Treatment of benign prostatic hyperplasia (BPH)

[TheFishman1]

I use. Avodart And something like maxi flow it’s a pill and now I basically never really wake up during the night in my flow and everything seems to be getting better

[Will B Good]

4 minutes ago, TheFishman1 said:

I use. Avodart And something like maxi flow it’s a pill and now I basically never really wake up during the night in my flow and everything seems to be getting better

 

I wonder if that is the same as Duodart?

 

I started to take that and read it was safe, BUT .......if you do develop a  cancerous tumour it can promote a much more aggressive form of cancer!!!

[OneManShow]

On 7/27/2025 at 11:35 AM, sardine said:

Could you advise me on an alternative treatment ?

If not caused by infection, as Sheryl mentioned, Alcohol (&caffeine) and dehydration (perhaps you even don't know) are 2 important factors, all prostate & bladder problems. 
 

[OneManShow]

I was on Avodart for 6 months and Harnal Ocaz (I stopped it after 30 days due to side effects, breathing problem at night).

My urine flow is good and no more pain and prostate discomfort. But I'm sensitive to alcohols (wine and beer are the worst). 
I drink sometimes, perhaps once a week and very limited. 

[how241]

11 hours ago, connda said:

can also be a prostate or bladder infection

You could get a urine test. If it shows white or red blood cells in your urine, then there is a good chance you might have an infection. Best to check with a doctor.

[Acharn]

On 7/27/2025 at 7:22 PM, Tazmo said:

I saw a Urologist 3 years ago, had MRI and found out it was benign and again with a repeat MRI a year after.

I was prescribed Finesteride 5 mg which I take at night and never had any problems.

I do get up at night to urinate twice, but good stream and bladder feels empty.

if I were you I would see a Consultant Urologist and get advice/ proper treatment and follow up if necessary.

You’re young and it could cause serious problems by the time you’re 70.

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

[Redacce]

15 hours ago, TedG said:

I was on finasteride for a while.  It makes your hair grow back, but other than that, the side effects were nasty. 

True. I'm thinking to change medication too. 

[Sheryl]

18 hours ago, Acharn said:

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

 

This is precisely my concern for the OP.

 

In his 50's, benign enlargement would usually not cause the degree of  symptoms he reports, he needs to rule out infection. 

 

It can be difficult to confirm infection in the prostate.

[Tazmo]

21 hours ago, Acharn said:

I saw a urologist three years ago, and he used an ultrasound to chedk my prostate. Much cheaper than MRI. He decided it wasn't enlarged enough to treat and prescribed something to increase my bill. Six months ago I found it was a urinary infection. My doctor (a pulmonary specialist) gave me an antibiotic and it was gone in five days. I still wake up two or three times a night and have to urinate, but it's much better. The urologist never thought to check for infection.

 

[Tazmo]

The Urologist I chose was one who had treated me for kidney stones in the past by a non invasive method.

 

 I chose MRI, because I have myself worked in Urology for a few years and although there are modern treatments now, I am aware that different Urologists have different approaches. I had consulted with several Urologists before here and in 2 other countries.

 

I had the option of a cheaper procedure ie a scan, but because of my family history of prostate cancer I was prepared to pay more and get confirmation of no cancer.

 

 know the signs and symptoms of urinary tract or other infections in the prostate region and that was not a concern. In fact my enlarged prostate was diagnosed a few years before I had the MRI.  But my PSA kept increasing, so I wanted to get a proper diagnosis.

 

There are good and bad Specialists everywhere. You did the right thing to get a second opinion. I had already had more than 2 opinions.

 

I am aware of options and costs and haven’t got money to throw away, but it was the best option for me at that time. I had had scars before but they are not able to detect cancer.

[wavodavo]

On 7/30/2025 at 2:09 PM, connda said:

I know people who had Turp and now have nothing but problems.  It's brutal.  Some hospitals do green-light laser surgery but I wouldn't have it don't unless I know the surgeon has done a lot of these procedures. And it's expensive. Up in the ฿250K and above range. I get the distinct feeling that BPH is more of a "farang" condition so the surgical options, in Thailand, are limited. As long as drugs at least marginally work, stick with drugs.  Surgery is a crap-shoot and you can end up worse off then you were. You just learn to live with it.  

I had the H.O.L.E.P. procedure done 6 years ago and very happy with it.

[Expat68]

9 hours ago, Sheryl said:

 

This is precisely my concern for the OP.

 

In his 50's, benign enlargement would usually not cause the degree of  symptoms he reports, he needs to rule out infection. 

 

It can be difficult to confirm infection in the prostate.

Go to Bangkok or Khon Kaen just has good as the UK in my opinion 

[Sheryl]

8 hours ago, Expat68 said:

Go to Bangkok or Khon Kaen just has good as the UK in my opinion 

No one suggestd he go to the UK. 

 

Just that he get another opinion. Here as elsewhere, individual doctors vary greatly in their competence and thoroughness. 

[Expat68]

14 hours ago, Sheryl said:

No one suggestd he go to the UK. 

 

Just that he get another opinion. Here as elsewhere, individual doctors vary greatly in their competence and thoroughness. 

I am not suggesting, all I am saying is in my experience Thailand (I have had an operation and stayed one week) is just as good as the UK.

[rickudon]

On 7/27/2025 at 2:31 PM, Will B Good said:

I was prescribed Duodart........but chickened out from taking it.......not a huge fan of meds if I can avoid them.

 

That was four years ago......don't take anything now........touch wood....getting away with it.

I am on Duodart - side effects for me have been minimal, Urinary frequency slightly better, main benefit is much improved urinary flow; emptying bladder still a bit of a problem, but maybe slightly better. Sex still possible.

[DrPhibes]

On 7/30/2025 at 11:03 AM, connda said:

3000 THB per box of 30 at a pharmacy in CM.  Like 100 THB per pill.  It's expensive. I use it on occasion.  If anyone knows a cheaper source, let me know. It is effective.

 

Are these 30 20mg pills?  I get 20mg tabs and cut them into 1/4 to get 5mg so that would be 120 or 25 baht per day (USD $0.77/day) for you.  Can attest that at 5mg, does work and I have a big prostate, still have to get up 1x per night if drinking. Ya, a bit of a side benefit 🙂