DEAR DR. ROACH: I’m 79, and for several years, I have been taking finasteride and tamsulosin for benign prostatic hyperplasia. (In the past, I underwent a TURP procedure, which I will never go through again.) As we know, within time, these medications will affect your sexual drive and erectile function.

My urologist wants to perform a new treatment on me called UroLift, which would increase my sexual drive and improve my erectile dysfunction. I would no longer need to take the above medications. I would like to know your pros and cons with this procedure. — B.M.R.

ANSWER: I am concerned that your understanding of the benefits of the UroLift procedure might be overly optimistic. UroLift uses mechanical implants to pull the prostate tissue away from the urethra (the tube that carries urine from the bladder to the outside of the body). This relieves the obstruction that can be caused by an enlarged prostate.

Most men have about a 90% improvement in prostate symptoms immediately after the procedure, which was then reduced to about 50% improvement over their baseline after five years. UroLift is very effective at preserving sexual function, but it does not guarantee improved sexual function.

Of the two medicines that you take, tamsulosin (Flomax) very infrequently affects erectile function, about as often as a placebo drug. Less than 2% of men will notice a loss of desire with tamsulosin — again, about the same as a placebo tablet (which doesn’t have an active ingredient).

Finasteride (Proscar) is more likely to cause problems with sexual function, but it is still uncommon. During the first year of treatment, erectile dysfunction was noted in 8.1% of finasteride-treated patients, compared to 3.7% of men who were on a placebo. Loss of interest was noted in 6% of men on finasteride, compared to 3% of men on a placebo.

If UroLift is successful, many men can stop their medications. If the medicine is the cause of their sexual troubles, then there is a good chance that it will improve. However, in one study, as few as 10% of men who had the UroLift procedure (and as many as 60% of men in another study) needed to continue their medications, and 22% needed another procedure within five years.

UroLift may succeed in relieving your enlarged prostate symptoms and may allow you to stop taking medication. However, not all men can stop their medicines, and the procedure itself does not improve sexual function or interest.

DEAR DR. ROACH: In a recent hospital stay for a bleeding stomach ulcer, I was diagnosed with Helicobacter pylori. I required two units of blood. Can you please explain how H. pylori is contracted/acquired? — R.N.

ANSWER: H. pylori is an intestinal bacterial species that was shown to be the cause of most stomach ulcers, apart from ulcers that are caused by medications like anti-inflammatory drugs. This changed the entire way in which we thought about ulcers, and the eradication of your H. pylori infection is indicated to prevent another ulcer.

It is thought that most people contract H. pylori during childhood, mostly through infected water. As sanitation has generally improved worldwide over the past 50 years, the rates of H. pylori have decreased. In Japan, for example, more than 60% of people who were born in the 1930s contracted H. pylori, compared to less than 10% of those who were born after 2000.

In more recent years, the improved identification and treatment of H. pylori have decreased the number of people who get infected. Among United States veterans, the prevalence of H. pylori decreased from 36% in the early 2000s to 18% in the mid-2010s.

H. pylori is usually treated with a combination of antibiotics and antacid drugs, but there are several effective regimens. Drs. Barry Marshall and Robin Warren won the 2005 Nobel Prize in Physiology or Medicine for this discovery.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc. All Rights Reserved