stupid decisions.

Actually it’s even more worse than that. Studies conclusively linked flomax to dementia in older men.

 

[jtmarlin]

When he felt it yesterday he said he suspected it to be 60-80 which is enormous. I don't understand. 20-25 is normal for a young man but I'm 43 and on 600mg of androgens right now so I will take 28.

So I had my ultrasound done and my prostate is not enlarged. It's 28cc. I don't know wtf is going on. No infection either. He's prescribing an alpha blocker.

So apparently he was correct on the DRE and my prostate was 50-60cc. Turns out the ultrasound tech got things wrong. The only reason I know that is that I went back for a followup void-test after all of my nocturia was gone (it was related to my contest diet and it resolved as soon I began eating eating normally again I shit you not - I don't even wake up once now for weeks after waking 5-6 times a night). I'm still holding residual urine after peeing... in the 200mL range. I went to a different urologist based on my wife's insistence and he ordered another ultrasound and did his own DRE (guessed 50-60cc NOT 28cc like the previous ultrasound showed) and the ultrasound done at a well regarded hospital showed 51cc on the pelvic ultrasound. I went in with 800mL in my bladder and peed 3 times in 15 minutes and still had 200+mL left. I didn't even know it. My flow test was terrible at 3ml/s.

So I am getting a cystoscopy next week to see and urodynamics. He seems to think given my age early 40s and history off off and on chronic prostatitis like issues for the past 15 years that this may be more than just prostate and some sort of primary bladder obstruction. I asked if I should stop androgen therapy and he say no we aren't there yet. We talked about testosterone etc and prostate and he said the relationship between androgens and DHT is murky at best when it comes to prostatic issues.

I've been on alfuzosin (I was taking it for the terrible flow test of 3) so it obviously isn't doing shit either which means it may not be prostate. Will know more after the cystoscopy I assume. The only thing that seems to take the edge off is naproxin.

 

[eryximachus]

Hang in their brother. Keep us updated with your progress. We're rooting for you!

 

[jtmarlin]

Hang in their brother. Keep us updated with your progress. We're rooting for you!

The craziest thing is that I would have never even known that I was retaining urine after peeing until it became a major major problem if I didn't have this voiding test... as I had zero idea.

 

[jtmarlin]

Hang in their brother. Keep us updated with your progress. We're rooting for you!

Had a cystoscopy last week and it's definitely an obstruction caused by prostatic enlargement of some kind. Also, my bladder muscles have developed against the obstruction (the prostate) in a bad way.

We are doing 3 weeks of bactrim + celebrex to see if it helps (that's best case it is prostatitis which I know deep down it is not). I'm seeing the men's health partner in the office who trained under Lipschultz mid-month to discuss whether coming off of testosterone therapy, starting finasteride, or some combo of both is the next step.

Surgery was mentioned but not there yet. I'm just wondering if I go hypogonadal again all of my LUTS problems will be solved. Crazy thing is my PSA pre TRT was 2 and it has stayed 2 for 5+ years on TRT plus cycling as high as 600 test/400 primo once. I have read that a certain area of the prostate the stromal part can grow without increasing PSA so perhaps thats where we are.

Has ANYONE out there had a prostate VOLUME measurement done on cycle and then off cycle and noticed a difference? I had an old scan done in 2010 and my prostate volume was 25cc which means that my prostate has doubled in size in 15 years. I spent 10 of those years with a total t of 300. Again I'm only 44 years old.

 

[Ghoul]

Had a cystoscopy last week and it's definitely an obstruction caused by prostatic enlargement of some kind. Also, my bladder muscles have developed against the obstruction (the prostate) in a bad way.

We are doing 3 weeks of bactrim + celebrex to see if it helps (that's best case it is prostatitis which I know deep down it is not). I'm seeing the men's health partner in the office who trained under Lipschultz mid-month to discuss whether coming off of testosterone therapy, starting finasteride, or some combo of both is the next step.

Surgery was mentioned but not there yet. I'm just wondering if I go hypogonadal again all of my LUTS problems will be solved. Crazy thing is my PSA pre TRT was 2 and it has stayed 2 for 5+ years on TRT plus cycling as high as 600 test/400 primo once. I have read that a certain area of the prostate the stromal part can grow without increasing PSA so perhaps thats where we are.

Has ANYONE out there had a prostate VOLUME measurement done on cycle and then off cycle and noticed a difference? I had an old scan done in 2010 and my prostate volume was 25cc which means that my prostate has doubled in size in 15 years. I spent 10 of those years with a total t of 300. Again I'm only 44 years old.

Not an answer to your question, but consider yourself lucky to be having this issue now vs just a decade ago.

There are a bunch of very safe advanced procedures that can eliminate obstructions using, basically, a medicated balloon that splits the prostate lobes, completely avoiding the older operations that had a high risk of causing nerve damage, incontinence etc. All quick outpatient operations.

No one wants surgery ofc. but know it's no longer the nightmare you probobly heard about in past years. Good luck.

 

[jtmarlin]

Not an answer to your question, but consider yourself lucky to be having this issue now vs just a decade ago.

There are a bunch of very safe advanced procedures that can eliminate obstructions using, basically, a medicated balloon that splits the prostate lobes, completely avoiding the older operations that had a high risk of causing nerve damage, incontinence etc. All quick outpatient operations.

No one wants surgery ofc. but know it's no longer the nightmare you probobly heard about in past years. Good luck.

Yes I did do research on the different surgical methods. We aren't there yet, but if I'm advised to get it sooner (ie:if my bladder is becoming irreversibly damaged), I'll go down that path.

 

[Liter O' Test]

I had prostate problems at a young age while only on TRT.
it was definately caused by high estrogen. I didn't realize it was a prostate problem until I went on blast, kept my estrogen in range and started taking dutasteride to mitigate all the extra DHT that all my urinary problems stopped in like two months. I stopped the dutasteride like 6 months later and I haven't had any problems since but this is a good reminder to get my PSA checked.

 

[jtmarlin]

I had prostate problems at a young age while only on TRT.
it was definately caused by high estrogen. I didn't realize it was a prostate problem until I went on blast, kept my estrogen in range and started taking dutasteride to mitigate all the extra DHT that all my urinary problems stopped in like two months. I stopped the dutasteride like 6 months later and I haven't had any problems since but this is a good reminder to get my PSA checked.

My estrogen has always been controlled on TRT bc I have either used low dose test, test + primo, or test + ai. I run my e2 mostly between 20 and 40. I will be interested to see if the men's health urologist suggests staying on T and adding finasteride/dutasteride to my alfuzosin. Can finasteride be titrated like anastrozole for e2 or is it kind of all or none for DHT? I'm just a bit scared of the sides. I'd almost rather go off gear than stay on and use fina.

As for my PSA, mine has been stable for years on or off TRT yet my prostate seems to have grown and my LUTS is off the charts.

 

[Liter O' Test]

My estrogen has always been controlled on TRT bc I have either used low dose test, test + primo, or test + ai. I run my e2 mostly between 20 and 40. I will be interested to see if the men's health urologist suggests staying on T and adding finasteride/dutasteride to my alfuzosin. Can finasteride be titrated like anastrozole for e2 or is it kind of all or none for DHT? I'm just a bit scared of the sides. I'd almost rather go off gear than stay on and use fina.

As for my PSA, mine has been stable for years on or off TRT yet my prostate seems to have grown and my LUTS is off the charts.

you could dial in finasteride/dutasteride by measuring dht serum, but the dht content in tissue is another story but atleast you could determine its not completely crashed for your own peace of mind. I think is something you probably have to go by "Feels" with and see how your urinary symptoms improve. but for me, it was 100% estrogen related or maybe even prolactin who knows, but I got improvement from dutasteride after increasing from TRT to 1500mg

 

[malfeasance]

Be very careful. Flomax is proven to cause cognitive decline. It was a contributing factor for my father experiencing mild cognitive impairment in his 70s. The technical definition is not what most people think as "mild". It's 1 full standard deviation below the mean for general intelligence.

It ultimately destroyed his quality of life and caused him to make some profoundly stupid decisions.

Actually it’s even more worse than that. Studies conclusively linked flomax to dementia in older men.

One standard deviation is 15 IQ points.

I will just say that even a brief search shows that there is nothing "conclusive" about the studies.

In fact, they are inconclusive, and there is a lot of disagreement.

The impact of tamsulosin on cognition in Alzheimer disease with benign prostate hyperplasia: A study using the Hallym Smart Clinical Data Warehouse - PubMed

Studies suggest that the use of alpha-blockers increases the risk of dementia in patients with benign prostate hyperplasia (BPH). Due to study limitations, the relationship between the use of alpha-blockers, such as tamsulosin, and the risk of dementia is still unclear. However...

pubmed.ncbi.nlm.nih.gov

"After propensity score matching, clinical characteristics such as educational attainment and vascular risk factors were similar in the tamsulosin and no-medication groups. The MMSE scores did not differ significantly between the tamsulosin and no-medication groups (P = .470).The results suggest that tamsulosin for BPH is not associated with worsening of the cognitive decline in patients with AD."

 

[malfeasance]

How to Read a Research Paper: An Exercise in Critical Thinking in the Context of an Epidemiologic Study on Tamsulosin and the Risk of Dementia

Tamsulosin, used to treat benign prostatic hyperplasia, was associated in a recent study with an increase in the risk of incident dementia. In this installment of his column, Dr Andrade uses that study as a point of departure to show ways in which readers can think more critically about study...

www.psychiatrist.com

Not a bad read if you have the intelligence, patience, and focus to pay attention diligently all the way through.

 

[jtmarlin]

I am 20 years older than OP and have a long history of an enlarged prostate. Competitive bodybuilding was, I am sure, the cause. I was scheduled for a TURP with my urologist but got a second opinion and he thought it could be managed with Finasteride. I was already taking Alfuzosin but not being able to pee.

Fortunately after 7 weeks the Fina seems to be working and I can pee fairly well most of the time. I am def not going to get the TURP, a fairly major procedure.

I also keep my test under 200 mgs/week.

Did you have any issues on finasteride? I switched from alfusozin to silosodin and it was like night and day, I could pee. I do get retrograde ejaculation. I stopped TRT last week and have been on HCG only and see the men's health uro next week to discuss what to do next (TRT+finasteride, run hypogonadal for awhile, stay on HCG monotherapy).

THe thing I find crazy is the testosterone defenders you see on a lot of TRT boards. Testosterone is beter for this this and this as cholesterol goes to shit and your prostate grows twice as fast. At least that's my case seemingly. I can't blame testosterone nor AAS blindly but my prostate doubled in size in 15 years. I had an old test I came acroiss from 15 years ago when I was battling so called "prostatitis" but it may very well have been prostatic irritation due to anabolics. I was natty for 10 years after that.

Also if I run 200mg of test split daily my total testosterone will be 2000+.



The update on this is that I'm getting a video urodynamics test shortly so we will know EXACTLY what the problem is and if my bladder is irreversibly damaged. Thats one of the biggest issues with this is that the bladder ends up destroyed and non functional from all of the straining due to obstruction. I already have signs of bladder damage based on the cystoscopy.

 

[MrTexas2]

Did you have any issues on finasteride? I switched from alfusozin to silosodin and it was like night and day, I could pee. I do get retrograde ejaculation. I stopped TRT last week and have been on HCG only and see the men's health uro next week to discuss what to do next (TRT+finasteride, run hypogonadal for awhile, stay on HCG monotherapy).

THe thing I find crazy is the testosterone defenders you see on a lot of TRT boards. Testosterone is beter for this this and this as cholesterol goes to shit and your prostate grows twice as fast. At least that's my case seemingly. I can't blame testosterone nor AAS blindly but my prostate doubled in size in 15 years. I had an old test I came acroiss from 15 years ago when I was battling so called "prostatitis" but it may very well have been prostatic irritation due to anabolics. I was natty for 10 years after that.

Also if I run 200mg of test split daily my total testosterone will be 2000+.



The update on this is that I'm getting a video urodynamics test shortly so we will know EXACTLY what the problem is and if my bladder is irreversibly damaged. Thats one of the biggest issues with this is that the bladder ends up destroyed and non functional from all of the straining due to obstruction. I already have signs of bladder damage based on the cystoscopy.

I have been pretty good on Finasteride. I inject 160 mgs of test weekly and then take a little test und. powder when I need a lift, usually 6 days after my shot.

So I am keeping my test intake under 200 mgs/week.

 

[Ateam2023]

I have been pretty good on Finasteride. I inject 160 mgs of test weekly and then take a little test und. powder when I need a lift, usually 6 days after my shot.

So I am keeping my test intake under 200 mgs/week.

what do you mean " take a little test und powder"? Dry scooping test und powder is a thing now, damn i been doing it alll wrong

 

[MrTexas2]

what do you mean " take a little test und powder"? Dry scooping test und powder is a thing now, damn i been doing it alll wrong

Testosterone undecanoate powder. When injecting only 160 mgs of test/week I am really feeling the drop off 6 days later so the TU power helps me fine tune things when I need a bit of a lift.

 

[Ghoul]

Testosterone undecanoate powder. When injecting only 160 mgs of test/week I am really feeling the drop off 6 days later so the TU power helps me fine tune things when I need a bit of a lift.

How do you use the powder?

 

[MrTexas2]

How do you use the powder?

People will laugh but I just dip a wet finger in and take a little that way. Been doing so for a long, long time.