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Posted 4/8/2007 5:30 AM (GMT -8)

After long and careful consideration I undertook  Brachy Therapy in September 2006. I chose Brachy over Radical Prostatectomy as the method seemed less likely to cause Impotence.

Before doing so, I was required to take   a hormonal  shot (Zelodex) in order to reduce the Prostate size.

The effect seemed positive,  but according to my Urologist, the Prostate had increased in size again on the day that BT was performed.

The result was that I had serious difficulties in urinating and after five months of sleepless nights and manual catheterisataion, I finally convinced my Urologist to perform another Op to opened up my Urethra.

This OP was performed on the 13th of February of this year and  seemed to work well though  the need to urinate is frequent.

Will the need to urinate reduce in frequency?

The most serious post Brachy problem that I have is regarding Impotence.

Although I was very happy with my new PSA count of 0.03, my testosterone levels are at 500, well below the average. My libido is reduce to close to zero as a result and worse still, when I do manage an erection, it is 3 inches less than pre Brachy.

My Urologist is reluctant to subscibe a Hormonal treatment to raise my tostestorone levels as this could cause a return of the tumor.

Cap all that with the fact that I now have Peyronies Disease and you can see why I am not a Happy Camper.

Can anyone help?

Posted 4/8/2007 8:49 AM (GMT -8)
Orph,

Well for beginners, your testosterone is not...I repeat, not your problem. You have a total T of 500....well into the norm actually. Have yout estradiol checked lately? The T level honestly isn't the cause of your lower libido. I'm thinking it's a combination of events that has lead to a decrease in desire. The decrease in size may benefit from a regular therapy routine with a VED and or doses of Viagra, Cialis or Levitra. You need to increase circulation to the penis itself. And you thought you'd go blind!!! Everything in life has a purpose, eh?

Depending on what other health problems and medications you may have, there is always the herbal route for enhancing libido....which may have some positive effects in your situation. Horny Goat Weed and L-Arginine both come to mind. Thanks for stopping in...we'd like to see you through some of this ....hang in there.

Swim
Posted 4/8/2007 8:55 AM (GMT -8)
PS:

400 IU of a good mixed E a day is first line for peyronies. L-Arginine and Horney Goat weed and daily small doses of Cialis are very commonly used. The VED may help reverse some of the damage. Peyronies or Kelami syndrome is not an uncommon event following prostate cancer treatment. Check out a forum called Peyroinie's Society...there are post PCa men there who have been dealing with the problems and may have some good advise for you.

Good Luck swim
Posted 4/8/2007 10:54 AM (GMT -8)
One of my close friends and a regular golf partner has shared that he has some of the same problems that you do. His Brachtherapy procedure was about the same time as yours.  He carries a manual catheter kit with him and for some time needed it all of the time.  That condition appears to be improving over the past week or so.   As an interesting aside, we have another mutual friend who had his brachy therapy at the same time.  He has never had a post procedure problem.  The only difference that we have been able to note is that the friend who has problems did not have a catheter inserted rightr after his procedure. The friend withOUT problems had a full catheter for about a week after.  We don't know if it that might be part of the reason, but it is worth considering.

Hope you get some more good advice soon.  Your decision to avoid surgery due to impotenance was a good one.  It is my major problem now after about 12 weeks.

Posted 4/8/2007 4:14 PM (GMT -8)
Would like to thank you both for your most informative feedback.
Am a little concerned about using Viagra as I heard that it could cause a return of the the tumor. However, would certainly give a herbal remedy a shot.
Even though 9 months have passed, I can´t help feeling that the Zelodex shot that I had last July had something to do with my lack of libido and low testoterone level. Prior to my last Op in Feb, I had hair shaved from my navel and upper thighs. Curiously enough these small hairs have not grown back, though hair has started to grow in a bald patch on my head.
I was told that my PSA would be around 2 after Brachy but was rewarded(?) with 0,03. This could be another indication that Zelodex has created an inbalance in my system.
The other disturbing surprise that I had in store for myself was that a rare orgasm of mine produced no semen whatsoever.
Strange fellows, these hormones.
I am also a golfer and I had to check myself from blaming golf for my condition!
Anyway, as far as my Libido is concerned, I am sure that I will get back into the "saddle" before I am through. I will keep you informed of my progress. Important thing is not to lose your sense of humor!
Any further feedback wold be most gratefully received
Orph
Posted 4/8/2007 6:51 PM (GMT -8)
Orph,

Who the hey told you Viagra causes tumors? Please talk to your Doc. There is absolutely no risk of recurring cancer from any of the PDE5 drugs. There are some no-no's to taking alternatives. People with certain conditions should stay away from arginine and goat weed. Any renal dysfunction is a no-no with arginine for example. Men with hard to control hypertension should not use goat weed. There are some things to consider so don't rush to the store without looking these up. Life Extension has some very useful articles. If you have no kidney problems and you don't have seriously elevated BP, look up goat weed and see if it's something you might be interested in. Goat weed, arginine and cialis is a common cocktail for men on the peyronie's site.

As for your libido, yeah, maybe the Zoledex has some to do with that stilll but, it should wear off soon. It has been a while. And...500 is not a low testosterone level. Perhaps lower than you want but certainly not hyogonadal. Has the Doc drawn a free-T level? Free T is probably more useful. If the free T is low then I see a potential cause to account for some ed and libido loss. I have some thoughts.........

Just for giggles, ask the Doc to check your estradiol level (should be between 10 and 30ish). High estrogen levels in men can cause low libido, lower free T levels and ED. Like Ca treatment isn't enough to contend with eh? If you are prone to carrying belly fat it is quite possible. Adrenal fatigue also comes to mind. It could also be possible you have a sluggish thyroid. Like you said...hormones are strange! The ole body and mind have been through some long term stress....stuff happens !

As you see, it isn't as simple as adding testosterone. Finding the cause is as important as the consideration of treatment. No Doc is going to add testosterone to a man with a level of 500...not any that I know of anyway. Good luck to you. Hang in there Orph.

Swim
Posted 4/9/2007 5:06 AM (GMT -8)
Lots of food for thought Swim.
Do not see any reason for not taking Goatweed and Arginine.
I´ll talk to the Urologist and ask him first. Will also ask him to give me a presciption to check my T and Estradial Levels.
I checked out the Peyronies Website that you had referred me to. Interesting. I have not posted anything just yet but have gathered some interesting information. They also recommended a VED and a fair few of their members have had encouraging results with the use of certain drugs. The Urologists that I have spoken to this end do not seem to take much interest in Peyronies. I suppose they prefer getting their teeth into life threatening issues...
Unless I can found one who specialises in this disease, it looks like I will have to do the groundwork myelf. (with a little help from you if you don´t mind)!
Thanks again for your help

Orph
Posted 4/9/2007 5:29 AM (GMT -8)
Orph,

Sure...whatever I can do.....let me know.

Quick cuz I need to scoot. I'm not so sure you have Peyronie's exactly but rather a syndrome called Kelami, better known as utethral manipulation syndrome. This might actually get better on its own with vitamin E, regular excersise with a VED and one of the big 3, 3 times a week (big 3 = Viagra, levitra or Cialis). If there is no plaque, no pain and the curvature was sudden, it's probably Kelami...better than true Peyronie's IMHO but treated the same. Kelami actually has a better chance at recovery probably but, you need to get that organ working often. If it doesn't get better...well, deal with that when it happens.

Paul developed a curvature seemingly over night a year after surgery but it hasn't gotten any worse. In hind sight, I saw the beginnings from day one after surgery. It has gotten no better but no worse since its onset. Yes, it has affected his eretions but that too we can deal with. The key for him is to keep a routine therapy program going and the key to that is him not being too lazy...he's a slacker ya know!
Posted 4/9/2007 6:02 AM (GMT -8)
Lol
Not experiencing pain as such but there is a slight burning sensation, almost a kind of rush, just after urinating. This sensation comes from the head of the penis and not the shaft, which leads me to believe that this is not Peyronie related.
Curiously, this mild burning sensation is less pronounced when I relieve a full or close to full bladder.
As I had said before, the need to urinate seems to be coming with more frequency during the day and I would love to know why.
Back to PD; the curvature of my unit was not sudden at all. In fact, it started to bend slightly BEFORE BT, so it would appear that the two are unrelated. All down to wear and tear, I guess!
One other thing that I would like to compare with other Brachy patients is if they experienced any difference with their bowel movements. For some strange reason I need to repeat two and sometimes three times in the morning and often urinating seems to want to trigger a bowel movement.

I am 53 years old, by the way.

BFN

Orph
Posted 4/10/2007 7:27 AM (GMT -8)

Hello:

I'm sorry to hear of your post-brachytherapy problems.  My husband had treatment last year (where does the time go?!) and never had any problems from the get go other than some fatigue.  The frequency will (or should) slow down - did your doctor prescribe you any Flo-Max - that seemed to help my husband tremendously.

I don't know where you heard Viagra causes a return of tumours - our Brachytherapist recommends one of Viagara, Levitra and/or Cialis so I cannot imagine her recommending something that would ultimately become a concern.

Best of luck to you - if you have any more questions please post.

Posted 4/19/2007 7:41 AM (GMT -8)
Thank you Julie

I will mention this "Flo Max" to my Urologist. This drug is to decrease urination frequency?

My  urination frequency is increasing and and as a result get very little sleep, waking on the hour almost.

I assume that the increase in urination frequency is down to the size of the Prostate?

If Swim is around, I would also like ot hear his views.

Orph

Posted 4/20/2007 9:00 AM (GMT -8)
Flo-Max essentially settles everything down so the flow is smooth (if that makes any sense) and you experience very little, if any, burning, etc. so there's very little discomfort.  Hope that helps.

Julie

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