Alternatives to Avodart and Flomax? Ask the Expert

Dear Dr. Motola,

I'm in my mid-70s and have been taking Avodart and Flomax for the last two years for enlarged prostate. Little improvements of the symptoms have been noticed with the medication therapy. Recently, my urologist recommended a two-step procedure to treat the condition. First try the heat treatment using microwave, and then followed by TURP, a more invasive procedure, if the first method does not produce the desired results. I would appreciate answers or comments to the following two questions:

1. Is the two-step procedure described above widely adopted by urologists?
2. Is there a better procedure than TURP, which results in a faster recovery with fewer complications and adverse side effects?

Combination therapies are used in many patients with great success, however after two years without any improvement an alternative therapy should be considered.

Staged procedures for treating enlarged prostates are described however the approach that you are referring to is not the most widely utilized. In theory the microwave would help facilitate the TURP by at least limiting the amount of blood loss that would occur with a large prostate that undergoes such a procedure.

Without knowing the exact volume of your prostate it is difficult to answer this question. The newest laser (Green Light HPS) enables the urologist to utilize higher energy settings, thus making it easier for urologists to treat larger prostates in one session.

If your doctor is raising the question of the need for a TURP after a microwave, it is wise to question whether the microwave is the ideal initial treatment.