Expert: Stephen W. Leslie, MD - 1/22/2007

Question
Dear Leslie,

I am really grateful for your expert advic.  Meanwhile I would like to know that daily use of multi vitamin which include "Zinc" would be helpful in improving prostate health and reducing PSA level?

Months ago I took VIAGRA 50 mg which worked for me. Later I switched to VEGA-100mg from some Indian Co. which worked at first but subsequently failed and I assume "excessive gas in large intestine and sever constipation" are the side effect of the drug 'VEGA'. Am I right?

Now, if I take approved drug VIAGRA of Pfizers, which suites me, will it be harmful to my prostate with raised PSA level?

Thanks.
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The text above is a follow-up to ...

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Dear Sir, Thank you very much for quick response.  Had visited Urologist who first put me on Hyterine 2 mg. It took it for 2 months but no improvement rather developed gastric problem. After 2-3 months statred cardura with the same results. so discontinued.  A month ago while facing, difficulty in passisng urine, also had sever constipation and excessive gas in larg intestine. Visted Urologist again who suggested above tests "urine flow and psa" Placed me on Xatral SR 5MG. I could take only 3 dosages which posed serious side effect and suffered with fever resulting weakness. For fever I took 1 paracitamol, 1 incidal and 1 capsul amoxil 3Xdaily for two days. Now I am having easy urine flow.

As for errection, I tried vacum device but no result. then took sildanfile tabs but little effect. Later got testosteron inj plus viagra 50mg. It worked occasionaly. I am afraid sever constipation & gas may not be bio-product of these medicines. Can I use viagra for errection in presence of the above conditions?

I am afraid of the Urologist for going into unnecessary tests/trials.


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The text above is a follow-up to ...

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I am 61 year old. Father of 7 kids. Remained sexually inactive for 10 years as my wife died. Am physically active. Do 4 brisk walking (30-45m)a week. No BP, Sugar, Depression. Got remarried last year. Having urinary as well as erection problem. My ultrasound shows normal prostate size but residual urine. Have 2-3 nocturnal visits to rest room. Feel difficulty in passing urine and have slow stream.  Recently had urine flow  and psa tests. Flow is ok and psa is 6.43. PSA test was done an hour after flow test. please advise:

1) about urinary problem.
2) about errection problem.

Thanks.  Waiting your response.
-----Answer-----
Seek advice of a good urologist.  Most likely you have BPH regardless of normal prostate size based on symptoms and high residual.  An alpha blocker medication should alleviate the urinary problems.  You also have ED which is also treatable.

The elevated PSA is more problematic.  Some urologists would recommend an immediate biopsy while others would suggest a 30 day trial of an antibiotic to see if the PSA would respond before ordering the biopsy.

Bottom line: see a urologist.
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It sounds like you were given appropriate treatment that unfortunately did not agree with you.  I do not approve of giving testosterone injections unless the patient has been proven to have low levels of male hormone.  Urine flow tests and a PSA are reasonable and useful examinations.

If you have a low hormone level, then testosterone will be helpful but it must be taken regularly and not just "once in a while".  Viagra's maximum dose is 100 mg.  Other meds such as Levitra and Cialis may work even if Viagra doesn't.  Other options include MUSE and penile injection therapy which have not yet been tried.

Unfortunately, your flow problem is not likely to have been cured and will probably return.  If medications are not effective or tolerable, you may be looking at some type of surgical procedure to fix the flow problem.

Answer
Oral zinc of and by itself is not particularly helpful as it usually fails to enter the prostate.  It's thought that selenium and vitamin B-6 may be necessary to help facilitate the movement of zinc into the prostate cells.

Vega100 is not a drug; just a supplement.  Since it's not a drug, it's not been tested.  If the label says that constipation and intestinal gas are side effects, that's probably correct.

There is no evidence suggesting that Viagra causes any harm to the prostate.