Why Medications May Not Work for Enlarged Prostate?

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-4044.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  We speak Spanish and Russian languages.

Treatment of Symptoms of Enlarged Prostate

shutterstock_68753587_BPHFor men with enlarged prostate symptoms such as a slow urinary stream, the need to wake up at night, urge to urinate, feeling of incomplete bladder emptying and frequent urination, medical treatment with medications such as Flomax (Tamsulosin), Proscar (finasteride), Rapaflo, and Avodart is often effective.

Men who are diagnosed with BPH are usually started on medical therapy empirically, based on symptoms.  Most common medications such as Flomax, Rapaflo, finasteride or Avodart are used.  Cialis 5 mg daily is also used especially in men who also have erectile dysfunction.  Significant improvement in symptoms within 1-2 weeks after initiation of therapy is expected.

In men who do not show a significant improvement in symptoms, a search for reasons for an inadequate response to medical therapy is necessary.  Usually evaluation involves ultrasound of the bladder, urodynamic testing and cystoscopy.

When medications do not produce the desired benefit or help only a little bit, other medical problems may be responsible for the symptoms or the patient may have a complicated and advanced case of an enlarged prostate.

Overactive Bladder Is a Cause of Frequent Urination in Some Men

There is a number of possible reasons why medications do not work as well as one would expect them to work.  Some men have enlarged prostate and in addition to that have a bladder problem called overactive bladder.  Without separate treatment directed at the overactive bladder, treating symptoms of BPH may be insufficient.

Other Causes of Persistent Symptoms When Medications for BPH May Not Work

Very large prostate, especially with a large median lobe, maybe a reason medications such as finasteride do not work.  Urethral stricture or narrowing from scar formation is another reason for the ineffectiveness of medications for enlarged prostate in some men.   Bladder tumors such as bladder cancer or bladder stones may also cause symptoms that will not be helped by medications such as tamsulosin and finasteride.

Tests and Studies Commonly Performed to Determine Why Medications such as Rapaflo, Flomax, and Proscar Do Not Help

  • Pelvic Ultrasound with post-void residual (PVR) as well as uroflowmetry (Uroflow) to measure the rate of urine flow.
  • Cystoscopy
  • Urodynamic testing

you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts of the USA. We also see international patients from Canada, Japan, South America, Russia, Asia, Europe, Middle East, Africa, the Caribbean and other parts of the world.