Archive for the ‘enlarged prostate’ Category

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.

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Saw Palmetto for the Enlarged Prostate Gland-What You Need to Know

January 23, 2015

Over 30 million Americans suffer from the enlarged prostate gland. The symptoms include getting up at night to urinate, frequency of urination, and dribbling after urination. Constantly rushing to the bathroom is a common complaint among the millions of men who develop an enlarged prostate gland, or benign prostatic hyperplasia (BPH). This blog will discuss the treatment with the herbal product, saw palmetto.

Saw palmetto has been used to treat urologic conditions since the days of the ancient Egyptians. It is a common non-medical approach to the enlarged prostate gland.

Here are five reasons you should skip saw palmetto and head to the doctor for advice instead.
1. It’s no better than a placebo.
Researchers have shown that saw palmetto is no better than a placebo at alleviating symptoms. Large studies have also shown the same effect in scientific studies comparing saw palmetto to placebo.

2. Its dosage may vary.
Even if you wanted to try taking a regular dose of saw palmetto, there’s currently no guarantee that the supplement you choose contains what it says it does. One study analyzed six different brands of the supplement and found that half of them contained less than 20 percent of the amount stated on the label.

3. It might not be safe.
Saw palmetto doesn’t seem to have any major side effects, but some users have reported headaches, nausea, and dizziness. However, we haven’t seen studies proving that saw palmetto is actually safe for the long term. In addition, supplements, including saw palmetto, are not well regulated by the FDA, and it’s not uncommon for wily manufacturers to distribute tainted products. You may think you’re taking a “natural” herbal remedy, but for all you know, you could be taking prescription, or even experimental, drugs.

4. It might mask another problem.
If you have symptoms of an enlarged prostate, including frequent urination, it doesn’t necessarily mean that you have an enlarged prostate. The same symptoms might pop up if you have prostatitis (an inflamed or infected prostate gland) or a bladder infection that can be treated with an antibiotic. Or the symptoms might even be a side effect of another medication. If supplements relieve your symptoms for some reason, you might neglect treating another ailment.

5. It’s a waste of money.
Instead of throwing your dollars away on saw palmetto supplements, see your doctor to get a proper diagnosis and find out about approved drugs that can help. Common treatments include alpha-blockers and 5-alpha-reductase inhibitors. Visit Consumer Reports’ Best Buy Drugs to find out more about drugs it recommends for treating enlarged prostate.

Bottom Line: The enlarged prostate is a common problem affecting millions of American men. Saw palmetto is an over the counter non-medical, herbal supplement that probably has minimal or even no benefit at all. All men with symptoms prostate enlargement should seek medical care as solutions are available.

New Help For the Enlarged Prostate Gland-The Uro-Lift

January 21, 2015

The enlarged prostate is a medical condition in which the prostate gland that surrounds the male urethra (tube in the penis that transports urine and semen located in the penis) becomes enlarged with advancing age and begins to obstruct the urinary system. The condition is common, affecting approximately 37 million men in the United States alone. BPH symptoms include sleepless nights as men are awakened to empty their bladder and urinary problems such as dribbling after urination, frequency of urination, and urgency of urination. This condition can cause loss of productivity, depression and decreased quality of life. About one in four men experience these urinary symptoms by age 55 and by age 70, over 80 percent of men suffer from BPH.

Treatment options
Medication is often the first-line therapy for enlarged prostate, but relief can be inadequate and temporary. Side effects of treatment can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using the drugs. For these patients, the classic alternative is surgery that cuts or ablates prostate tissue to open the blocked urethra. While current surgical options, such as transurethral resection of the prostate (TURP or “roto rooter”), can be very effective in relieving symptoms, it can also leave patients with permanent side effects such as urinary incontinence, erectile dysfunction and retrograde ejaculation (dry orgasm).

A new study in published in Urology Practice, an official journal of the American Urological Association, concluded that the UroLift System preserves sexual function and provides rapid improvement in symptoms, flow and quality of life that are sustained to two years.

UroLift, which provides rapid relief of enlarged prostate symptoms with minimal side effects, are durable for at least two years after treatment, with less than one in ten patients requiring an additional procedure for symptom relief. At two years only 7.5% of patients required an additional procedure for lower urinary tract symptoms. Adverse events were typically early, mild and transient. There was no occurrence of de novo sustained ejaculatory or erectile dysfunction\impotence.

Bottom Line: Millions of American men suffer from the enlarged prostate gland. Help is available often starting with medication. Another option is Uro-Lift which can be done in the ambulatory treatment center and has immediate results.

Take “One” Cialis And Call Me In The Morning-A New Treatment For Both Erectile Dysfunction and The Enlarged Prostate Gland

October 9, 2011

This past week the FDA has approved the use of Cialis, a drug commonly used in the treatment of erectile dysfunction, will also be approved for the management of benign enlargement of the prostate gland. Cialis, manufactured by Eli Lilly and Co., was approved for the treatment of erectile dysfunction (ED) in 2003. It can now be used to treat ED AND prostate gland enlargement, or both if symptoms of the two conditions occur together.

Benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged, is common in older men. Symptoms include difficulty starting urination, a weak urine stream, a sudden urge to urinate and more frequent urination including awakening at night to empty the bladder. BPH can have a big impact on a patient’s quality of life if a man gets up more than a couple of times each night. Cialis offers these men another treatment option, particularly those who also have ED, which is also common in older men affecting nearly 33 million men in the United States.

In two clinical trials, men with BPH who took 5 milligrams of Cialis once daily experienced a significant improvement in their urinary symptoms of BPH compared to men who were treated with placebo.
Cialis should not be used in patients taking nitrates, for example nitroglycerin, because the combination can cause an unsafe decrease in blood pressure, the FDA said. And the use of Cialis in combination with alpha blockers for the treatment of BPH as there is a risk of lowering blood pressure.

Bottom Line: If you are experiencing both difficulty with urination and also have inability to successfully engage in sexual intimacy as often as you would like, you should speak to your doctor about the use of daily Cialis, 5mg, which is effective in treating both conditions with a single pill.

Flossing Your Teeth and Prostate Disease-There Just Might Be A Connection

August 29, 2010

Who would have thunk that flossing would be prostate gland protecting?  It has been well-documented that inflammation in the mouth, i.e., gum disease is linked to heart disease, diabetes, rheumatoid arthritis, and now even Alzheimer’s disease.  Now good research from Case Western Univeristy in Cleveland, Ohio has made a connection between gum disease and prostate health. The researchers from the dental school and the department of urology and the Institute of Pathology at the hospital found those with the most severe form of the prostatitis also showed signs for periodontitis, or severe gum disease.  It is theorized that reducing inflammation in the mouth-by daily flossing may also reduce prostate gland inflammation.  As my wonderful Jewish mother would say, “It may not help but it vouden’t hoit!”  So if you are looking for one more reason to start flossing, you now have one.

Excerpted from Journal of Periodontology, the official journal of the American Academy of Periodontology

Prostate Cancer-The Least You Need To Know

May 24, 2010

Prostate cancer is the most commonly diagnosed cancer in American men (excluding skin cancers). Each day approximately 500 American men are diagnosed with prostate cancer.  There are over 26,000 men who die each year from prostate cancer making it the second most common cause of death.  The diagnosis is often made as the result of a blood test known as the prostate specific antigen (PSA) test, followed by a prostate gland biopsy.

Treatment options for prostate cancer include radiation, surgical removal, and watchful waiting or following the man with regular PSA tests and a digital rectal examination.  While a man’s initial reaction to a diagnosis of prostate cancer may be “I just want it out,” the reality is that a number of factors need to be considered before treatment options are selected. These factors include age, general health, and the results of other tests like the Gleason score, which is derived from prostate biopsy.

Most prostate cancers develop in older men and grow very slowly, but some grow quickly and spread beyond the gland. It is sometimes difficult to distinguish men who will benefit from treatment from others in whom the side effects of treatment will outweigh the benefits.

Many prostate cancers will grow so slowly that the man will probably die of another cause before the prostate cancer becomes threatening. Similarly, some prostate cancers at diagnosis have already spread beyond the prostate gland, and surgery or radiation would offer no benefits.

Patients with prostate cancer confined to the prostate gland might derive the most good from surgery or radiation.  You can obtain more information from  American Cancer Society (http://www.cancer.org/docroot/home/index.asp) or speak with your doctor.

11 Suggestions For Decreasing Prostate Symptoms

May 11, 2010

The prostate gland is walnut sized organ at the base of the bladder.  In order men the gland increases in size and causes symptoms such as going to the bathroom frequently, dribbling after urination, and getting up at night to urinate.  Here are a 11 suggestions that you might consider to relieve those symptoms.

1.  Don’t drink anything several hours before you go to sleep.

2.  Avoid caffeinated beverages such as coffee and tea as the caffeine acts as a diuretic

3.  Limit your alcohol consumption especially at the dinner meal.

4.  Avoid spicy foods.

5.  Take medications such as your diuretics or water pills early in the day when going to the bathroom to urinate is not such an inconvenience.

6.  Avoid antihistamines and decongestants

7.  Don’t hold off going to the restroom

8.  Use the clock to help with urination. Make an effort to urinate every 3-4 hours.  Putting your bladder on a schedule is very helpful and a good habit to have.

9. Go and then go again. Stand at the toilet and empty your bladder, walk away from the toilet for a minute or two and then return and try emptying the bladder again.

10. Avoid cold seats such as at football games in the winter.

11. If you bike ride, especially for long distances, stand on the pedals every 10 or 15 minutes to take the pressure off of your prostate gland.

Bottom Line: These steps won’t cure the enlarged prostate but they will lessen the symptoms.  If your symptoms persist, consider a visit to your urologist

Urinary Tract Infections in Men

May 4, 2010

Urinary tract infections (UTI) indicate inflammation anywhere within the urinary system.  In men it can occur in the kidneys, bladder, prostate or urethra.  UTIs are more common in women, but they also affect men, especially in men more than 50 years of age.  If UTIs are left untreated, they can result in spread of the infection and cause permanent kidney damage.

Prostate infections are the most common infections in men.  Acute prostatitis occurs when bacteria lodge in the prostate and produce symptoms such as fever, chills, difficulty with urination, back pain, or blood in the urine.  The treatment is antibiotics for 7-10 days.

Chronic bacterial prostatitis is similar to the acute infection but without the fever or chills.  These men also may have painful ejaculation and low back pain.  The treatment is also antibiotics but often the medication has to be taken several weeks or even months.  Men with chronic prostatitis also may be advised to avoid caffeine, alcohol, spicy foods and chocolate.

In many men, prostatitis occurs without identifying any bacterial culprit.  This is called abacterial prostatitis or prostadynia.  The symptoms are the same a chronic bacterial prostatitis.  The pain and vague urinary problems are a result of spasm or congestion of the pelvic floor muscles or congestion within the prostate gland itself.  In most instances, antibiotics are not helpful in treating this condition.  The treatment consists of anti-inflammatory medication, muscle relaxants or alpha blockers.

UTIs can also occur after instruments are inserted into the urinary tract such as catheters or tubes as they may transport bacteria from outside of the body to the bladder and prostate gland.

Previous infections such as some of the sexually transmitted diseases may leave scars in the urethra and cause it narrow or stricture.  This disrupts the normal flow of urine and may result in infections of the urinary tract.

The diagnosis of a UTI is made with a history, physical examination and a urinalysis and a urine culture.  The latter is a test that identifies the offending bacterial and the best antibiotic to treat the infection.  Occasionally, additional tests such as a CAT scan and cystoscopy are required.

General measures for treating UTIs in men include increasing the consumption of water. Alkaline substances, such as citrates, taken in water might improve symptoms. By making the urine more alkaline, they make the environment more hostile to bacterial growth and improve the results of antibiotic therapy.

Antibiotics are the mainstay of treatment. Trimethoprim (Trimpex) is currently the first choice for lower UTI , because it is cost-effective, well tolerated and works in 80 per cent of infections. Cephalosporins and quinolones are reserved as second line drugs in patients with lower UTI, but are first choices in patients with signs of kidney infection.

You can prevent UTIs by drinking lots of fluids every day, empty your bladder often and completely, practice safe sex, always use latex or polyurethane condoms, urinate after sex to flush out bacteria, if you are uncircumcised, and wash under the foreskin each time you take a bath or shower.

Although UTIs are aggravating and affect the quality of life of those with the condition, they do not cause prostate cancer, benign enlargement of the prostate, or perhaps more importantly, impotence.

Bottom Line: With an accurate diagnosis and the correct treatment, most cases of UTIs in men can be cured, treated or certainly controlled.

Bladder Testing-Urodynamics

May 3, 2010

Urodynamics are simply a combination of several useful tests which provide information about your lower urinary tract. This information is obtained much in the same way that an electrocardiogram (EKG) proxies information about your heart. Urodynamics “draws a picture” for your doctor and helps to determine the diagnosis and what will be the appropriate treatment of your urinary problem(s).

Urodynamics testing is done at the office and usually takes 30-45 minutes.

During the test you will be catherized at least once. Your bladder will be filled one or more times with carbon dioxide gas or water or both. You may have a very small tube placed in the rectum. The nurse will tell you beforehand whether you are to have this done. Muscle activity in your pelvis will be recorded during the tests by small electrodes which are placed on the skin near the rectum. These electrodes are very similar to those used for an EKG.

Preparation for Urodynamics

It is important to have a full bladder when you arrive for the studies; please be ready to urinate! There are no other special preparations or food restrictions for this test. If you wear padding, external catheters, etc., you may wish to bring extra supplies for replacement after the test. You can help to make the test easier by remaining relaxed. Each step of the evaluation will be explained to you throughout the test by the experienced nurse who performs the studies. Every effort will be made to make you as comfortable as possible during the procedure. A urodynamics evaluation usually includes the following tests:

CystometrogramlElectromyogram (CMG\EMG)

This test involves filling your bladder through a catheter with sterile gas or water. The nurse will ask you when you feel the urge to urinate, and when your bladder feels completely full. Pelvic muscle activity will be recorded as already described.

Flow Rate

A flow rate is done simply by asking you to void into a special toilet which records the pattern of your urine stream on a graph and the amount of urine you void. Muscle activity in your pelvis will usually be recorded while you void via the electrodes already described. The amount of urine left in your bladder after you void (the residual urine) will also be measured at this time.

Cystoscopy

Cystoscopy is a test that allows your doctor to look at the interior lining of the bladder and the urethra. The cystoscope is a thin, lighted viewing instrument that is inserted into the urethra and advanced into the bladder.

The cystoscope is inserted into your urethra and slowly advanced into the bladder while your doctor looks through the scope to examine the inside of the urethra. Your doctor then examines the inside of your bladder for stones, tumors, bleeding, and infection. Cystoscopy allows your doctor to look at areas of your bladder and urethra that usually do not show up well on X-rays. Tiny surgical instruments can be advanced through the cystoscope that allow your doctor to remove samples of tissue (biopsy) or samples of urine from each kidney.

Cystoscopy can also be used to treat some bladder problems. Small bladder stones and some small growths can be removed by using tiny surgical instruments that slide through the cystoscope. This may eliminate the need for more extensive surgery.

After Urodynamics:

After urodynamics, you may experience some burning on urination or some increased frequency of urination for a short time. If you drink plenty of fluids afterwards, it will help to alleviate this sensation. You may also have some blood in your urine for a short while, which should be minimal. To decrease the risk of urinary tract infection, you will be given a few days of antibiotics to take by mouth.

You should notify your doctor if you experience fever, chills, severe bleeding or severe discomfort after your urodynamic study.

Living With Prostate Gland Enlargement-Lifestyle Changes

April 26, 2010

Prostate enlargement or benign prostate hyperplasia (BPH) is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.

The symptoms of prostate gland enlargement include decrease in the force and caliber of the urinary stream, frequency or urination, urgency, feeling of not emptying the bladder and nocturia or the need to get up at night to urinate.

Although lifestyle changes will not cure the problem, they can alleviate some of the symptoms.

Making some lifestyle changes can often help control the symptoms of an enlarged prostate and prevent your condition from worsening. Try these measures:

Remember what goes in must come out.  Therefore don’t drink anything several hours before you go to sleep.  Especially avoid caffeinated beverages such as coffee (also causes insomnia) and tea as the caffeine acts as a diuretic and causes increased urine output that may result in getting up at night to empty your bladder,

Limit your alcohol consumption especially at the dinner meal.  Again alcohol acts as a diuretic causing increased production of urine causing your bladder to fill up sooner than you would like.

Avoid spicy foods.  These appear to irritate the bladder and can result in urinary frequency and nighttime voiding.

Check your medications.  Some medications like lasix and hydrochlorothiazide are diuretics and increase urine production.  I suggest you take those medications early in the day when going to the bathroom to urinate is not such an inconvenience.  You may also speak with your doctor about lowering the dosage of the diuretic especially the evening dose if you are bothered by nighttime urination.

Avoid antihistamines and decongestants as these cause the bladder to decrease the force of contraction and results in the bladder not to empty as well.  If you have to take anti-histamines, use them earlier in the day.

Don’t hold off going to the restroom.  This habit distends the bladder and can result in a weaker muscle to expel the urine from the bladder.

Use the clock to help with urination.  If you find that you are going to the bathroom infrequently and then more at night, make an effort to urinate every 3-4 hours.  Putting your bladder on a schedule is very helpful and a good habit to have.

Go and then go again.  Double voiding is a technique to ensure adequate emptying of the bladder.  If you stand at the toilet and empty your bladder, walk away from the toilet for a minute or two and then return and try emptying the bladder again.  This helps to expel more urine from your bladder than just standing there one time and voiding.

Avoid cold seats such as at football games in the winter.  The cold temperature seems to cause the muscles around the prostate gland to contract and makes urination difficult.  Instead take a blanket or a cushion. Your prostate gland will be glad that you did.

If you bike ride, especially for long distances, stand on the pedals every 10 or 15 minutes to take the pressure off of your prostate gland.  Also consider using a seat that has a groove down the middle which alleviates the pressure on your prostate gland.

Bottom Line: These steps won’t cure the enlarged prostate but they will lessen the symptoms.  If they don’t help, see your doctor for medication one of the treatments that reduces the obstruction of your prostate gland.