Prostate treatment is meds first

Dear Dr. Roach: In a prior column, you discussed an enlarged prostate, or BPH. How does one know if they have BPH or overactive bladder? I wake up three times a night to urinate. I tried Flomax for three weeks. Tamsulosin plus finasteride seems risky. Why not just get surgery to reduce the prostate and be done with it? — E.M.

The symptoms of an enlarged prostate and overactive bladder can look the same in men. Many doctors will give a trial of tamsulosin (Flomax) or similar drug, but if it fails, some simple testing can help to make an accurate diagnosis.

Surgery is not appropriate for overactive bladder symptoms, but if it’s proven that your prostate is the source of the problem, then surgery is one of the many options available. A patient’s personal preference is very important in deciding the best therapy, but surgery is usually reserved for people who do not respond to medication treatments. Surgery itself has the potential for side effects. Some patients’ symptoms worsen after surgery, and many continue to require medications.

There are a range of alternatives to traditional surgery, a good number of these have a lower risk for side effects. Only a urologist, after a thorough evaluation, can make personalized recommendations, but I advise against rushing to surgery.

Dear Dr. Roach: Will donating blood decrease my immunity during the coronavirus pandemic? I am a healthy 58-year-old female. — P.A.

No, the effect on your immune system from donating blood is minuscule. There is still a need for blood donation, and blood donation drives — a big source for blood banks to acquire donors — have been largely canceled. Check with your local blood bank about donating. If you are healthy, please consider doing so.