Hope you guys don't get all shy about
a lady joining the conversation...
I've read pretty much this entire topic with interest, because my S.O. has BPH and was initially prescribed Galebon (0.4 mg prolonged-release tamsulosin hydrochloride) which he's been taking for just over a year, but has now also been prescribed finasteride as the tamsulosin hasn't done thie trick. Which has pretty much killed our 10-year relationship
He's suggested that we 'downgrade' the relationship to 'just friends', because of the side effects of these drugs. I'm desperate to find an alternative, effective treatment for his BPH.
However, things aren't all that straightforward.
25 years ago he was diagnosed with testicular cancer and had a testicle removed (and I'm ashamed to say I can't remember if it was left or right!) However, because of post-surgical complications (bowel adhesions) he had further surgery and has internal staples still in place (very odd - feels like a zipper under his skin) and a large scar from just below his sternum to the top of his pubic bone. He also had chemo- and radiotherapy.
He did go on to have two more children with his ex-wife following surgery, so fertility was clearly not an issue!
I suspect his medical history may mean that surgical treatments are out. The transurethral treatments are simply barbaric, and the side effects of those... well, just no...
So that leaves the percutaneous treatments.
Venous coil embolisation? Possibly, but might not be possible for some of the ISV collaterals. Arterial embolisation? Nope - doesn't make sense to me. Venous sclerotherapy? Seems like the best choice.
I've read soooo many papers, articles, what-have-you. Gat and Goren's explanation of how a varicocele (even sub-clinical) can result in BPH and why their method would work makes sense on so many levels. As do their explanations of how it improves fertility.
There are a few things I wish I had the answers to; for instance the correlation between varicocele and BPH. Not all patients with unilateral or even bilateral varicocele have BPH, but do all patients with BPH have varicoceles?
The drug therapies seem to treat the symptoms (sometimes!), but don't actually address the problem, and frankly I think the side effects are pretty unacceptable - and even more so for the transurethral treatments. But then, the symptoms of BPH (and complications thereof) are pretty darn horrific for you poor guys too, so I guess you're all between a rock and a hard place on this one...
Good luck and best wishes to all of you, whichever treatment options you choose.