Dear Dr. Roach: I am 71, and I recently saw my urologist for urinating a lot and not getting enough sleep. He performed a flow test and a scope, then told me that I have an enlarged prostate. My urologist is recommending a procedure but doesn’t support the idea of using a balloon treatment.

Next week, I am scheduled to have my prostate measured to decide on the best procedure. I have been taking 0.4 mg of tamsulosin and 5 mg of finasteride. Is there anything over-the-counter that can help me not urinate as much until I get the treatment? I don’t know when this will happen.

— D.B.

Answer: Men with a symptomatic enlarged prostate are normally treated with tamsulosin, but in men with severe symptoms who don’t respond to tamsulosin, finasteride is used. Occasionally, I have used two tamsulosin pills (for a total of 0.8 mg) in men who have symptoms while awaiting definitive treatment with a surgical procedure. You might ask your urologist if this is an option for you.

I do not recommend any of the over-the-counter treatments as there is very little indication that they add anything to the medication regimen you are on.

There are many surgical options, from the traditional transurethral resection of the prostate (TURP) that still has excellent outcomes, to other treatments (laser, cold, heat, microwave and others) that may not be quite as effective but have fewer side effects. I never second-guess the urologist, who has the knowledge and experience to make the best recommendation for you.

Dear Dr. Roach: After having cataract surgery four years ago, I have had constant pain and itching in spite of trying over-the-counter eye drops as well as high-priced prescriptions. Nothing, including upper/lower plugs and laser treatments, has helped. At night, I usually wake up at 2-hour intervals and have to apply more drops. I’ve now developed what looks like dandruff around my lashes, which increases the itchiness.

My ophthalmologist is naturally attentive, and I have a drawer full of samples that he has given me to try, none of which have helped. Do you have any advice or help for me, or is this as good as it gets?

— I.F.

Answer: Dry or itchy eyes are very common after cataract surgery, but it normally lasts for just a few weeks. I have also seen people get “stuck” in a cycle of rubbing their eyes, which makes them more irritated and causes them to itch more. Different drops can often be the solution (along with being careful not to rub your eyes).

However, your ophthalmologist has much more experience than I do and seems to have tried many different treatments. There is a key finding in what you have told me that leads me to have a suspicion, which I hope will help you:

The “dandruff” around your lashes is highly suggestive of an infestation of Demodex, a tiny mite that lives in the hair follicles around the eye. Although this isn’t specific to eye surgeries, sometimes the number of mites gets out of control, causing itching and swelling in the eyelid that doesn’t get better with standard therapies. Ask your eye doctor to do an exam of an eyelash under the microscope to look for Demodex. There are many effective treatments if this is the case.

The meibomian glands in the eyelid can also be blocked, which leads to dry, itchy eyes. There are ophthalmologists who specialize in the treatment of dry eyes and eyelid disorders if your cataract surgeon is unable to help.

Contact Dr. Roach at ToYourGoodHealth@med.cornell.edu.