Archive for the ‘Benign enlargement of the prostate’ Category

The Care and Feeding of the Enlarged Prostate Gland

October 21, 2016

If you are a man, then you have a prostate gland.  If you have a prostate gland, then you are likely to be one of the 14 million American men who experience bothersome symptoms beginning around age 50.  This article will discuss the diagnosis of the enlarged prostate gland and what are some of the available treatment options that can reduce the symptoms associated with this common condition.  It is a walnut sized organ at the base of the bladder and surrounds the urethra or tube that is in the penis and transports urine from the bladder to the outside of the body.  It is common and even normal for the prostate gland to become enlarged as a man ages. Though the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until middle age or around 50. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their seventies and eighties have symptoms of BPH.

The prostate gland encircles the urethra like a donut, so problems with urination can occur if the gland restricts urine flow through the urethra. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose.

The following changes occur over a period of time.

  • The bladder wall becomes thicker and will contract without the owner’s permission causing urgency of urination.
  • The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
  • Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder.

The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Some problems associated with BPH are

  • Urinating more often during the day
  • Need to urinate frequently during the night
  • Urinary urgency, which means the urge to urinate is so strong and sudden, you may not make it to the toilet in time and soil your clothing-very embarrassing!
  • The urine stream is slow to start
  • Dribbling after urination
  • A sensation that the bladder isn’t emptied after urination
  • Lack of force to the urine flow, which makes aiming more difficult
  • The sensation of needing to go again a few minutes after urinating

Diagnoses

You may first notice symptoms of BPH yourself, or your doctor may find that your prostate is enlarged during a routine check-up. The doctor can determine the size of the prostate gland during a physical examination.

The diagnosis is made with several of the following tests:

Symptom Score

This is a brief questionnaire that provides a numerical value to the symptoms associated with urination.  The higher the score (maximum is 25), the more symptoms a man has and the more likely he will want to have treatment for relief of his symptoms.

Urinalysis

A urine sample is taken to look for signs of blood and infection.

Digital Rectal Examination (DRE)

Your doctor inserts a gloved finger into the rectum to feel the condition of the prostate that lies close to the rectal wall. If your doctor feels something suspicious such as a lump or bump, further tests will be carried out. Other tests are needed to enable a more accurate diagnosis. 

Prostate Specific Antigen (PSA) Test

A blood sample is taken by your doctor to check for prostate specific antigen (PSA), which is produced by the prostate and is increased by cellular abnormalities within the prostate.

As men get older the prostate gland grows and so the PSA is likely to rise. A high PSA may indicate some type of prostate disease. The level can be raised due to inflammation of the prostate (Prostatitis) and enlargement of the prostate gland (Benign Prostatic Hyperplasia or BPH).

Urine flow rate

This test consists of a man urinating in private over a funnel which measures the volume of urine and the time that it takes to empty the bladder.  The urine flow rate is expressed in milliliters per second.  Normal is greater than 15 ml\second.

Urodynamics

Sometimes the doctor will ask a patient to urinate into a special device that measures how quickly the urine is flowing. A reduced flow often suggests BPH.

Imaging studies

The ultrasound examination evaluates the size of the prostate gland which often determines the treatment option which is best for your situation.  It is a painless examination consisting of the insertion of a small pencil-size probe into the rectum and uses sound waves to determine the appropriate treatment for prostate gland enlargement.

Cystoscopy

In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after a solution numbs the inside of the penis so all sensation is lost. The tube, called a cystoscope, contains a lens and a light system, which help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.

Treatment options

  1. Watchful waiting-If the person has BPH but is not bothered by the symptoms, the patient and the doctor may decide to simply wait and monitor the condition regularly. This option requires regular check-ups with the doctor – usually once a year – to see if the condition is getting any worse.
  1. Drug therapyYour doctor may advise drug therapy which aims at shrinking the enlarged prostate. The doctor will select the medication that best suits the condition, keeping in mind the person’s general health condition, medical history, medications taken for other conditions and quality of life considerations.
  1. Minimally invasive treatments-The prostatic urethral lift or UroLift is an implant of several polyester sutures connected by two small metallic tabs that opens the prostate gland located in the urethra and improves the flow of urine thus decreasing the symptoms of the enlarged prostate gland. UroLift has been approved by the FDA to relieve the symptoms of the enlarged prostate gland. There have been nearly xx thousand of men who have had the treatment which reports favorable results up to 4 years. Most insurance companies will now pay for the UroLift procedure 
  1. Surgery-Surgery is another option for the treatment of BPH. The most common type of surgery for BPH is TURP (Trans Urethral Resection of the Prostate). This procedure requires an admission to the hospital, a general anesthesia, a urinary catheter for several days, and the risk of sexual problems afterwards.

Bottom Line:  Nearly all men will experience the problems associated with the enlarged prostate gland.  The enlarged prostate gland impacts a man’s quality of life.  Help is available and nearly all men can be helped.  If you have symptoms associated with urination, speak to your doctor.

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Don’t Beat the Band to Treat the Enlarged Prostrate Gland

October 21, 2016

The prostate is just a walnut sized gland that forms a part of the male reproductive system. The gland is constructed of two lobes, or areas, surrounded by an outer layer of tissue. For reasons not entirely understood, the prostate gland becomes enlarged, causes problems with urination, and affects a man’s quality of life.  That may be the bad news.  The good news is that there are ways to treat it.

 

The prostate can be found in front of the rectum and just beneath the urinary bladder, where urine is stored. The prostate also encompasses the urethra, the duct by which urine passes out from the body. For most men, the nightly bathroom runs can be the very first indication of an enlarged prostate. Other symptoms might include problem beginning a flow of urine, leaking or dribbling.

 

During the early stage of prostate enlargement, the urinary bladder muscle becomes thicker and forces pee through the narrow urethra by contracting more strongly. Like grey hair, an enlarged prostate is just a natural byproduct of getting older, doctors say.

Although it is just not known why only some males develop an enlarged prostate, it is clear that increasing age is the primary risk factor. The problem is, the nightly bathroom runs can be frequent, finally edging their way into the day routine. I recommend seeing your doctor if you develop urinary difficulties because of an enlarged prostate.

 

Benign prostatic hypertrophy is a non-cancerous enhancement of the prostate gland, often found in men over the age of fifty. Problem in passing urine or pain when passing urine, a burning or stinging feeling when passing urine, strong, regular urge to pass urine, even when there is just a small amount of urine are the signs of benign prostatic hypertrophy.

 

Treatment for an enlarged prostate is dependent upon the symptoms and signs and their severity. In case you have significant problems, like urinary bleeding, persistent bladder infections, urinary bladder and kidney harm, your physician will likely recommend treatment.

 

In case your prostate is enlarged, but your symptoms are not too bothersome, treatment might not be necessary. This is referred to as watchful waiting.  If you and your doctor select this option, you will be asked to return about once a year for a symptom check, a prostate exam and a PSA test or prostate specific antigen test which is a screen test for prostate cancer in men between the ages of 50 and 75.

 

There are two kinds of medication that help to control the signs of an enlarged prostate, they are alpha blockers and alpha reductase Inhibitors.

The alpha blockers work by calming the muscles at the neck of the urinary bladder making urination easier. Alpha reductase inhibitors work be actually shrinking the size of the prostate gland.  An enlarged prostate now is just easier to treat if the treatment begins early. These medications have side effects including reducing the volume of the ejaculate at the time of sexual intimacy.  The alpha blockers also affect the ability to have cataract surgery which is very common in older men.  Finally, the drugs must be taken for the rest of man’s life.

 

Now there are minimally invasive treatments such as lasers, prostatic urethral implants or UroLift to open the prostate to allow an improved flow of urine from the bladder to the outside of your body, and the use of steam or water vapor to heat the prostate tissue to reduce its size and affect urine flow.

 

Finally, there are surgical procedures to remove the prostate tissue.  The most common is the transurethral resection of the prostate or TURP.  These operations require admission to the hospital, a general anesthesia so the patient doesn’t experience any pain, the use of a catheter for a few days, and several weeks or moths to return to normal activity.

 

Your doctor will explain the different treatments and which might be best for your situation.

 

FAQs on the Enlarged Prostate

October 21, 2016

 

What is BPH?
 Benign prostatic hyperplasia is commonly known as enlarged prostate. BPH is a non-cancerous condition in which prostate cells grow, enlarging the gland and causing it to squeeze the urethra. A variety of symptoms may result, including difficult, frequent or urgent urination.

When Should I Seek BPH Treatment?
If you are experiencing BPH symptoms that are affecting your quality of life, such as losing sleep because you need to wake during the night to urinate, you are unable to urinate, you are unable to delay urination, have hesitancy, or a weak urine stream, check with your urologist to discuss if it is time to seek treatment.

BPH is not cancerous and is not life threatening, but it does create bothersome symptoms can significantly impact quality of life.

What Are the Long Term Risks of BPH?

If left untreated, BPH can progress and cause subsequent medical issues. When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones, blood in the urine (hematuria), incontinence, or urinary retention. In rare cases, bladder and/or kidney damage can develop from BPH.

What are the Treatment Options?

Based on the AUA Guidelines for the treatment of BPH, there are four recommended treatment options: Watchful Waiting, medications, in-office therapy, and surgery.

Are In-Office Therapies Safe?

Yes, these treatments are safe. UroLift has been cleared by the FDA to treat BPH. In-Office BPH Treatments are associated with few side effects and adverse events.

Are In-Office Therapies Effective?

Based on clinical studies, in office procedures is proven to be a safe, effective and durable option for BPH with very few side effects.

Are In-Office Therapies Covered By Insurance?

Medicare and many commercial insurance plans provide coverage for the UroLift procedure. Ask your doctor’s office to assist you by providing the information your insurance plan may require.

Do In-Office Therapies Hurt?

Some men describe the UroLift as causing some discomfort, while most men report no discomfort at all.

Will I need a catheter after the treatment?

Most patients will not need a catheter after the procedure.

Can I go home right after the procedure?
 Yes. You should arrange for someone to drive you home because you may have been given some medication to help you relax during the procedure. Your urologist will give you post-treatment instructions and prescriptions and explain the recovery period to you.

Bottom Line: BPH is a common problem and effective treatments are available.  For more answers, speak to your physician.

Testosterone and the Prostate Gland-Hormone Replacement Is Safe For Your Prostate Gland

January 28, 2016

I am also asked if using testosterone, injections, topical gels, or pellets, will worsen urinary symptoms in men suffering from testosterone deficiency.

Millions of Americans suffer from testosterone deficiency.  They have symptoms of loss of energy, erectile dysfunction, loss of libido, loss of muscle mass, and emotional mood swings.  The diagnosis is easily made with a testosterone blood test.

A recent review finds no evidence that testosterone replacement therapy causes or worsens urinary tract symptoms or increase the size of the prostate gland.

Although the Endocrine Society and other associations have suggested severe urinary symptoms as a contraindication to TRT treatment, investigators found little evidence to support it worsening urinary symptoms in men using testosterone replacement therapy.

The investigators discovered that men with mild urinary sympmtoms experienced either no change or an improvement in their symptoms following TRT.

Remarkably, the study explained that the therapy may actually improve voiding symptoms.

Bottom Line:  Testosterone replacement therapy is safe in men with urinary symptoms and will not worsen those symptoms but may actually improve their symptoms.

Source

Kathrins M, Doersch K, Nimeh T, Canto A, Niederberger C, and Seftel A. The Relationship Between Testosterone Replacement Therapy and Lower Urinary Tract Symptoms: A Systematic Review. Urology S0090-4295(15)01053-3. doi:10.1016/j.urology.2015.11.006.

New Treatment For The Enlarged Prostate Gland-The UroLift

March 13, 2015

NEW ORLEANS – It’s a condition that men may not want to talk about, but it affects their sleep, their intimate relationships, and work.

But now there’s a new, simple fix for a common prostate condition.

Doug Depp is one of the millions of baby boomer men with a common health problem, Benign Prostatic Hyperplasia, called BPH.
“I was getting up 4, 5 times a night easy and feeling the discomforts of it. I couldn’t empty my bladder. I lost a lot of confidence in being able to go places, be comfortable,” said Depp, 68.

After the age of 50, the prostate gland, for some reason, grows. When it does, it squeezes down the size of the tube that urine flows through. It affects a man’s quality of life. But now there is a new procedure called UroLift System. It involves no cutting or heating away tissue in an O.R.

“I think this is a game changer, and the reason being is that often times men who have an enlarged prostate, are treated with medications. These medications affect their sex life,” explained Dr. Neil Baum, a urologist at Touro.

The UroLift has a pin on one side and a clip on the other. In less than an hour in the office or outpatient surgery, Dr. Baum inserts a few of the devices through the urethra. They permanently hold both sides of the enlarged prostate away from putting pressure on the urethra. Men can either be under mild IV sedation or a local anesthesia.

“This procedure, the UroLift, preserves sexual performance. The men have no problem with ejaculation. It doesn’t affect their erections and the beauty is when they have the procedure, they go out without a catheter most of the time, and they are able to urinate with improved stream immediately,” Dr. Baum explained.

Depp says there was not a lot of discomfort and a few days later he was 100 percent normal again.

“I used to always think of a place to go, you know, McDonald’s or some place you know, on the way, and you have to pick and choose but now it’s a lot more freedom not to worry about it,” laughs Depp.

The UroLift is FDA approved and most insurance companies pay for the procedure.

What Every Woman Should Know….About Her Man

November 26, 2014

Men live 5-7 years less than women and often have poorer health than their female counterparts. This may be due to many factors but certainly one is that men seek out preventive healthcare much less often than women. This blog is intended to give you an overview of the unique healthcare problems of men and what women can do to help their men lead happier and healthier lives.

ED\Impotence
ED is a common condition that affects as many as 30 million American men. Most men are uncomfortable discussing their sexual problems with either their partners or their healthcare providers. As a result men feel embarrassed and women often feel that the man in their life doesn’t find them attractive.

About 70% of the time, ED is caused by an underlying health problem, most often diabetes, high blood pressure, high cholesterol levels, or heart disease. The remaining 30% of men suffer from ED caused by stress, anxiety, depression, the side effects of medication, or drug and alcohol abuse.

In most cases, ED is treatable, which means that it doesn’t have to be a natural or inevitable part of growing older. Treatments include drug therapy (Cialis, Levitra, or Viagra) vacuum devices, injections, or penile implants. If your partner is suffering from ED, encourage him to seek medical care as certainly this condition can be effectively treated.

Testosterone
Testosterone is one of the most important hormones for the normal growth and development of male sex and reproductive organs. It is responsible for the development of male characteristics such as body and facial hair, muscle growth and strength, and deep voice.

Men’s testosterone levels naturally decrease as men age. But if the levels drop below the normal range, some uncomfortable and often distressing symptoms may develop, including:
Decreased libido or sex drive
Importance or ED
Depression
Fatigue or loss of energy
Loss of muscle mass

As many as 10 million men suffer from low testosterone (low T) but only 5% are being treated.

The diagnosis is made with a simple blood test that measures the blood level of testosterone. If the T level is decreased and the man has symptoms of low T, then replacement therapy with injections, topical gels, or pellets can be prescribed.

Prostate
The prostate is a walnut-sized gland that manufactures fluid for semen. It is located at the base of the bladder and surrounds the urethra or the tube that transports urine from the bladder through the penis to the outside of the body.

Prostatitis is a condition often caused by a bacterial infection or an inflammatory response similar to that seen with allergies and asthma. Symptoms may include a discharge, discomfort, pain in the area underneath the scrotum or testicles, frequent urination, and burning with urination. Treatment usually consists of medication and medications t decrease the inflammatory response in the prostate gland.

Benign prostate gland enlargement affects most men after age 50. The symptoms consist of frequent urination, getting up at night to urinate, and a decrease in the force and the caliber of the urine stream. Treatment consists of oral medication to reduce the size of the prostate gland, or medication that can relax the prostate and improve the urine flow. Now there are minimally invasive treatments such as microwaves, lasers, and even a new treatment, UroLift, that pins open the prostate gland in a 15 minute procedure in an outpatient setting.

Prostate cancer is the most common cancer in men. Nearly 240,000 new cases are diagnosed every year and causes 30,000 deaths each year making it the second most common cause of death due to cancer in men. The diagnosis is made by a digital rectal exam and a blood test, PSA test. If prostate cancer is caught early, it is often curable and nearly always treatable.

In the early stages, prostate cancer usually causes NO symptoms. However, as the disease progresses, so do the symptoms such as hip or back pain, difficulty with urination, painful or burning on urination or blood in the urine.

Every man should consider a baseline PSA test and a digital rectal examination at age 40. Additionally, African Americans and men with a family history of prostate cancer see a physician annually beginning at age 40.

Treatment options for prostate cancer include surgical removal of the prostate gland, radiation therapy, hormone therapy, immunotherapy or cryosurgery. Some men with localized, low risk prostate cancer might select active surveillance or watchful waiting which closes monitors the cancer to see if it progresses or becomes aggressive. If the cancer progresses, then treatment is usually instituted.

Testicular cancer
Cancer of the testicle is the most common cancer in men between the ages of 15-35. Although, there is nothing to prevent testicular cancer, if the cancer is diagnosed early, there is a high cure rate. Early detection is the key to success.

Symptoms of testicle cancer include:
Lumps or enlargement of either testicle
A feeling of pulling or unusual weight in the scrotum
Pain or discomfort in the testicle or scrotum
Dull ache in the lower abdomen
Enlargement or tenderness of the breasts

The best way to diagnose testicle cancer is be doing a testicle self-examination. Men\boys should examine themselves once a month just as women are recommended to do a monthly breast self examination. If a man experiences a lump or bump on the testicle or in the scrotum, contact your physician as soon as possible.

So what do I recommend?
In your 20s
A physical examination every three years
Check blood pressure every year
Screening for cancers of the thyroid, testicles, lymph nodes, mouth, and skin every three years
Cholesterol test every three years
Testicular self-exam every month

In your 30s
All of the above and a physical exam every two years

In your 40s
A physical exam every two years
A PSA test and a digital rectal exam if you are in a high-risk group
A stool test for colon and rectal cancer every year

At age 50 and above
A colonoscopy every 5 years or as recommended by your physician
A PSA and digital rectal exam every year

Bottom Line: Women can be so helpful in guiding men to good health. If you love your man, encourage him to follow these guidelines.

In the next blog we will discuss what men need to know about women’s health.

Cialis For Erectile Dysfunction AND Prostate Gland Enlargement

September 28, 2014

Many middle aged men have both erectile dysfunction (ED) and benign enlargement of the prostate gland. Now there’s one pill that can resolve both problems.

Studies have demonstrated the satisfactory quality of low dose Cialis, 5mg\day, for treating both medical conditions.

Millions of men have both ED and the enlarged prostate gland. The symptoms of the enlarged prostate gland include getting up at night to urinate, poor stream, frequency of urination, and dribbling after urination. It is believed that Cialis relaxes the muscles in both the penis and the prostate gland alleviating both conditions.

The side effects of daily Cialis include mild backache, flushing, and nasal congestion. Cialis is absolutely contraindicated in men using nitrates or nitroglycerin. Other treatment options for men who can’t use Cialis include a vacuum erection device (VED), self injections of drugs that create an erection prior to sexual intimacy, or a surgical insertion of a penile prosthesis.

Bottom Line:  If you have symptoms of an enlarged prostate gland and ED, speak to your physician about the possible use of daily low dose Cialis.

Prostate Gland Enlargement-A New Minimally Invasive FDA Approved Treatment

June 18, 2014

Most men experience benign enlargement of the prostate gland that causes symptoms of difficulty with urination, dribbling after urination and getting up multiple times at night to urinate. All of these symptoms can impact a man’s quality of life.
Enlargement of the prostate gland occurs naturally as men age. Unfortunately, this process can press on the urethra and result in some frustrating side effects including urination and bladder problems. The good news is that an enlarged prostate is benign (not cancerous) nor will it increase your risk of prostate cancer; for these reasons it is often referred to as benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy.

The exact cause of BPH is unknown; however, a common hypothesis points to changes in the balance of the sex hormones during the aging process. The testicles may also play an important role in prostate growth: for example, men who have had their testicles removed (i.e. as a result of testicular cancer) do not develop BPH. Furthermore, men who have their testicles removed after having developed BPH will experience a decrease in prostate size.
Medications

Prescription drugs are typically the first line of treatment for BPH. Alpha blockers are typically associated with high blood pressure, but in the case of BPH, act by relaxing the muscles in both the bladder neck and prostate, resulting in effortless urination. The effects of alpha blockers are typically seen very quickly (in about a day or two). Some well-known examples are drugs like Rapaflo or Flomax.

Another set of medications, 5 alpha reductase inhibitors, reduce the size of the prostate, thus reducing the pressure on the urethra. Examples of these are Avodart or Proscar. Often, improvements are not seen for a couple of weeks or even months. Common side effects include decreased sex drive and erectile dysfuction. Combination therapy of alpha blockers and 5 alpha reductase inhibitors can be more effective than either drug alone. Antibiotics may also be prescribed to treat prostatitis (prostate inflammation) which can accompany BPH.

Minimally Invasive Procedures
GreenLight Laser uses a high-powered laser combined with fiber optics to vaporize the overgrowth of prostate cells quickly and accurately. The heat of the laser also cauterizes blood vessels, resulting in minimal bleeding. It is an out-patient procedure that involves catheterization for about two days. Stents can be placed in the urethra to help keep it open and allow urine to flow easier. These stents must be replaced every four to six weeks, and as such, are not considered a long term treatment option.

Now a new treatment, the Urolift, has been approved by the FDA and is a minimally invasive treatment that can be done in the doctor’s office under a local anesthetic with immediate results after a 20-30 minute procedure. The procedure consists of inserting two to four implants that opens the urethra directly by retracting the obstructing prostatic lobes without cutting, heating, or removing prostate tissue. The implants pushes aside the obstructive prostate lobes like opening window curtains. Small permanent UroLift implants are deployed, holding the lobes in the retracted position, and thus opening the urethra while leaving the prostate intact. Patients report marked improvement in symptoms immediately after the procedure. There is no problems with erections after the procedure.

Prostate, shown in yellow, with blockage of the urethra

Prostate, shown in yellow, with blockage of the urethra


4 pins in the prostate open the gland and allow improvement in urinary symptoms

4 pins in the prostate open the gland and allow improvement in urinary symptoms

Surgical Procedures
If medications are not effective, or if your prostate is too large, surgical intervention may be necessary. Transurethral resection of the prostate (TURP), or the modified Button TURP, involves the removal of portions of prostate which block urine flow. Hospital stay is typically one day with a two-day catheterization. Reserved for those with unbearable BPH symptoms and extremely large prostates, prostatectomy is the complete removal of the prostate gland. It is more invasive than either TURP or GreenLight Laser, and usually has a higher risk of complications and side effects and requires a longer catheterization. For these reasons, prostatectomies are typically not recommended for those with BPH, but rather the go to surgical intervention for men diagnosed with prostate cancer.
Bottom Line: Prostate enlargement affects nearly 14 million American men mostly after age 50. There are many treatment options available for BPH: medications, minimally-invasive procedures and surgery. Which treatment option is best for you depends on your overall treatment goals, the size of your prostate, your symptoms, your age, and your overall health. Make sure you speak with your doctor about the different treatment options; your doctor will recommend treatments based on your symptoms and treatment goals.

Urinary Incontinence-Non-Medication Solutions

March 9, 2014

Millions of Americans suffer from incontinence. Americans are already “polymedicated” or taking far too many drugs. Many of my patients are trying to solve problems naturally without the use of medications. This blog will discuss the treatment of urinary incontinence without prescription medications.

Incontinence is a symptom of a urinary tract problem, and there are different types of urinary incontinence. Women commonly have overactive bladder\urge incontinence or stress incontinence with the loss of urine with coughing, sneezing, or with exercise.

Men most commonly experience stress incontinence — the accidental release of urine when the bladder is under pressure — after being treated for prostate cancer.
Another type of incontinence called overflow incontinence, occurs more commonly in men. This is associated with enlarged prostate — benign prostatic hyperplasia (BPH). BPH can squeeze the urethra and keep the bladder from completely emptying.

Whether you have stress incontinence, urge or overflow incontinence, there are natural steps you can take to support your urinary health and restore continence. If an enlarged prostate is causing your symptoms, you can learn how to promote a normal prostate size.

The lifestyle choices you make and the foods you eat can help you regain control of your bladder. Following are several lifestyle changes you can make that will positively affect your bladder control, prostate and urinary health.
Manage Fluids

Drink pure water. While it is important to stay properly hydrated, you want to avoid drinking in the two to three hours before bedtime.
Supplements

There are several natural supplements that support the urinary tract, and many supplements that shrink the prostate. Many men find urinary health benefits from quercetin, saw palmetto, curcumin, green tea extract, cranberry, stinging nettle and pygeum.

Fruits And Vegetables
These foods are high in antioxidants, vitamins, minerals and fiber. These support prostate health and urinary tract health, as well as being good for the rest of you too.

Consume Healthy Fats
Healthy fats such as omega-3 fatty acids and monounsaturated fats help promote prostate health.

Avoid Food Additives And Sugar
Some foods and additives are harmful to the prostate and your urinary function. Try to avoid the worst ingredients in processed foods.

Maintain A Healthy Weight
Being overweight can worsen symptoms of urinary incontinence by putting excess pressure on the bladder. Exercise helps promote prostate health.

Kegel Exercises
Doing Kegels every day can help improve bladder control. Other alternative treatments such as physical therapy may also be of help.

Avoid Cigarettes Or Drink
Smoking is a risk factor for stress incontinence. Alcohol increases urinary frequency, so try to limit or avoid it.

Drink Green Tea
Green tea health benefits come from its strong antioxidant and anti-inflammatory properties. Whether your drink it or take it as a supplement, look for caffeine-free green tea.

Avoid Caffeine
Caffeine from coffee, tea and soda can promote urinary frequency. A study on incontinence in men and caffeine shows that men who consumed 234 mg or more of caffeine every day were 72 percent more likely to have some urinary incontinence compared to men who drink small amounts.

Avoid Foods That Irritate The Bladder
Foods and drinks that can irritate the bladder include citrus fruits, citrus juice, carbonated drinks and spicy foods.

Go When You Need to Go
Don’t hold your urine when you need to go. Holding it can irritate your urinary tract and possibly lead to a urinary tract infection.

Of course, there are medications and other treatments that can help with urinary symptoms of BPH, but they have some unwanted side effects. Before taking any medications, you should give some of the natural supplements and lifestyle changes a try. They may help and they won’t hurt.

Bottom Line: The first step is to talk to your doctor about what is causing your urinary incontinence and to develop a plan for dealing with the problem. Learn as much as you can about urinary incontinence. If you suffer from urinary incontinence, try some of these non-prescription alternatives. They just might work and will decrease your dependence on Depends!

This blog was inspired and modified by an article Treat Urinary Incontinence Naturally
Dr. Geo Espinosa
http://easyhealthoptions.com/easy-health-options-digest/treat-urinary-incontinence-naturally/

Saw Palmetto Effect On the PSA Level

September 29, 2013

Saw palmetto is a commonly used herbal supplement used to treat men with mild symptoms of the enlarged prostate gland or BPH (benign prostatic hyperplasia). Despite years of controversy regarding efficacy, saw palmetto remains the most common herbal treatment for men with lower urinary tract symptoms.
Extracted from the fruit of the saw palmetto dwarf tree, the extract exerts effects by diminishing 5-alpha-reductase activity and binding to androgen receptors in prostatic cells. Saw palmetto reduces prostatic dihydrotestosterone by 32%. As a result of this anti-androgen effect, concerns have been raised as to whether serum PSA values should be adjusted accordingly.

In a new study published in the Journal of Urology (2013;189:486-492), researchers evaluated serum PSA values in 369 patients randomized to receive saw palmetto or placebo.
These men were part of the CAMUS (Complementary and Alternative Medicine for Urological Symptoms) trial, a double-blinded, randomized controlled study designed to determine whether saw palmetto extract reduced the American Urological Association symptom score compared with placebo at 72 weeks.
Even with triple the recommended dose of saw palmetto, serum PSA remained unaffected compared with placebo. These data can help guide clinicians using PSA for the early detection of prostate cancer in those patients taking this common herbal remedy.

Bottom Line: Many men will use the herbal supplement, saw palmetto, for the treatment of their lower urinary tract symptoms of benign enlargement of the prostate gland. There is no affect on the PSA level but middle aged men taking saw palmetto should be tested with a PSA and no adjustment need to be made in the PSA level.