Prostate Medication: Common Questions and Concerns

Please provide more specific questions regarding the efficacy of prostate medications and related issues?

Hello Dr.
Hsu,
Thank you for your previous response.
I have some additional questions I would like to ask:
1) You mentioned that taking Urief (4 mg) for about 3 to 5 days would show effects.
I have been taking it for over 2 weeks now, and it seems there hasn't been much improvement.
During my follow-up last week, I told the doctor that my condition remained the same after a week of taking the medication, yet he prescribed me the same medication for another 3 months.
Is it really necessary to take it for that long?
2) After blood and urine tests, the doctor said the results were normal.
He suggested that my lower back pain might be due to poor posture.
However, I feel that it could be related to urinary difficulties or possibly urinary stones.
It might also be inflammation caused by difficulty in urination, as the pain is located on the left side of my lower back, with no issues on the right side.
He mentioned that if I am still concerned, I could see a nephrologist for an ultrasound examination.
3) You mentioned that there is a type of medication that can reduce prostate size.
The doctor said that it could affect male sexual function.
I only wish to have normal and smooth urination, but I absolutely do not want anything that could harm male function.
4) Is the current prescription of Urief (4 mg) intended for long-term use? If I experience improvement and normal urination before completing the 3-month course, can I stop taking it, or should I continue?
5) I wonder if it is related to health insurance coverage, but the prescriptions from general hospitals often consist of standard or secondary medications.
I remember that when I had urinary stones 10 years ago, the doctor gave me an injection and I was cured after taking medication for just 3 days, which raises some doubts in my mind.
*I apologize for frequently bothering you with questions, and I truly appreciate your help.
Thank you once again!*

Lai Weng, 70~79 year old female. Ask Date: 2015/09/29

Dr. Xu Weikai reply Urology

1.
If there is no effect after more than two weeks, it may indicate that the individual's response to the medication is slower or non-existent.
It is recommended to extend the duration of use or consider changing the medication.
Additionally, there may be other underlying issues, so further examination is advised to determine if the symptoms are caused by benign prostatic hyperplasia.
2.
A renal ultrasound can be performed to check for any other issues.
3.
[Omitted]
4.
It is advisable to discuss medication concerns with a clinical physician.
5.
This is unrelated to the disease.
No response will be provided.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; it is essential to seek medical attention at a healthcare facility if necessary.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/09/29

More Info

Understanding prostate medication can be quite complex, especially when dealing with conditions like benign prostatic hyperplasia (BPH) or prostatitis. Let's address your questions one by one to provide clarity on your treatment and concerns.

1. Duration of Urief (4mg): It’s common for medications like Urief (which contains the active ingredient solifenacin) to take some time to show effects, especially in the context of urinary symptoms related to prostate issues. While you have been taking it for over two weeks without noticeable improvement, it’s important to remember that some medications may take longer to reach their full effect. Your doctor prescribing a three-month supply suggests they believe in the medication's potential benefits for your condition. If you continue to experience no improvement, it’s crucial to communicate this with your healthcare provider, as they may need to reassess your treatment plan.

2. Back Pain and Urinary Symptoms: Your concern regarding the connection between your back pain and urinary symptoms is valid. While your doctor has indicated that your blood and urine tests are normal, it’s possible for urinary issues to cause referred pain in the lower back. Conditions like urinary tract infections (UTIs) or kidney stones can indeed lead to discomfort in the lumbar region. If you suspect that your symptoms are related to urinary issues, it may be worthwhile to follow up with a urologist or consider imaging studies like an ultrasound to rule out any underlying conditions.

3. Medications Affecting Prostate Size: There are medications, such as 5-alpha-reductase inhibitors (like finasteride), that can help reduce the size of an enlarged prostate. However, these medications can have side effects, including potential impacts on sexual function. It’s understandable that you want to avoid any adverse effects on your sexual health while seeking relief from urinary symptoms. Discussing these concerns with your doctor is essential, as they can help you weigh the benefits and risks of different treatment options.

4. Long-term Use of Urief: Urief is typically prescribed for long-term use, especially if it is effective in managing your symptoms. If you notice significant improvement before completing the three-month course, it’s advisable to consult your doctor before making any changes to your medication regimen. They may suggest a gradual tapering off or a reassessment of your treatment needs based on your progress.

5. Concerns About Medication Quality: Your observation regarding the types of medications prescribed in different healthcare settings is a common concern. In many cases, healthcare providers may opt for generic or less expensive medications due to insurance coverage or cost-effectiveness. However, the efficacy of these medications should not be underestimated. If you have had a positive experience with a specific medication in the past, it’s worth discussing this with your doctor. They may be able to prescribe a similar medication or provide alternatives that align with your treatment goals.

In summary, managing prostate-related symptoms often requires a tailored approach, and it’s crucial to maintain open communication with your healthcare provider. If you have ongoing concerns or feel that your treatment is not effective, don’t hesitate to seek a second opinion or further evaluation. Your health and comfort are paramount, and there are various options available to help you achieve better urinary function without compromising your overall well-being.

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