Not flowing freely!

[NWSRG]

Ok men, need some advice / guidance.

I'm a 42 year old man, generally healthy, weight fine, non smoker, occasional drinker. I've noticed recently that when I pee, it doesn't seem to be flowing just as easily! Nothing major, no problems starting or emptying fully, just a sense that the flow rate isn't as fast as it used it used to be. The only other symptom is a need to get up for a good pee in the middle of the night. Again, all works ok, it's only once (and by no means every night), but again, the flow just seems a wee bit less than normal.

Usually, I can hold all day (wife says I've the bladder of a camel), so I'm a bit conscious of the slight change.

I'm considering going to the docs, but I suppose I'm looking some reassurance before I go!!

[HEATHROW DIRECTOR]

I've had something similar for many, many years and I think it's the price of being a bloke. Doc checked me out and said it was BPH (google it). He did not prescribe medicine but I take Saw Palmetto daily (from healthfood shops or Boots) and nothing has changed much. I do recommend that you get the doc to check it out.. and close your eyes when he pulls the Marigolds on up to his elbow!

[cavortingcheetah]

You must surely know the likely response?
Slip nimbly over the marigolds as advised and suggest to your medico that he take a blood PSA test with a repeat in six to twelve weeks.
Abstain from sexual activity and bicycle riding for seventy two hours prior to the test.
The PSA test is by no means an accurate guide but it does provide a base line of sorts.
Not a doctor myself but occasionally have to visit the GP in England so as to advance his training and improve his diagnostic skills.

[NWSRG]

You must surely know the likely response?

Er, no! Hence the seeking of advice!

[HEATHROW DIRECTOR]

The proper response is to see the doc to rule out prostate cancer.

[Radgirl]

Ok so here is the boring medical stuff

Go and see your GP. It is possible you have a low grade infection he can look for. Otherwise you may have benign prostatic hypertrophy. The prostate is a small gland at the neck of the bladder. Women don't have one. It enlarges with age and then starts to block the flow of urine out of the bladder so the flow reduces and you may have to stand and wait. The body needs to empty the bladder before it gets too big as then the force generated by the bladder is reduced. So you find your body makes you want to empty more frequently and so you get up at night

Everyone has it to a degree as they get older, but some more than others. A doctor sticks his finger just inside your rectum to feel the size and consistency as a diagnosis

You can take a couple of drugs which will counteract the effects. However the definitive treatment is an operation to remove part of the prostate. This used to be a big operation but now the fashion is just to bore out the centre. Often done under spinal anaesthesia you only have to stay in hospital for a couple of days because you will have a catheter initially

The comments about PSA which is a test for prostate cancer really have no place on this thread but your doctor will put your mind at rest when he feels your prostate

So it is common, straight forward to treat effectively and you need to get off to your GP. Let us know what happens:ok:

[ettore]

Hi guys,
Am I on PeePrune ?

[obgraham]

Radgirl has hit the nail on the head (so to speak). Although, OP, you seem a little young to be starting the nightly trek.

[NWSRG]

Hi folks,

Well, spoke to the doc. She didn't seem overly concerned...suggested I drop by with a sample and monitor things for a while. So will do just that.

Thanks for your help!

[gingernut]

Rule out Chlamydia, (the most likely reason for your symptoms), then follow the advice on this forum :)

[cavortingcheetah]

Prostate-Specific Antigen test or PSA is not a test for prostate cancer. It is a measurement in the blood of a protein which is produced by the prostate gland. As such it is an aid in a general diagnosis which might lead to a medical decision, taking into account all the factors present, to carry out a biopsy in the case of a suspicion of prostate cancer presence. But note that even a multi core biopsy is not a 'golden' indicator of the presence of prostate cancer. A negative biopsy does not mean that cancer is not present in the gland, only that no cancer cells were found in the core samples taken.
The use and validity of the PSA test as a method of cancer screening is the subject of much ongoing medical debate. There are many circumstances which can produce a rise in PSA. An infection of the prostate, Benign Prostatic Hyperplasia( BPH) or even a Digital rectal Examination (DRE) will all perform that trick.
Prostate cancer diagnostic research needs to move forward and there is much that still needs to be done to determine an unequivocal and non invasive test for prostate cancer. Early breast cancer testing/screening and diagnosis has been the target of vast amounts of research funding in the last few decades. In the battle of the sexes it's high time the prostate moved to the funding foreground.

[RedhillPhil]

Ok men, need some advice / guidance.

I'm a 42 year old man, generally healthy, weight fine, non smoker, occasional drinker. I've noticed recently that when I pee, it doesn't seem to be flowing just as easily! Nothing major, no problems starting or emptying fully, just a sense that the flow rate isn't as fast as it used it used to be. The only other symptom is a need to get up for a good pee in the middle of the night. Again, all works ok, it's only once (and by no means every night), but again, the flow just seems a wee bit less than normal.

Usually, I can hold all day (wife says I've the bladder of a camel), so I'm a bit conscious of the slight change.

I'm considering going to the docs, but I suppose I'm looking some reassurance before I go!!

Welcome to the wonderful world of the middle aged:)

[Radgirl]

Cavortingcheetah

If PSA isnt a test for prostate cancer, what is it a test for???? Regardless of which protein is measured, the test is done for prostate cancer, the same as haemaglobin is a test for anaemia even though it too measures a protein.

Important to be on the ball on this so we can provide clear advice - which is to test for infection then BPH.

The rest of your post is correct, except the last part - we dont actually need vast amounts of money thrown at research, what we need is controlled studies to compare the various treatments currently available. The problem is knowing which treatment is best for whom!! However, although everyone should seek their own medical advice, it is important to remember almost all elderly men have prostate cancer - it is very common and rarely kills.

Back on thread - this isnt about cancer but benign hypertrophy!!

[cavortingcheetah]

Radgirl,
Quite didactically so!

[gingernut]

I'd be tempted to rule stuff out, before ruling stuff in. Has anyone tested your urine ?

I'd have to have a good think before sending for a PSA in a 42 yr old man, I'd be wondering what to do if it was high, and what to do if it was low.

It sounds like your problem could easily be sorted, initially, I'd expect your doc to:



listen to your symptoms carefully
have a feel of your tummy, and look at your "tackle." I'd probably perform a DRE ("finger up the bum")
Test your urine and probably send a sample to the lab for further scrutiny
Review your situation with your results, and maybe trial some treatment.

Let us know how you get on :-)

[NWSRG]

Welcome to the wonderful world of the middle aged

Redhillphil, thanks for that! That's one diagnosis that I probably, sadly, have to accept! :)

[Thomas coupling]

Just had my DRE thank you very much! Slightly enlarged "as expected" says the doc. He also says that it is estimated that 50% of men over 50 have early signs of PC and 80% of over 80 year old actually have PC:sad:
Stormin Norman had it. Roger Moore has it, et al......

[cavortingcheetah]

Jolly old prostate cancer, another ball game altogether.

[NWSRG]

Well, been to docs. Didn't do the dreaded inspection, but did test pee, and ask for a full blood test. All came back normal (including PSA, although it seems 'normal' is not easily defined there). Waterworks seem to be pretty well back to normal...and no night runs either! Think I may have had a minor infection or similar...

Thanks for all the advice!

[RequestPidgeons]

PSA results will indicate a trend. So, if you have had one, keep going for them at regular intervals so that GP can monitor what is happening. If it remains constant, or only rises gradually, you probably have nothing to fear - the gradual rise probably relates to the gradual enlargement of the prostate. A large change in the figure is the indicator for further investigation.

Just had my HoLEP (laser enuculeation of the prostate) this week. I am pain free, two days on hospital, two weeks recovery and pissing like a stallion!
:eek:

[Radgirl]

Sorry RP your advice on PSA is very logical but not supported by the great and good in urology

PSA is very controversial because it has false positives and also because it doesn't differentiate between aggressive cancer that needs treatment and cancers that can just be monitored. Fortunately we are within a few years of getting tests that will differentiate

Until then the advice is just one PSA and no repeat for many years - as so often in medicine if you ask two doctors what many years means you get three opinions. But regular or frequent measurements following a normal result has a significant risk of false positives

If your occasional PSA is raised please see a urologist. This is a terribly difficult disease - we have lots of treatments but struggle to know which if any is applicable to a particular patient - and should not be left with a GP

[noosariver]

Radgirl, you appear to be familiar with this area. RP says he had Holep. What is your view on this compared to the traditional TURP and other methods like the Green Light Laser?

[Radgirl]

Noosariver

I am not a urologist

I presume we are talking about benign prostatism

The treatment is simple - remove a core to stop the obstruction. The urololgists I know have not been impressed with green light because of high recurrence. They prefer to remove under direct vision. I know little about Holep but would be suspicious it may be similar

The best advice is to ask your GP who he would go to and then ask that urologist what he is happiest with. Far better to have the guy strutting his normal stuff than to be experimenting or struggling with something he is less familiar with

This is a routine operation. Go to the guy who does lots of them and you will be giving yourself the best chance of success

[JimR]

Over the years I've had a few PSA tests and have come to the conclusion that I'm not going to take much notice of them any more. Over the last 15 years the level has varied between 3.3 and 6.0 ng/mL.
11 years ago when it was 6.0 I went for a biopsy. The result was negative thank goodness, so I'm not sure why the high reading. I remember mostly a difference of opinion with the doctor as to what his and my idea of pain was when he inserted the instrument up the the nether regions.
In June this year it was up to 5.4 again. Doc seemed to think everything felt ok with a DRE.
Normally, I take the bus down to the clinic, but last week decided to take the car for a repeat PSA test. The journey can be a bit bumpy on some of the roads here and so, having read that riding a bike should be avoided before the test, reasoned that maybe a more comfortable ride in the car might help. Result 4.0; the lowest its been since 2008. Doc still thinks that I should see a urologist, but quite honestly I can't see why since I'm almost 69. Yes the water has slowed a bit, but not too bad as far as I'm concerned.

[ShyTorque]

Abstain from sexual activity and bicycle riding for seventy two hours prior to the test.

I've not done both together for many years, not since I fell off and dented my helmet.

[Loose rivets]

Radgirl. I'm given to understand you have a world authority on Brachytherapy down there.


I'm a retired pilot, not a doctor. While in Texas, we go to a wellness clinic for blood and ECG etc. Since I was getting a flow problem, wife pestered me to get the PSA included. It was 8.3

Went to a GP for digital. He said get yourself to a urologist.

Went to a urologist. He said he'd press on the prostate and cause some drips which would be analysed. The left side was squished, and then he went to the right.

"Oh, no need to do the test. You need a biopsy."

Wonderful doctor in San Antonio did the biopsy and the pain was less than the sting from an elastic band, which I'd been warned would be the level. When the results came back I had a Gleason of 7, BUT, it was a 4 + 3, the worst way round. (For some reason, the 3 + 4 is not as critical.)

He suggested getting a move on.

Back home I was offered Ordinary surgery. DaVinci machine surgery. Hormone treatment. External Beam radiation. Or Brachytherapy. Of all the treatments, the Hormone was the one I'd run a mile from. Did not like the sound of that. I was just inside the boundary for Brachytherapy, but was allowed that.

Southend under Mr Lodge. Volume studies. General anesthetic, but a non event otherwise. Go home.

They order the 'seeds' (radio iodine 125) and tell you to appear. General anesthetic, and they implant as many as 80 of these little rods. Have a nice rest, and go home. THAT'S IT - apart from sending in PSA results every 6 months.

This summer, 5 years after the procedure, I went to see Mr Lodge. He looked at my latest reading of a billionth of a PSA unit, and said go home, you're fine. He did in fact offer a MRI but another crisis meant I could not make the date.

Given my age, I'm extremely youthful, with a quite tedious preoccupation with sex. Sensitivity is fine. In most respects I'm very lucky - apart from the fact the extraordinarily young looking Rivetess has all but left me after 48 years.

Life has a way of being a pain in the arse whatever you do. :uhoh:

[RequestPidgeons]

Rad

Dont want to get into a pissing contest, but, having spent a fair bit of time with a urologist over the last few weeks leading to HoLEP last week, your advice and his are contradictory. I only repeated his explanation to me.

Noosa

Again, urologist told me that with TURP there is only a finite period of time that cutting take place and then surgeon must stop; thus the full procedure may not be completed. The advantage of HoLEP is less trauma, but with the same result. Here in NZ, his advice was to go private and undergo HoLEP, as there was no guarantee that Laser would be available on the day of surgery i the public hospital. A couple of links that I found useful, if you havent already searched:

Transurethral Resection of the Prostate (TURP) | Johns Hopkins Medicine Health Library (http://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/transurethral_resection_of_the_prostate_turp_92,P09349/)

Holmium laser prostate surgery at Mayo Clinic (http://www.mayoclinic.org/holmium-laser-prostate-surgery/)

HoLEP vs. TURP for Benign Prostatic Enlargement: Johns Hopkins Health Alerts (http://www.johnshopkinshealthalerts.com/alerts/enlarged_prostate/HoLEP-for-Benign-Prostatic-Enlargement_6490-1.html)

[cavortingcheetah]

In the event of an early diagnosis of prostate cancer, which is not really what this thread is about, gender reassessment on the UK NHS would no doubt nicely fit the bill, thus enabling the patient, having vanquished the male sexual miasma, to prepare herself for the potential of the female mammary maelstrom.
Excellent brachytherapy may be had in Johannesburg for the price of a good meal for two in London if such a thing may be found at all.

[Radgirl]

Loose rivets

Great story. I think it underlies my gut feeling that there are many treatments and we really don't know which to offer many patients. Surgeons each have their own preference. You were given a choice and seem more happy as a result. Congratulations

RP

We must be careful as you are talking about two separate pathologies. You too underline the fact that different doctors give differing advice. On this thread I merely try to reflect that. Most of my comments are not my own so to speak as they are not from within my specialty but I attempt to reflect up to date opinions. That is why everyone is told not to rely on the thread but to get individual face to face advice.

I stick to what I said as that is the current view, but some doctors will disagree. Equally this new device you have been offered is just that - new - and if you look at the links you provided you will see that and need to consider evidence on that basis. Green light was thought to be fantastic and I can't count the number of hospitals that spent money putting in special sockets for the device. Where I am based most have been removed. Holep may be the bees knees or may be the same. Caveat emptor

[obgraham]

I believe that Radgirl has pretty much summed up the state of things regarding prostate conditions, and the general consensus thereof. Nothing inconsistent in what she wrote.

In particular the very complex issue of PSA testing, which has not quite worked out to be all that it was promised. Rivets points out that an individual exam was what got him into the treatment protocol.

Now Pidgeon's experience is an example of what happens when a new technology comes along. Some very excellent results are obtained, and some of the "early adopters" decide that's it, that's the best treatment. And convince their patients of it. But the overall efficacy of the procedure must await further study, collections of outcomes, evaluation of risks and complications, and comparison to standardly available treatment.

Sometimes what starts out promising turns out to be less so when the bigger picture is evaluated. (And of course, sometimes not!)

[cavortingcheetah]

The resolution of ambiguity is helped along a tad with a prostatectomy procedure, perhaps performed by an experienced surgeon at the controls of a Da Vinci machine. Someone such as RK at the LPC, who recently put his own machine to the test on himself. This procedure was carried out by one of his team of course. Self help only extends so far. The subsequent pathology report on the quivering gland will inevitably reveal the degree and perhaps the extent of any cancer.
Surgery often presents choices and unfortunately sometimes collateral damage. A British composer of renown underwent a Da Vinci procedure a year or two ago. Apparently scar tissue from an old appendectomy procedure created a problem which led to the surgeon having to remove rather more tissue than had been envisaged by the musical maestro. The best laid plans sometimes do go wrong in the theatre and the only stick waving around in this maestro's right hand from now on is likely to be his conductor's baton.
The above tale is well documented and in the public domain. The man in question was generous enough to make his private information public in the interests of helping fellow prostate cancer sufferers.

[Radgirl]

And your point CC is?????

I do hope this RK has also given you his permission to discuss his personal medical history.

Sorry but I do not think we should discuss other people without their permission. I do try to amuse by mentioning cases from the past but I would never identify anyone

[Hobo]

It's already, here (http://www.dailymail.co.uk/health/article-2291798/Prostate-cancer-In-cruel-twist-fate-prostate-cancer-experts-ALL-hit-disease-Their-stories-vital-reading-men--loved-ones.html), in the public domain Radgirl.

[RequestPidgeons]

A couple of links, if anyone is interested.

The procedure, as developed in NZ. Note the video is dated 2009, so at least three years of experience and improvement since this was taken.
BPH: HoLEP & Tissue Morcellation with Dr. Gilling & Dr. Fraundorfer - YouTube
WARNING: If you are about to go in for surgery, you may not want to watch the procedure, but some interesting data within the video, as well as in the comment under the video (if viewed in YouTube - sorry about the pun :\).

Interesting to note that urologists from around the world are coming to NZ (and staying!) to learn the procedure, as shown here:
Christophe Chemasle - New Zealand | LinkedIn (http://www.linkedin.com/pub/christop...sle/46/b38/164)

I could not find a lot of information on Green Laser Surgery and whether it is the same as HoLEP. But from my limited reading, I think green laser uses an ablation process (vapourisation), rather than enucleation (resection?).
Prostate laser surgery - MayoClinic.com (http://www.mayoclinic.com/health/prostate-laser-surgery/my00611)
Green Light Laser Surgery for Prostate Enlargement (http://www.mitchamprivate.com.au/Our-Services/green-light-laser-surgery.aspx)

I hope this helps? But, as Rad states, the best advice comes from your urologist who will know what techniques are available in your location and more importantly, your condition.

[cavortingcheetah]

Relatively easy as were the points of my previous post to diagnose, I suppose they could be enumerated thus:
1. Prostate cancer diagnosis can be ambiguous and the real state of affairs downstairs may only be determined after prostate removal and subsequent histology.
2. The Da Vinci machine is a pretty keen piece of kit.
3. There are some good operators out there.
4. Even they are not immune from prostate cancer.
5. There are often choices to be made in surgery and not all of them turn out as either the patient or the surgeon would wish,
6. Collateral damage in cancer care surgery is often a consequence.
7. There's a musician with soul out there in the wild shores of Britain.
I think that covers it Radgirl except perhaps to say that research is usually of benefit before expostulative conclusion.

[RequestPidgeons]

As for me?
Day 4 at home, no pain relief required.
The rosé is now a sav blanc.
Re-learning to aim straight. :\
Uncomfortable but not painful during the sitting and standing evolutions, but getting better all the time.
Discomfort 'à la pointe' ;) while passing but also getting better quickly.
An uninterrupted 8 hours sleep, as opposed to 1.5 hours max, pre-op.

Finally, in spite only recent introduction of HoLEP, my pre and post operative reading and advice convinced me that I had made the correct decision. Independent advice, backed by data in the John Hopkins link in #27 above were enough to help me choose this course of action for the op.

[cavortingcheetah]

Let's hope your venture into Holmium laser treatment, used at the Mayo, proves to continue to be a success.

[RequestPidgeons]

Thanks, CC.

:ok:

[Loose rivets]

Radgirl - see your PMs


Is Dr Fraundorfer's first name Mark?


Part I


HoLEP Procedure for BPH - YouTube


Free PSA. Had to laugh. I questioned the urology folk down here about this test. The numbers are reversed for this by the way.

"No, we charge for that."
"no, I mean the Free PSA test, it's different to . . ."
"No, we charge for PSA tests."

:ugh::ugh::ugh::ugh::ugh:

[obgraham]

Her's another point, alluded to above but very important:

Never try to push your surgeon into using some technique other than the one(s) he prefers to use. He might well say "fine, I've always wanted to try that", and you do NOT want to be in the first few cases he ever did. The more hi-tech the procedure, the more important this is.

If you've decided on a certain technique, change docs if you must, but find a surgeon who has a lot of experience with that technique.

[Ulster]

Loose Rivets' video on HoLEP is very interesting to watch, but WHY, oh WHY, oh WHY does it need such loud and awful noise to accompany ( I can't bring myself to call it music - it's not !) ?

It seems that just EVERYTHING nowadays is accompanied by loud NOISE (often being presented as if it were music).

Is it any wonder that more and more class 1 medical holders are failing to meet the laid down audio standards these days ? :ugh: :ugh: :ugh:

[BARKINGMAD]

To the OP and others relatively young, hopefully before symptoms appear, l would ask if they've heard the theory that if the gland is emptied as often as possible, then malfunctioning in later life may be less likely.

Just a thought......:)

I wait to be educated by the gloved finger brigade!

[cavortingcheetah]

Giacomo Casanova is rumoured to have died of a stricture of the penis in 1798,(not to be confused with the Pineal gland) a condition which might well, in those days, have been caused by prostate cancer.
I'm terribly afraid to say that this knocks the theory of preventative masturbation or prophylactic coitus for a bit of a six.

[Radgirl]

Syphilis!!

[cavortingcheetah]

I warned about confusing the penis with the Pineal gland and the tumours that can be found there in cases of tertiary syphilis. But anyway it was my rumour. Mind you though Girolamo, who died at the then rambunctious old age of 73, used condoms, referring to them as 'redingote Anglaise’ or English riding coats. Goodness knows what he put on when he fancied a bit of side saddle or a trot bareback without stirrups.

[Radgirl]

Oh dear CC

Syphilis can cause urethral strictures. Cancer of the prostate is not normally associated with urethral strictures although they can be a complication of surgery. Cassanova did not have surgery. He did have various venereal diseases including…….syphilis. So on the balance of probability his stricture was due to syphilis

The pineal never crossed my mind

[cavortingcheetah]

It is rumoured that, in actuality, Casanova was bisexual so the balance of probabilities is that he died of aids with the possible source of infection being a lost condom. He died at the age of seventy three in an era when the average age of the ordinary man was something in the order of thirty. Possibly therefore, the rumour that his death was the consequence of old age is true.

[Radgirl]

AIDS?????

In 1798???

[Ulster]

Totally agreed, Radgirl ; VERY unlikely !

FRom a very well known internet source of information :
Genetic research indicates that HIV originated in west-central Africa during the early twentieth century. AIDS was first recognized by the Centers for Disease Control and Prevention (CDC) in 1981 and its cause—HIV infection—was identified in the early part of the decade

Crikey ; that's even before I learned to fly ! ;)

[cavortingcheetah]

So then Loeys-Dietz didn't exist until the Centers for Disease Control, or some other organization, had recognized that it did? That sounds like bad medicine?
In any event, all is rumour and Casanova's cause of death has never been determined.

[baggersup]

Medications can be effective solutions, too, once any disease has been ruled out.

'Im Indoors pops a Proscar every day. Problem solved. Even reduced the size of that thing causing all the discomfort.

[Ulster]

I'm Indoors pops a Proscar every day

Ah, the thread has returned to prostates, after a brief, but nevertheless entertaining, diversion !

The mention of drugs serves to remind pilots, especially class 1 holders, that some drugs commonly used for BPH are a bit contentious in the aviation arena. The best advice is, if prescribed things like finasteride or tamsulosin, to discuss with your AME before actually starting to take them. :ok:

[Mac the Knife]

"Giacomo Casanova is rumoured to have died of a stricture of the penis in 1798"

"Syphilis!"

May I inform you amateur historical speculators that the cause is far more more likely to have been gonorrheal in origin.

Gonorrheal strictures are very common, syphilitic strictures (mostly at the meatus) are not.

And many patients who have syphilis also have gonorrhea - as John Hunter unfortunately found out.

[cavortingcheetah]

It's an excellent place to which to take a new girl friend before lunching her somewhere deliciously expensive and impressive for it is a sure cure to keep the overheads down.

[Radgirl]

I agree about gonorrhoea Mac (although given your handle I worry about your interest in such matters!!!!). However gonorrhoea rarely kills. There are some lovely urethral dilator sets in the Gordon museum in London so a stricture could have been dilated ( possible septicaemia as a cause of death .......). However there are historical claims of syphilis and some later behaviours did suggest tertiary syphilis

He most likely had both of course

[cavortingcheetah]

Surely Mac the Knife isn't masquerading as a Mohel?

[keith williams]

Welcome to the wonderful world of the middle aged

Infirmity and beyond.......Whissss...dribble....dribble....dribble...

Buzz Blightyears

[Mac the Knife]

No CC, I am not a Mohel (I think routine circumcision is mischievous), though I do perform quite a lot of genital reconstruction!

Radgirl, it seems that Casanova started his Memoirs in 1789 (at 63 - he died in 1798 at 73), as "the only remedy to keep from going mad or dying of grief". The first draft was finished in 1792, and he spent the next six years revising it.

He would have been infected with syphilis many years previously and it is unlikely that he had neurosyphilis, for his memoirs are both lucid and erudite. There are no hints that he had gummatous syphilis, though he may well have had cardiovascular syphilis.

I agree about dilatation for strictures - dilator sets were common and frequently used, probably more for prostatic hypertrophy than gonococcal strictures. In the days before transurethral resection of the prostate there were many chronic catheter patients and we were taught the techniques of urethral dilatation (I was rather good at it!). Certainly it is possible to make a false passage and induce septicaemia if you are unlucky.

There are so many things that he could have died from that it is impossible to say, but chronic renal failure from recurrent pyelonephritis subsequent to outflow obstruction must be high on the cards.

:ok:

[One source says that he had 116 lovers in his life, which, when you think about is isn't that many for a man of his propensities.]

[BehindBlueEyes]

Quick question about 1mg Finasteride - how much does it ACTUALLY effect and lower the results of a PSA test and how long do you have to be taking it before it does? I would have thought that the dose was too low to have much impact but there seems to be contradictory advice all over the place about it.

[Radgirl]

There are publications recording a 50% fall within a year - the same as with 5mg finasteride

[bafanguy]

There are publications recording a 50% fall within a year...

Radgirl,

You're referring to a 50% drop in PSA within a year ?

[Radgirl]

Yes, but based on one paper

[BehindBlueEyes]

Also read that Lycopene supplements can affect PSA results - particularly concerning as a lot of men take Lycopene in the belief that it offers some protection against PCa. If that is indeed the case, the supplement could be artificially lowering the PSA leading to prompt diagnosis being missed.