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Urology/Prostate Issues


QUESTION: How are most prostate problems detected? What cancer symptoms would there be? Other than urination troubles how is over enlarged prostate detected? What other issues are there? And lastly in the case of enlarged prostate how does one reduce its size other than avatart?

ANSWER: James:

Lots of good questions  Here goes:

Prostate problems are usually detected by urinary complaints from the patient such as weak stream, frequency, urgency, nocturia and similar symptoms.  A digital rectal exam can confirm enlargement or inflammation.  We can also check the urinary stream with a flowmeter and the bladder residual urine with an ultrasound scanner.  In some cases, a direct look through the prostate into the bladder is needed (cystoscopy).

There are no symptoms specific for prostate cancer.

The digital rectal exam can estimate prostate size even without urinary symptoms.

The only known ways to reduce prostate size are Avodart (dutasteride), Proscar (finasteride) or surgery.

---------- FOLLOW-UP ----------

QUESTION: Well the reason I ask about treatments for oversized prostate is because I think I may have issues with mine, and for 10 days I was on Propecia for hair loss which I'm told is similar to Avodart, and it only gave me suicidal thoughts.


Propecia is a very low dose of finasteride which is similar, but not identical, to dutasteride (Avodart).  The dosage is not sufficient to affect the prostate and if it didn't agree with you, you should probably avoid it.

If you think you have issues with an enlarged prostate, talk to your physician or consult urology.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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