Using ED Medications to Treat BPH | Off the Cuff with Mark Moyad, MD, MPH & Steven Gange, MD

PCRI's resident moderator, Mark Moyad, MD, MPH, sits down with urologist Steven Gange, MD, FACS, to discuss the use of Cialis to treat lower urinary tract symptoms, bladder control drugs, and the use of supplements to treat benign prostatic hyperplasia (BPH, or prostate enlargement).
Dr. Steven Gange graduated from the UCLA School of Medicine in 1986. After his Urology residency training at the University of Kentucky in 1991, he entered the US Army as an academic urologist, teaching, and training residents. He joined Western Urological Clinic (now Summit Urology Group) in Salt Lake City, UT, in 1996. With over 25 years of clinical and research experience, he has developed an expertise in Men’s Health Urology, emphasizing minimally invasive procedures. He continues to be active as a Clinical Researcher and as such was the first Urologist in North America to perform the NeoTract UroLift for BPH, and the first in the world to perform UroLift under local anesthesia.
0:06 Cialis (tadalafil) as a treatment for BPH - Cialis (tadalafil) has an indication for the treatment of both erectile dysfunction and benign prostatic hyperplasia. Some men using Cialis have noticed an improvement in urinary symptoms, but it is not well understood why. Cialis is used, as opposed to a drug like Viagra, simply because Cialis lasts longer. A downside is that Cialis is expensive and it is also less effective for BPH than the alpha-blockers and 5-alpha reductase inhibitors.
2:28 Overactive bladder drugs - It often happens that a patient who is treated for urinary obstruction from BPH will continue to experience urinary symptoms due to overactive bladder. As the bladder begins to lose function, it will sometimes become hyperactive. Overactive bladder drugs relax the bladder so that it squeezes left often. Dr. Gange is unsatisfied with the side effect profiles of every bladder control drug with the exception of Myrbetriq, a beta-3 agonist.
4:55 Prostate supplements - There are no supplements that have outperformed placebo for BPH; however, placebos have performed so well that both Dr. Moyad and Dr. Gange are open to patients cautiously using supplements if they are improving symptoms.
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#BPH #MarkMoyadMD #StevenGangeMD

[@markscholz1219]

Cialis is now generic and therefore quite inexpensive

[@FactChecker1378]

Cialis was originally designed for bph, the boner is a side effect. BigPharm decided to market cialis for ED cause they can charge more.

[@gozitan5]

Tadalafil sorted my BPH / Nocturia. Gone from 3 - 4 times a night to once with no delay and a good flow, no after dribble. 5mg per day.

[@benixmaximus]

How long did it take? I've been taking it for about 6 weeks now. I've also been doing kegels

[@gozitan5]

@@benixmaximus If I remember it didn’t take long Ben….it’s been a few years now. Was great initially but the last six months I’ve been getting up maybe twice in the night. Other factors …obviously how much fluid consumed close to sleep time which I think has increased for me which doesn’t help. Through the winter months doesn’t help. I’ve found having a walk after dinner or an hour or so before bed helps to.

[@davidschreiner6667]

They gave me two alpha blockers and nearly killed me. I ended up with serious hypotension and a extremely low diastolic blood pressure. I have chronic nocturia and I figure I won't see next Christmas. I requested low-dose Cialis last week after doing some research. I no longer have much faith in the pharmaceutical sales technicians who are pretending to be doctors. So far the medical profession has cost me my left testicle due to a botched vasectomy, next they paralyzed me doing a myelogram after I asked them to stop. I ended up with 13 hours of emergency surgery and a sixteen-inch scar with fourteen metal rods and assorted plates and screws from what was supposed to be a second opinion on a herniated disc. I can no longer walk without crutches and for the last 14 years I have spent most of my time in a wheelchair. Nope I don't trust the white coats at all. I have PTSD Physician's Traumatic Stress Disorder.

[@way2fitTV]

: (

[@gr8ride411]

Tamsulosin hasn’t worked at all for my BPH. The side effects work though. 🙃

[@AdenosinePush]

I did this for a couple guys recently during residency who couldn't tolerate flomax and didn't want finasteride and oh my God they LOVED it. Good to know that you guys also don't really know how cialis works for BPH, glad we're talking about it :D

[@robertmccabe8632]

Address the insulin resistance first. Cut the carb.

[@cathum]

Thanks for this informative interview - addressing overactive bladder and drugs; tamsulosin works very well but has the side effect of dry ejaculation.

[@notofthisworld5998]

Not really a problem unless you are trying to have children.

[@miketony8152]

I just paid $8.00 for 90 tablets of 5 mg of tadalafil from an online pharmacy. My Dr. sent them the prescription, and they mailed it to me for $5.00

[@LewdCracker]

Who did you use? I’ve been looking around online and there are so many online places advertising it

[@RobCLynch]

I'm on Tamsulosin plus Finasteride for BPH and weak flow and I was wondering if anybody had an opinion on me changing Tamsulosin for Cialis? The Finasteride has improved the nocturia but I'm concerned about the links to dementia. The question is, would Cialis be as effective as Tamsulosin in improving urine flow?

[@waynegulledge864]

I QUIT TAKING FLOWMAX BECAUSE OF DEMENTIA CONCERN IM GOING TO GET TADADIL 5MG AND SEE IF THAT WORKS

[@vicroyer2745]

Yes you "wouldn't have to do this work anymore". Say I Love the Japanese art btw ha.. :) great stuff very informative.

[@Velo1010]

The alpha blockers are not without side effect. Namely one. When you ejaculate it doesn’t come out of the penis. Rather it goes back into the bladder.

[@samkitty5894]

There are 100 other ones...

[@Velo1010]

@@samkitty5894 well I’d like to know which drugs don’t cause retrograde ejaculation. So I can ask my urologist about those alternatives.

[@liveloveride1676]

I did try Flowmax for 4 days and did not like the side effects but the main one was I started to get an ulcer as I have a sensitive tummy, what I want to know is do all of the alpha blockers relax all your smooth muscles, especially the one in your tummy?

[@claudiocapelli7507]

Here is my finding, hop infusion through out the day, hop contains a molecule called Xanthohumol, which is an antidiuretic, works great with me, a beer (alcohol free) in the evening does a great job as well, just a physiological single pit stop at night.

[@ShubhamGupta-md5ps]

Hi Team, My father(53) was diagnosed with prostate cancer, and underwent RARP + BIL PLND in mid feb, his biopsy came out with negative surgical margins and no lymph node involvement, April starting his PSA was 0.01, May starting it went to 0.03, And today 29th may it is 0.1, Tripling every 4 weeks, Please suggest what should we do ??

[@daxmac3691]

Prostate supplements 05:25 "the only supplements of value have side effects"

[@michaelchin3550]

I used to sometimes get up every two hours a night to pee. I take 20MG of Sidenfil daily and now go 4 hours before getting up to pee.

[@samkitty5894]

20mg for daily use is way, way too much...considering Cialis stays in body for 36-72 hours. You may experience bad side effects...be careful and talk to your urologist.

[@michaelchin3550]

@@samkitty5894 How about 10mg once a week? I haven't taken any in probably a month now. I consume pumpkin seeds.

[@scotniver7180]

PROSTAGUTT

[@beingorganic8459]

Sir Please talk about zoledronic acid injection for bones. My father has been advised to get injected every month.

[@ThePCRI]

Hello, I will add this to our list of questions for future videos.

[@beingorganic8459]

@@ThePCRI thank you so much. Please talk abouts its short and long term side effects also.