DEAR DR. ROACHES: In the previous column, you discussed prostate enlargement, or BPH. How do you know if they have BPH or an overactive bladder? I woke up three times last night to urinate. I tried Flomax for three weeks, but it didn’t work. Tamsulosin plus finasteride seems risky, having two drugs in one system. Why not just undergo surgery to reduce the prostate and be done with it, rather than relying on two drugs for life with the risk of side effects? – E.M.
ANSWER: The symptoms of an enlarged prostate and bladder that are too active can look the same in men. Many doctors will give trials of tamsulosin (Flomax) or similar drugs, but if it fails, some simple tests can help make an accurate diagnosis. Urologists measure urine flow and bladder pressure to confirm the diagnosis.
Surgery is not suitable for overactive bladder symptoms, but if it is proven that your prostate is the source of the problem, surgery is one of the many options available. The patient’s personal preference is very important in determining the best therapy, but surgery is usually reserved for people who do not respond to drug treatment. Surgery itself has potential side effects. Some of the symptoms of patients get worse after surgery, and many continue to need medication even after surgical treatment.
There are various alternatives to traditional surgery, some of which have a lower risk for side effects. Only a urologist, after a thorough evaluation, can make personalized recommendations, but I advise against haste to undergo surgery.
DEAR DR. ROACHES: Will blood donation decrease my immunity during a coronavirus pandemic? I am a healthy woman, 58 years old. – P.
ANSWER: No, the effect on your immune system from donating blood is very small. There is still a need for blood donors, and the drive for blood donations – a large source of blood banks to get donors – has largely been canceled. Check with your local blood bank, such as the American Red Cross, about donations. If you are healthy, consider doing it.
DEAR DR. ROACHES: A column recently showed a 75-year-old reader who experienced a burning sensation shortly before and during urination. If the urinary tract infection has indeed been removed, I would like to suggest an effective one-week test that uncle can easily manage on his own. Simply remove the caffeine, alcohol, and hot spices for one week to see whether the burning sensation subsides. I learned this from my urologist many years ago, and it’s amazing how often these simple adjustments to diets work for people. – B.P.
ANSWER: I thank B.P. to write. I also add that sometimes drinking more water can relieve symptoms, because very concentrated urine can cause burning, and people may consciously or unconsciously drink less to avoid feeling uncomfortable when urinating. This is an easy solution to try before a more thorough examination must be carried out.
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