Hello! I will be working closely with my dad‘s urologist and PCP, but was hoping for some guidance/advice for navigating things for my dad.
He is 80 and had a stroke right before covid, I’ve been his primary caregiver since. He has been on finasteride for the past couple of years to help manage BPH symptoms, and it’s been okay (trips to the bathroom every 90 min to 2 hours, helping him with the urinal at night about 2 - 4x depending). He is very well hydrated, so the number of times *almost* makes sense, but he does have a hard time starting, then has starts/stops/weak stream/not feeling like his bladder is empty.
This past week, though, we are taking him every 60 min and sometimes have to pull out the urinal before we make it to the bathroom. This has never happens before. Definitely increased frequency and urgency.
I have an appt scheduled with his urologist, who asked us to do a CT-ivp beforehand, and he will do a cystoscopy in a couple weeks.
In the meantime, our PCP started my dad on tamsulosin and tadalafil. Giving him the first doses tonight and tomorrow, respectively.
My question is: how do you determine whether to treat your symptoms with medications or with another intervention?
My dad is on blood thinners and has right sided weakness so of course I don’t want to put him through a procedure. However, even the previous bathroom frequency affected his QOL. Plus I don’t necessarily want to be in this position of asking this question 2 - 5 years down the road.
I will of course discuss this with his medical team but as a family we’re trying to decide.
If the meds work to alleviate his symptoms, is it even necessary to do the cystoscopy? Will the meds help shrink the prostrate enough over time, or should we be considering a Holep or ProVee (or whatever the least invasive option is)? PCP seems to be leaning toward using the meds while they work. Not sure what the urologist will suggest but was curious how you guys decided when to use meds vs a procedure since the posts here seem to be a mix of both.
thank you in advance!!!