Q: My 64 years old father has been suffering from frequent urination for the last couple of months. He had a heart stroke 20 years back. He had diabetes ten years back, but now his sugar level is under control. We consulted a urologist and uroflowmetry, transrectal ultrasound and urine and blood tests (PSA) were done. After tests, prostate size - 4.5 x 3.9 x 3.1 cm (volume 28 cc), PSA - 1.07 mg/ml and uroflowmetry - maximum flow (11 ml/sec), average flow (5 ml/sec) were found. An enlarged prostate was diagnosed and the doctor asked my father to take tamdura for six months and asked to go for the same tests after the medication course. Does my father need to take tamdura for prostate size of 28 cc? He is already taking a few medicines for other medical conditions. Can we wait for the medication course, as the only symptom that my father has is frequent urination (4 times at night).

A:1. Tamdura contains tamsulosin and dutasteride. While tamsulosin improves the flow, dutasteride reduces the size of prostate over long term. Dutasteride is useful only for prostates large in size, usually more than 30 ml. 2. Decision to prescribe medication must have been based on the poor flow seen on uroflometry (11 ml/sec). Your father's night frequency may be related to obstruction due to prostate, but may also result from pedal edema with poor heart function, or uncontrolled diabetes apart from many other clinical conditions. Such clinical decision can only be taken after proper examination and clinical correlation of investigations, and iis not possible on incomplete information provided via mails or telephone.