Archive for the ‘benign prostate enlargment’ Category

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.

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Options for Treating The Enlarged Prostate Gland

November 16, 2015

For reasons not entirely known, the prostate gland starts to increase in size around age 50 and causes symptoms of difficulty with urination. The prostate gland is a walnut sized organ at the base of the bladder and surrounds the tube, the urethra, which transports urine from the bladder to the outside of the body. When the prostate gland grows, it compresses the urethra making urination difficult.

By the time men are in their 40s or 50s, many are already experiencing symptoms, such as having to get up at night to urinate. Into their 60s and 70s, they may have to get up two or three times.

In addition, an enlarged prostate can also result in other urinary symptoms such as having to go frequently during the day, having a weak stream or having to go urgently.

The “gold standard” is called a transurethral resection of the prostate (TURP), where an instrument is inserted up the urethra to remove prostate tissue that is blocking urine flow. It is sometimes colloquially referred to as a “roto-rooter” procedure. The purpose of the TURP to carve out the inner portion of the prostate and leave just the shell. The procedure allows a much stronger stream and men who have it will have to urinate much less frequently.

However, the procedure requires general anesthesia and a hospital stay. While it does not usually interfere with the ability to have an erection, more than half of those who have it will experience “retrograde ejaculation,” meaning that no fluid comes out of the penis during orgasm. Instead, the fluid goes into the bladder where it is eliminated during urination. Men will also have to wear a catheter for a few days after the procedure and will require several months before they can resume all activities including sexual intimacy and heavy lifting.

Similar procedures known as GreenLight Laser Treatment, which uses a high-energy laser to vaporize prostate tissue, and holmium laser enucleation of the prostate (HoLEP), which also uses a laser to destroy prostate tissue, are also available. They are pretty much the same in terms of outcomes. They just use different energy sources.

Now there is a new treatment, the UroLift, that doesn’t remove any tissue but relieves the compression on the prostate gland making urnation easier and reducing the symptoms. The procedure can be done in the office setting, does not require any catheter, and does not cause any sexual side effects or retrograde ejaculation.

Bottom Line: Many middle aged men have sympotms related to the enlarged prostate gland. There are multiple treatment options and men can plan to resume their activities after treatment for benign prostate disease.

If you are 50 or older and you have any of these symptoms and they are bothersome, talk to your doctor.

 

 

 

 

Male Health Month

May 21, 2015

June is Male health. Here are 10 health concerns for men:

1. Prostate cancer. Approximately 30,000 men die of prostate cancer each ear. All meds should undergo a baseline prostate specific antigen blood test at age 40. Men with a family history of prostate cancer, African American men, and veterans exposed to agent orange are at high risk. These men should consider getting screening each year beginning at age 40.

2. Benign enlargement of the prostate is also a concern for men after the age of 50. 50% of them between the ages of 50 and 60 will develop enlargement of the prostate which is a benign disease but affects a man’s quality of life.

3. Erectile dysfunction. Failure to achieve and maintain an erection can be caused by heart disease, diabetes, certain medications, lifestyle, or other problems. Effective drugs are available for treating this common condition that affects over 30 million American men.

4. Cardiovascular disease. Heart disease and stroke are often associated with high cholesterol and high blood pressure. Both can usually be controlled with diet and exercise, sometimes combined with medication.

5. Testicular cancer. Testicular cancer is the most common form of cancer in men between the ages of 20-35 and in most cases can be cured.

6. Diabetes. Men with diabetes or more likely to suffer from heart disease, stroke, kidney disease, vision problems and erectile dysfunction.

7. Skin cancer. Anyone who spends a lot of time in the sun is at risk for skin cancer.

8. Low testosterone. As men age, their testosterone decreases. This can called Andropause, a condition similar to menopause in women.

9. Colorectal cancer. Cancer of the colon and rectum can usually be treated if caught early.

10. Depression. Men are less likely than women to seek help for depression and are 4 times more likely to commit suicide. Help can take the form of medication, counseling, or a combination of both.

I know in New Orleans we have the attitude that “if ain’t broke don’t fix it”. That may apply to your car but not to your body. Take good care of yourself and see your doctor once a year for fine-tuning your health and wellness.