Bladder neck hypertrophy/prostate hyperplasia

[Zafar68]

am a male 42 years old. I was diagnosed with minimal prostate hyperplasia and bladder neck hypertrophy. Are these two different conditions with different treatments?
The urine culture  always came out negative but even then I have taken oflaxcin for 6 weeks and then Bectrin DS for 4 weeks.  Antibiotics help for a while but then cause more problems like stomach pain and cramps. I had leukocytes in the urine but the culture was negative.
I have been on flomax (0.4)mg but the urge to urinate was there all the time so my doctor added (Vesicare 5mg). It was good for few weeks but then the urge got stronger and I was again given Bactrim DS for 4 weeks and now even with Bactrim DC I am not feeling any better. Few days back the doctor increased the dose of Floamx to 0.8 mg and stopped the Vesicare. It did not help and the urge to urinate is there all the time and there is tightness in the bladder. I also took Celebrex for few days and it helped a little bit. i am also taking EZ tea but nothing is working. Please let me know if surgery would relive all the symptoms and what other options do I have? Can I take effexor with Flomax and vesicare as I had anxiety disorder and use to take effexor before but stopped it about 1 year back. Now I am having a lot more anxiety due to my present condition. After stopping the Vesicar I am feeling the urge to urine all the time and i have to use to wash room every hour. Should I start 5mmg Vesicare again?

[Zafar68]

Thanks for the reply. I had four urine cultures done and nothing showed up. I had another urine culture done last week and it showed positive for Enterococcus. Now I am on Amoxicilin 500mg three times a day for 7 days. Before I was on 6 weeks course of floxacin and then 4 weeks on Bactrin DS, assuming that I had E.Coli infection though nothing showed up in urine culture.
Now my concern is that, is this infection the cause of the symptoms or just an add on to bladder hypertrophy and minimally obstructive prostate, that were the findings of Cystoscopy.
Its possible to get infected after cystoscopy. From what I have read enterococcus infection can occur due to hospital procedures.

[John987]

First, it's difficult to answer all these specifics in a forum like this.  But a couple of things:   often a prostate infection is not detected with urine cultures, and semen culture are required after you've been off antibiotics for a while.   The two conditions can be separate OR part of the same condition.  This condition is very frustrating because sometimes there is no explanation.  But medications that relieve muscle contractions ( Flomax and other alpha blockers) usually ease the symptoms when the problem is prostatic.
Make sure there are not other meds that aggravate it such as anti-histamines or decongestants which can make a prostate miserable.    Avoid cold, and warm the area with hot baths.  Empty the bladder more completely by urinating in a seated position and take your time as the muscles won't relax easily. Avoid caffeine and tea along with real spicey things.    If Vesicare helps, try the smallest dose that helps.   Also, there are some very good publications offered by Johns Hopkins on the prostate.