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Urology/prostate problem at young age


Hi .. I am 41 yrs old and suffer from enlarged prostate. I have been taking meds (@1 receptors) for the past 5 years (intermittently) or so. However, urine flow isn't improving much, though frequency has come down.

Doctor now recommends surgery as the only option (TURP) - considering bladder walls will weaken further if its not treated. (As per previous scan/test, bladder is weak at 1+ and walls are trabeculated). I have a few questions:

1. I am currently on Duasteride + Tamsulosin (brand name Duodart) - is there a higher/better medication than this.
2. I requested for a change (due to side effects like erectile dysfunction) and Doctor recommends Finasteride & Alfuzosin - is it any better or worse?
3. How about silodosine -  is it likely to have lesser of these side effects?
4. If surgery is the only option - is TUNA better than TURP?


The available medications are very similar except that tamsosin tends to have ejaculatory side effects. Changing to silodosin will not help much.  However we do not like to do surgery on someone so young. Consider a second opinion before doing any surgery.  TURP is more invasive but he really considered a better surgery. Be sure to ask the surgeon how many he has done as more experience is better.


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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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