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

[Ateam2023]

Well I'm in my mid 40s so I think I would have to have my head in the sand to think this was "going to happen anyways" by this age. I've got very little doubt that my gear use has contributed to this. I may also have some sort of additional problem as this began in my late 20s. I don't know. When I started using gear 15-20 years ago everyone was using large amounts of testosterone. The standard beginner cycle was 500mg of testosterone per week. Looking back, I probably would have gone a different route and avoided all of that DHT. I didn't know any better. I didn't touch gear for 10 years and had some prostate flares which were dubbed chronic prostatitis by my uro (but it was most likely the beginnings of my current issues). I started TRT again 5 years ago and have cycled a little during that time. Pretty sure my cycling days are done.

well you don't have to "cycle" , just do Trt and if possible hgh , if you have built any kind of legit muscle in your lifetime, you can at least stay "optimized" with smaller doses and maintain a decent physique,

 

[SnowyMiami]

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.

Did you end up having optilume done?

 

[SnowyMiami]

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.

PSA usually stays the same for BPH.

 

[SnowyMiami]

Be careful with Prostatic Artery Embolization (PAE). It's being touted as the latest miracle treatment for BPH. It can mess with ejaculation which could be a big problem if you want kids.

Ejaculatory disorders after prostatic artery embolization: a reassessment of two prospective clinical trials - PubMed

Although anejaculation occurs less frequently after PAE (16%) compared to TURP (52%), patients have to be informed about the relevant risk of ejaculatory disorders, especially diminished ejaculation.

pubmed.ncbi.nlm.nih.gov

There really is no fantastic solution for BPH. The drugs do little and the physical interventions have big drawbacks. The final solution is HOLEP which just cores out the entire prostate. Say goodbye to nutting and decent erections after.

 

[jtmarlin]

Did you end up having optilume done?

I have had nothing procedural yet. My urologist was not convinced that it was my prostate vs some sort of bladder neck issue independent of prostate.
We will talk today about my options.

His recommendations were pelvic floor therapy, alpha blocker, finasteride. I am on silodosin but have refused finasteride. The strange thing about my issues is that they get WAY WAY worse if I have sex. I dropped my testosterone completely for a month and didn't have any sexual activity for 3 weeks and I pissed seemingly fine (I was ready to just pack it all in and live hypogonadal). Resumed TRT at the INSISTENCE of my urologist, started getting horny again and having sex and masturbating regularly and I can barely piss.

Thing is, I CAN live like this. I have no nocturia. I sleep straight thru the night. My bladder is still ok but is showing signs of stress (mild trabeculation), a small wide mouth pouch is forming. But my bladder musculature is ok. No UTI, no stones, no kidney damage but I do retain about 200ml of urine every test.

 

[CarvinDC125]

Well I'm in my mid 40s so I think I would have to have my head in the sand to think this was "going to happen anyways" by this age. I've got very little doubt that my gear use has contributed to this. I may also have some sort of additional problem as this began in my late 20s. I don't know. When I started using gear 15-20 years ago everyone was using large amounts of testosterone. The standard beginner cycle was 500mg of testosterone per week. Looking back, I probably would have gone a different route and avoided all of that DHT. I didn't know any better. I didn't touch gear for 10 years and had some prostate flares which were dubbed chronic prostatitis by my uro (but it was most likely the beginnings of my current issues). I started TRT again 5 years ago and have cycled a little during that time. Pretty sure my cycling days are done.

Yeah I am 41 and outside of running one cycle of just winstrol (lulz) when I was 19 I am just now considering running gear. I am no stranger to HGH and pro hormones but decided early in my first cycle of gear would be in my 40s when my T starts declining naturally.
I am considering starting my very first real cycle in November. Likely just going to be 300mg a week test C.
Many of my gym mates laugh at me for waiting so long but now I’m just getting started and they are having to come off.
Of course they have enjoyed the wonderful eye candy benefits for years and at 41 I’m not sure I could ever get myself looking te same as someone who’s in their 20s on gear, but I’m sure I will look better at 41 on gear rather than off it lol.
I worked at Golds gym in my 20s and it’s a miracle I managed to not hop on for so long, but I took the advice of a 50 year old body builder that looked just incredible! He said you get 25 good years on gear, after that it’s nothing but side effects. He said it’s better to start in your 40s and look better than 99% of others your age, then start in your 20s when you already look great and end up spending your 50s and beyond broken down.

 

[jtmarlin]

Yeah I am 41 and outside of running one cycle of just winstrol (lulz) when I was 19 I am just now considering running gear. I am no stranger to HGH and pro hormones but decided early in my first cycle of gear would be in my 40s when my T starts declining naturally.
I am considering starting my very first real cycle in November. Likely just going to be 300mg a week test C.
Many of my gym mates laugh at me for waiting so long but now I’m just getting started and they are having to come off.
Of course they have enjoyed the wonderful eye candy benefits for years and at 41 I’m not sure I could ever get myself looking te same as someone who’s in their 20s on gear, but I’m sure I will look better at 41 on gear rather than off it lol.
I worked at Golds gym in my 20s and it’s a miracle I managed to not hop on for so long, but I took the advice of a 50 year old body builder that looked just incredible! He said you get 25 good years on gear, after that it’s nothing but side effects. He said it’s better to start in your 40s and look better than 99% of others your age, then start in your 20s when you already look great and end up spending your 50s and beyond broken down.

It's impossible to know if you will get the same side effects due to age as everyone else hopping off of gear. When you are 27, using 300mg of test affects you quite differently than when you're in your 40s. Only one way to find out.

 

[CarvinDC125]

It's impossible to know if you will get the same side effects due to age as everyone else hopping off of gear. When you are 27, using 300mg of test affects you quite differently than when you're in your 40s. Only one way to find out.

For sure!
Everyone is different

 

[jtmarlin]

Be careful with Prostatic Artery Embolization (PAE). It's being touted as the latest miracle treatment for BPH. It can mess with ejaculation which could be a big problem if you want kids.

Ejaculatory disorders after prostatic artery embolization: a reassessment of two prospective clinical trials - PubMed

Although anejaculation occurs less frequently after PAE (16%) compared to TURP (52%), patients have to be informed about the relevant risk of ejaculatory disorders, especially diminished ejaculation.

pubmed.ncbi.nlm.nih.gov

There really is no fantastic solution for BPH. The drugs do little and the physical interventions have big drawbacks. The final solution is HOLEP which just cores out the entire prostate. Say goodbye to nutting and decent erections after.

I had my call with him today and he advised something procedural. He said that my bladder will fail and this isn't a quality of life issue. He recommended urolift and mentioned optilume an d is going to put me in touch with his colleague who worked on the optilume clinical trials. He had a discussion with the IR doctor who does PAE at the hospital and the PAE guys who has done 1000s told him that I am not a good candidate based on prostate size and age.

For now I am leaning towards urolift.

 

[CarvinDC125]

I had my call with him today and he advised something procedural. He said that my bladder will fail and this isn't a quality of life issue. He recommended urolift and mentioned optilume an d is going to put me in touch with his colleague who worked on the optilume clinical trials. He had a discussion with the IR doctor who does PAE at the hospital and the PAE guys who has done 1000s told him that I am not a good candidate based on prostate size and age.

For now I am leaning towards urolift.

Bro I am so sorry this is happening to you.
I really do wish you the best.
Am I right in thinking you have been somewhat dealing with this for around 15 years or so and it just now is becoming a major problem?

 

[jtmarlin]

Bro I am so sorry this is happening to you.
I really do wish you the best.
Am I right in thinking you have been somewhat dealing with this for around 15 years or so and it just now is becoming a major problem?

Yes. I didnt realize anything was really that wrong until recently. I was dieting for a contest and I must have had something wrong with my carbohydrate storage/water balance system bc I was waking up 5-6 times every night to piss during prep. Went to urologist and he said my prostate was enlarged and I was retaining urine. After the show I began eating normally and my nocturia went back to zero which is my baseline so I thought I was fine. I went in for a follow up and was still retaining lots of urine after peeing. Then I started getting additional testing and it showed how bad my obstruction is and how hard my bladder works. I merely thought for years I had on and off prostate flares and had been diagnosed with chronic prostatitis. I never knew I had obstruction/BPH brewing until recently. I thought how I was peeing was somewhat normal.

 

[demon]

Yes. I didnt realize anything was really that wrong until recently. I was dieting for a contest and I must have had something wrong with my carbohydrate storage/water balance system bc I was waking up 5-6 times every night to piss during prep. Went to urologist and he said my prostate was enlarged and I was retaining urine. After the show I began eating normally and my nocturia went back to zero which is my baseline so I thought I was fine. I went in for a follow up and was still retaining lots of urine after peeing. Then I started getting additional testing and it showed how bad my obstruction is and how hard my bladder works. I merely thought for years I had on and off prostate flares and had been diagnosed with chronic prostatitis. I never knew I had obstruction/BPH brewing until recently. I thought how I was peeing was somewhat normal.

havent had a chance to read the entire thread but was wondering did you get a psa test, if so what was the reading?

 

[jtmarlin]

havent had a chance to read the entire thread but was wondering did you get a psa test, if so what was the reading?

My PSA has been stable between 1.8 and 2.2 for years. I had one 6 months ago that showed the same. After the cystoscopy, urodynamics test, PVR ultrasound and the DRE, it's pretty clear this is obstructive BPH. I'm in line for an aquablation as soon as I can get it done. There is definitely an inflammatory component too bc if I don't have sex for a few days and have taken an NSAID I can pee much better. If I have had sex/masturbated my flow is way way worse for a couple of day. The urologists don't seem to care about that part.

The thing I learned in all of this is that BPH is not a quality of life issue. You cannot just "live with it" bc the pressure buildup eventually destroys your bladder.

 

[jtmarlin]

Another update on this. Definitely have obstruction due to BPH. I am getting an Aquablation (it's an ablation of prostate tissue with a high powered water jet) done asap and am just waiting to be scheduled by the surgeon's office (we met this week).

This has been happening FOR A LONG TIME as I have a wide mouth diverticulum on my bladder and that takes years and years and years to develop.

To recap I abused testosterone and other AAS but mainly testosterone and dianabol beginning 17 years ago in my late 20s for 3 years. I spent the majority of those 3 years on testosterone. I was completely natural for the next 10 years and then began TRT - I also cycled a bit as well with primo and higher levels of testosterone during TRT years but most of the time was on true TRT. This means that my BPH obstruction began in my late 20s/early 30s for this diverticulum to have time to form and time has pushed it over the edge. I'm convinced it was the gear and there is a lesson there. Avoid my mistakes and don't get a coronary artery calcification and an enlarged prostate in your 40s.

The interesting thing is that every urologist I have met with consulted with procedurally on this journey has told me to stay on testosterone and were rabidly against the use of finasteride.

 

[malfeasance]

Let us know how it goes.

I wake up once or twice at night to pee, very occasionally 3X, but I am late 50s and have a bad habit of drinking things in bed prior to going to sleep, so . . .
Nevertheless, I am sure I have something going on with my prostate, because it takes me longer to pee than it did when I was younger.

 

[AlexDavis43]

The interesting thing is that every urologist I have met with consulted with procedurally on this journey has told me to stay on testosterone and were rabidly against the use of finasteride.

Did they explain why "rabidly against" (not just a little against) the use of finasteride?

Seems effective for BPH but I guess your urologists were weighing that sexual side effect and mental wellness (?)

 

[jtmarlin]

Did they explain why "rabidly against" (not just a little against) the use of finasteride?

Seems effective for BPH but I guess your urologists were weighing that sexual side effect and mental wellness (?)

They said it wouldn't work for my level of obstruction and it would make me feel like garbage. The other actually discussed post finasteride syndrome with me. He's the urologist who prescribes my testosterone.

 

[jtmarlin]

Let us know how it goes.

I wake up once or twice at night to pee, very occasionally 3X, but I am late 50s and have a bad habit of drinking things in bed prior to going to sleep, so . . .
Nevertheless, I am sure I have something going on with my prostate, because it takes me longer to pee than it did when I was younger.

It's very easy to determine. All you need is a flow test. If that is low, you either have an obstruction or a weak bladder musculature or both. Then a urodynamics test will give a flow vs pressure result and you will know with certainty. Strange thing is that I do not have any sort of nocturia whatsoever.

 

[bubba618]

They said it wouldn't work for my level of obstruction and it would make me feel like garbage. The other actually discussed post finasteride syndrome with me. He's the urologist who prescribes my testosterone.

My urologist who handles my TRT didn't want to Rx finasteride saying, "You won't like the side effects." My PCP/GP on the other hand was ready to write the Rx as soon as I said, "I know it's vanity, but I'm concerned about my thinning hair...."

My PCP/GP wrote the Rx for 5mg Cialis on the spot, too, for BPH-related urinary (actual) and ED issues (claimed).

 

[malfeasance]

It's very easy to determine. All you need is a flow test. If that is low, you either have an obstruction or a weak bladder musculature or both. Then a urodynamics test will give a flow vs pressure result and you will know with certainty. Strange thing is that I do not have any sort of nocturia whatsoever.

Is that something I can do, or do I need a hospital or doctor?