Avodart, seminal vesicles, excess seminal fluid (Mapletop)

[mapletop]

I just started Avodart for my swollen prostate. I don't think my prostate can drain effectively and retains secretions that dry and occlude the ducts. Anyone had any results with avodart? I will post any changes in the months to come.

[webslave]

Avodart is Dutasteride and is similar to finasteride. Search this site for "finasteride".

[carld]

My first uro put me on avodart http://www.avodart.com/ and let me tell you something...It was the worst experience...I was an emotional wreck...I cried more in that two months then in all my life...even when I was in the wane of the wax and wane...

The idea was this according to my first uro...He thought an inflamed prostate needs to be reduced to a normal size...seems great...but that is for BPH and it did nothing to reduce the burning discomfort and pain that is CP/CPPS. I'm not a doctor and you should follow your doctor's advise...but my experience was not good. Fair warning...Keep us posted

Best, Carl...

[webslave]

The general feeling about these drugs is that they are not much good for UCPPS.

[mpozatek]

Avodart is a 5 alpha recuctase which will shrink the prostate. It usually takes about 3-6 months to work and are very effective if an enlarged prostate is the cause of your issues.

[webslave]

But since he is 26, that is highly unlikely.

[mpozatek]

The prostate grows throughout a man's life, when it will cause problems nobody knows.
Remember, it is not the size of the prostate but rather the size of the hole that contains the urethra within it. Men can have a huge prostate and have no issues and vice versa.

A large prostate is not a problem unless you experience issues. Avodart will definitely shrink it. If the the problem exists elswhere then maybe another route is the way to go.

[webslave]

The prostate grows throughout a man's life, when it will cause problems nobody knows.

Not quite true. We have a pretty good idea of the chances of having problems with prostatism with age.

[mpozatek]

Your graph actually shows that what I said is quite true. The prostate continually grows throughout your life and your are "more likely" to experience issues as you get older.

I don't think it is wise to always dismiss the idea that medical treatment can help somebody. It may or may not.

There is more than one way to skin a cat.

[webslave]

As the graph shows, a man of his age has a less than 5% chance (1 in 20) of BPH problems. So as I said, it's unlikely. It's best not to mention the most unlikely cause first. Swollen prostates in men of his age, when combined with other symptoms, are not a sign of BPH in the main, but are far more likely to be CPPS.

And in fact drugs like this are not recommended for other reasons, like impotence and decreased libido (which can occur at rates as high as 38%), which can be devastating for a young man.

[carld]

Your graph actually shows that what I said is quite true. The prostate continually grows throughout your life and your are "more likely" to experience issues as you get older.

I don't think it is wise to always dismiss the idea that medical treatment can help somebody. It may or may not.

There is more than one way to skin a cat.

Mpozatek,

Have you taken this drug? I have for two long horrible months...and it did nothing to relieve the pain and burning discomfort. If you have BPH, then I can see the use for it to shrink the prostate, but the side effects for any man isn't worth it...believe me I know first hand...You better off with an alpha blocker...for BPH not CP/CPPS/UCPPS...

[mpozatek]

Carl,

I'm in the medical field so I understand disease state progression and the pharmacokinetics of drugs. You are correct in stating that alpha blockers and 5 alpha reductase inhibitors work for BPH and not CP/ chronic prostatitis / chronic pelvic pain syndrome etc. It is up to the individual to decide which side effects they can and cannot live through. Recent studies show that combinatin therapy with say a Flomax and Avodart work better for BPH symptoms then solo therapy.

The reason I posted my initial reply is that it is not crazy for a young man to experience BPH symptoms. Yes, BPH will mainly affect older adults and nearly all of us will have it if we live long enough. If shrinking the prostate or relaxing the bladder neck will help him then he should give it a try. Let him decide if he gets side effects he doesn't like.

Also, it is important to remember that all drugs cause effects. It is only the unwarranted ones that we call side effects. A perfect example is Viagra. Viagra was originally designed to be blood pressure lowering drug. During clinical trials, it was discovered that a very high number of patients were experiencing stronger and longer lasting erections. So now erections are considered the effect of Viagra and not a side effect.

Also, many side effects of drugs tend to wear off during treatment. Avodart is one in particular that takes roughly 3-6 months to begin working and for the body to adjust. Again, it is up to you.

If there were a drug that all of us on this board could take to help ease the pain and take away this dreaded problem, we could probably deal with some dizziness, loss of libido etc.

All in how you look at it.

[carld]

Fair enough...

But as far as UCPPS...I strongly disagree with any man wanting to try it. It simply won't work to relieve the pain, burning and dysfunction associated with our syndrome.

The emotional side effects and what I believe was retrograde ejaculation or decreased ejaculation and no interest in sex was too much for me. Even my second urologist was dismayed that my first uro put me on that sh*t...for our condition with no medical studies that showed any efficacy in treatment for UCPPS...

Best, Carl...

[mapletop]

Thanks guys. I wanted to try avodart because I had been through the regime for prostatitis. Also my main problem was excess seminal fluid that caused pressure and urgency, that could be squeezed out while at the bathroom. One of the side effects was reduced semen volume. I thought that maybe this could help my problem. I have not experienced any side effects so far, none for about 20 days on the drug. I had a TRUS done and my doctor said that my prostate was normal size, no dilated ducts, but my seminal vesicles were enlarged, so I'm thinking this problem lies with them entirely or that they are the source of my prostatitis. Any thoughts?

[webslave]

That could be so, because the excess fluid is not a typical symptom. Dr Shoskes specialised in removal of the SVs at one stage, so perhaps you could see him if you decide to have them removed.

Date: Mon, 25 Aug 1997
From: Daniel Shoskes
Subject: Seminal Vesicle removal

The indications for seminal vesiculectomy (surgical removal of seminal vesicle) are limited to very unusual and specific cases of infertility or chronic infection. In the FEW patients in whom it may be indicated however, there is justifiable reluctance to proceed due to the difficulty of the standard surgical approach (which often involves division of the bladder neck or prostate) and the high complication rate.

Along with my colleague Dr.J Rajfer (who specializes in infertility), we have developed a new surgical approach to remove a seminal vesicle that avoids the above mentioned problems completely. It is done through a lower abdominal incision (called a "Gibson", which incidentally is the incision I use for a kidney transplant) and leaves the bladder and prostate untouched. Between the 2 of us, we have done about 20 of these operations now, although only one was in my own patient with documented obstruction and infection who failed antibiotics. It was a technical success, but we are too soon after to assess changes in symptoms or EPS.The other 19 operations, mostly infertility related, were unassociated with any major complications such as impotence or incontinence.

In any case, we are planning to write up the operation for publication, but the lag time for journals even if it is accepted right away can be several months or even a year. Therefore, if anyone has been considering this operation for a valid, documented indication, I would be glad to discuss this approach with their own urologist. Please have them email me, or they can leave a message for me at my prostatitis clinic.
Daniel Shoskes MD