I am frequently urinating at night and having pain. Please suggest me what to do.

Hi,

Welcome to icliniq.com.

This is prostatic hyperplasia. Enlargement of the prostate is physiological after 50 years, and according to the shape, it causes blockage. Now you are symptomatic, and further evaluation is indicated. Some tests are required here, such as urine analysis and culture, serum PSA (prostate-specific antigen), uroflowmetry, serum ADH (arginine vasopressin) level, and fasting blood sugar. I suggest tablet Tamsulosin 0.4 mg once at night. More frequency at night could be due to prostate enlargement. It can also be due to inappropriate ADH hormone secretion, leading to increased frequency at night. I prefer to have the above tests done to be a complete workup, but if you could not do it, then you can start the treatment for prostate enlargement at the moment and then follow up later with the requested investigations. Please make your last drink two hours before bed and pass urine immediately before sleep. I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

No doubt, as your sleep is affected, tiredness is there. Painful orgasm can be due to prostate enlargement or inflammation. Stepwise treatment is better, in my view. You go ahead with the first treatment. If there is still painful ejaculation, we will do a semen culture to rule out bacterial prostatitis.

I hope it is clear.

Thank you.

Hello,

Welcome back to icliniq.com.

Since you are experiencing plenty of side effects, you can stop the medication. There is a herbal tablet with a similar impact on the prostate and almost no side effects. The name of the medicine is Saw Palmetto (Serenoa repens), or if you found capsule Prostafree, it will be better. The dose is once a day, and since it is herbal, there are fewer side effects. Suppose your poor flow symptoms persist after using the mentioned medication for a month. In that case, the other treatment option will be endoscopic resection of the prostate. Before the procedure, all tests should be done, like urine analysis and culture and ultrasound KUB (kidneys, ureters, and urinary bladder) uroflowmetry.

If you have any questions, please let me know.

Regards.

Hello,

Welcome back to icliniq.com.

Yes, the success is great, and the FDA approves this drug. It would be best to get capsule Prostafree; otherwise, you may continue Saw Palmetto (Serenoa repens).

All the best and keep in touch.

Regards.

Hi,

Welcome back to icliniq.com.

I understand your concern.

The effects of finasteride are prolonged and need at least three months to subside. Another thing, in my opinion, you should have testosterone tests and thyroid tests done. To see why depression and prolonged sleep. Thirdly you should treat your prostate with a urolift procedure to control symptoms without medications. Another option is REZUM which is far better than TURP with much lesser side effects.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Yes, that is right. Tadalafil with a daily dose of 5 mg will be great. The recommended dose will be 5 mg daily, and on the day you want to have sex, make it 10 mg (2 tablets together).