Posts Tagged ‘prostate gland enlargement’

Don’t Fight the Nite With Prostate Enlargement

February 6, 2017

 

Nearly every man over the age of 50 experiences symptoms of prostate gland enlargement.  The symptoms are going to the bath room frequently, poor force of the urine stream, dribbling after urination and perhaps the most troublesome of all is getting up at night to urinate.  Every night, between 12 and 15 million men in the U.S. are likely to have loss of sleep because of an enlarged prostate gland.  This article will discuss the purpose of the prostate gland and what treatment options are available for this common condition.

The prostate gland is typically the size and shape of a walnut and is located in the lower part of the pelvis, below the bladder. It envelops the urethra, the tube through which urine flows from the bladder out of the body. When the prostate gland grows bigger – which happens to virtually every man as he ages – it can compress the urethra and make it difficult to pass urine.

Benign enlargement of the prostate gland does not cause prostate cancer or affect a man’s ability to have, but if the symptoms bother you, seek treatment. If left untreated, BPH can lead to urinary retention and cause bladder, urinary tract and kidney problems.

Coping Techniques.

Try behavioral changesPerhaps the easiest suggestion is limiting your fluid intake at night and not drinking anything for two hours before bedtime.  I also caution to decrease those foods and beverages that are diuretics (and will therefore prompt you to urinate more), such as coffee, caffeinated tea, herbal tea, lemon juice, chocolate, pineapple, grapes and cherries.

If those behavioral changes don’t help much, consider medication. A change in habits will help some but not all men with BPH, and for those whose symptoms aren’t relieved, medication is an option.  The most commonly used medications are alpha blockers, (Flomax) which can relax the muscle at the base of the bladder and the prostate, and 5 alpha reductase inhibitors, (Proscar) which can, over a period of months, shrink the prostate.  Like nearly all medications, they do have side effects.  For example, alpha blockers can cause the man taking them to faint and by decreasing his blood pressure when moving from laying down to standing upright quickly.  Alpha blockers also can cause sexual side effects like decreasing the volume of the ejaculate or having no ejaculation at all.  The 5 alpha reductase inhibitors can cause sexual dysfunction, such as impotence. Some physicians are also prescribing tadalafil, commonly known by its brand name Cialis, which is often marketed as a drug that treats erectile dysfunction, but can also help to relax the muscles in the prostate gland and thus relieve urinary symptoms.

If behavioral changes and medication don’t work or cease to be effective, surgical procedures are an option.  Until recently the two most common procedures are a transurethral resection or TURP, in which an instrument is inserted up the urethra to cut out the part of the prostate that’s blocking urine flow, and a laser procedure, which vaporizes the tissue obstructing the urethra. Both procedures are typically effective but carry the risk of side effects such as erectile dysfunction. Other, newer procedures, such as the UroLift System, in which a urologist places tiny implants in the prostate to increase the opening of the urethra and allow for greater urine flow.  This procedure can be accomplished in the outpatient or ambulatory treatment center or even in the doctor’s office.  The advantage of the UroLift is that there are no sexual side effects and the results are noted almost immediately after the procedure.

Bottom Line:  The enlarged prostate gland affects millions of American men.  It significantly impacts a man’s quality of life.  Help is available.  Speak to your doctor.

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.

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.

Complications of the Large Prostate Gland

October 21, 2016

 

The most common condition affecting millions of middle age American men is benign enlargement of the prostate gland.  This is called benign prostatic hyperplasia or BPH, which is a non-cancerous enlargement of the prostate. For reasons not entirely known, the prostate increases in size around age 50.  As the prostate gland grows, the gland compresses the urethra, which is the tube that transports urine from the bladder to the outside of the body.

Over time, the growth causes the urethra to become so compressed that it becomes difficult for men to empty the bladder.   The symptoms associated with enlarged prostate gland include frequency of urination, urgency of urination, dribbling after urination and even the complete inability to urinate or allowing only a small amount of urine to exit the bladder.

Bladder stones are formed when crystals inside the bladder collect together and harden to form a stone.  They often occur when the bladder is not fully emptying, so the urine that is left behind remains in the bladder for long time and coalesce and form stones.

Symptoms of bladder stones include frequent urination throughout the day, lower abdominal pain, a burning sensation when urinating, urine that appears cloudy or contains blood, and urgency of urination.

Urinary retention is the inability to fully empty your bladder. Acute urinary retention is a medical emergency, so it does require immediate medical attention.

There are two main types of urinary retention.  If there is an obstruction such as a bladder or kidney stone, then urine cannot properly be released, resulting in urine remaining in the bladder after urination. In this case, urinary retention can be life threatening, and you will require immediate medical intervention and the insertion of a catheter to relieve the blockage.

The most common cause of acute urinary retention is the enlarged prostate which compresses the urethra or the tube from the bladder that transports urine from the bladder to the outside of the body.

Non-obstructive urinary retention is caused by the weakening of the bladder muscles or nerve problems disrupting the communication between the bladder and the brain. Causes of non-obstructive urinary retention include stroke, pelvic injury or trauma, nerve diseases, impaired muscle or nerve function, and spinal cord injury that affects the nerves to the bladder.

Chronic urinary retention mainly affects men as a result of prostate enlargement. Although the condition is not life threatening, it can lead to permanent kidney damage. In chronic urinary retention, a man is unable to fully void their bladder, so urine stays within the bladder, increasing the risk of urinary tract infections.

Symptoms of chronic urinary retention include urinary frequency, urgency and hesitancy, nighttime urination, symptoms similar to a urinary tract infection, and lethargy and emotional irritability.

Urinary tract infections are often associated with urinary retention. Symptoms include cloudy or foul-smelling urine, blood in urine, difficulty urinating, pain while urinating, nausea, vomiting, shaking and chills, and fever.

Hematuria, or blood in urine, is frequently a benign condition, but there may be a risk of a more serious condition, too. For men with documented blood in the urine which is confirmed by a urine examination, you will will need some additional testing such as urine culture, a radiologic examination of the kidneys, and a cystoscopy or a look in the bladder with a lighted tube.

As the bladder retains urine, it continues to stretch. Excess stretching weakens the bladder muscles, making it impossible for the bladder to contract.  If this is left untreated, then permanent damage to the bladder muscle will occur and even if the obstruction is relieved the bladder muscle cannot contract and the man may be left with a permanent urinary catheter or may have to catherize himself several times a day.

Bottom Line: Every man over age 50 should see his doctor every year to check his prostate and to obtain a PSA blood test which is a screening test for prostate cancer.  Nearly every man can be treated with either medications or minimally invasive procedures that can often be done in the doctor’s office.

Prostate Enlargement-Eating Your Way To Prostate Health

June 3, 2015

The prostate gland, which is located at the base of the bladder and surrounds the urethra like a donut, enlarges in men after age 40 and continues to grow and obstruct the flow of urine from the bladder to the outside of the body. This problem affects millions of American men and impacts their quality of life. This blog will discuss reducing the symptoms using dietary modification.

Fifty percent of men over the age of 60 suffer from an enlarged prostate or benign prostatic hyperplasia (BPH). By the age of 85, over 95 percent of men will live with BPH.
The good news is that a diet rich in certain vitamins and minerals can keep your prostate healthy and lower your risk of BPH. And because being overweight is another risk factor for BPH, making nutritious food choices is a great way to lower both your weight and your symptoms of the enlarged prostate gland.

The symptoms of the enlarged prostate gland include frequency of urination, dribbling after urination, and getting up at night to urinate multiple times.

Sesame seeds are rich in zinc, a mineral essential to the health of the prostate. Men with either BPH or prostate cancer have lower levels of zinc in their bodies — sometimes up to 75 percent lower than healthy prostates.

Zinc that comes from food is easier to absorb than zinc supplements. Help your body by snacking on sesame seeds. Or try oysters, adzuki beans, pumpkin seeds, and almonds, which are all high in zinc.

Salmon is rich in omega-3 fatty acids. These are healthy fats that can protect you from cardiovascular disease, cancer, and rheumatoid arthritis. Fatty acids also help in the synthesis of prostaglandin. Fatty acids deficiency may lead to prostate problems.

If you’re not a fan of fish, you can get your omega-3s from walnuts, ground flax seeds, canola oil, and kidney beans.
It is a known fact that Asian men have a lower risk of developing BPH than Western men. One possible reason is that Asian men eat more soy. Soybean isoflavones have been linked to a lower risk for an enlarged prostate. Eating more soy may reduce the risk of developing prostate cancer.
For other sources of soybean isoflavones, try low-fat soymilk, tempeh, roasted soybeans, soy yogurt, and meat substitutes made with soy.

Vitamin C is an antioxidant that might play a role in fighting BPH. Not all vitamin C is the same, however. Only vitamin C obtained from vegetables lowers your risk of an enlarged prostate. Fruits don’t offer the same benefit. Bell peppers contain more vitamin C than any other vegetable. One cup of raw bell peppers contains 195 percent of your daily requirement intake of vitamin C. Other vegetables to try include broccoli, cauliflower, kale, and Brussels sprouts.

Tomatoes are rich in lycopene, the bright carotenoid that gives tomatoes its red color. Lycopene may lower the risk of developing prostate cancer. It can also help men with BPH. Lycopene also helps lower the blood level of antigen, a protein connected to prostate inflammation and BPH.
Tomatoes and tomato products (such as tomato sauce and tomato juice) are the best source of lycopene. You can also get this carotenoid from watermelon, apricots, pink grapefruit, and papaya.

Avocadoes are rich in beta-sitosterol, a plant sterol. Beta-sitosterol can help reduce symptoms associated with BPH. Men taking beta-sitosterol supplements have better urinary flow and less residual urine volume.
Beta-sitosterol can help strengthen the immune system. It can reduce inflammation and pain, as well.
Besides avocadoes, other foods rich in beta-sitosterol include pumpkin seeds, wheat germ, soybeans, and pecans.

Eating more vegetables can help lower your risk of BPH. Green leafy vegetables are especially important because they are rich in antioxidants. Cruciferous vegetables like broccoli also reduce the risk of prostate problems, including BPH and prostate cancer.
People who eat onion and garlic regularly might also have a lower risk of BPH. Onions and garlic are often used in natural medicine to fight infection and help strengthen the immune system.

Bottom Line: Prostate gland affects the majority of men after middle age. The symptoms can affect a man’s quality of life and even impact his productivity in the work place. There are dietary modifications that may reduce the symptoms. If these are ineffective, speak to your doctor as there are medications and treatment options that can restore a man’s urinary health.

Over the Counter Cold Medicnes May Wreck Havoc With Your Prostate Gland.

February 10, 2015

Nearly 14 million American men have symptoms related to an enlarged prostate gland. Nearly 50% of men over age 50 will have symptoms. OTC cold medications such as diphenhydramine (Benadryl), brompheniramine (Dimetapp), and loratadine (Claritin), pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) may worsen your prostate symptoms.

The prostate gland is a walnut sized organ at the base of bladder and surrounds the urethra or the tube in the penis that transports urine from the bladder to the outside of the body. For reasons not entirely known, the prostate gland enlarges after age 50 and compresses the urethra making urination difficult and rarely impossible. Often men who have enlargement of the prostate gland have the cold or the flu and will take cold medications containing antihistamines and decongestants, which can worsen prostate symptoms.

It’s very important that men with enlarged prostate avoid cold medicines with pseudoephedrine or phenylephrine. Those are ingredients in decongestants and they constrict the prostatic and cause more compression on the urethra thus aggravating men’s urinary symptoms. Antihistamines aren’t quite as bad, because they work more on the bladder muscle, but they can decrease bladder contractility thus making it difficult for men to empty their bladder of urine.

Enlargement of the prostate is more common in older men, because as men age their prostate continues to grow. Nearly 80 percent of men age 50 and older will be diagnosed with some degree of the disease. Sometimes men need to get up every hour at night. I recommend against waiting too long to visit a doctor for this problem as urinary retention can occur and can cause kidney damage and other serious issues.

If a man is already having a little difficulty and his stream is already slow, and then you (make it worse) it by adding one of these OTC cold medicines, it’s the recipe for causing retention.

Cold remedies that are inhaled, such as a nasal corticosteroid, will not have the same side effects as an oral agent. Mentholated ointments are a safer alternative to decongestants.
If men notice problems with urination after taking certain medicines, they may need to weigh the risks and benefits of the OTC medications.

Bottom Line: I urge men to carefully read over-the-counter drug labels. You have to be aware of what a medication’s potential side-effects are. Unfortunately, the package insert for most medications is quite lengthy. Men need to have a relationship with a primary care doctor or a urologist, doctor who specializes in treatments of the enlarged prostate gland.

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.

Saw Palmetto Has No Effect on PSA

August 16, 2014

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 activity f an enzyme that is responsible for prostate cell growth. As a result of this effect decreasing prostate cells, concerns have been raised as to whether serum PSA values should be adjusted accordingly.

In a new study published in the Journal of Urology researchers evaluated serum PSA values in patients receiving either saw palmetto or placebo.

The results showed that 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: Saw palmetto may have a small effect on reducing prostate symptoms but has no effect on the PSA level.

The Enlarged Prostate-Spending Too Much Time On the Toilet

June 1, 2013

Normal prostate (L) vs. Prostate gland enlargement (R)

Normal prostate (L) vs. Prostate gland enlargement (R)


Prostate enlargement affects million of American men over age 50 who have symptoms of frequency and urgency of urination, poor force and caliber of the urine stream and getting up multiple times a night to go to the restroom to urinate. The enlarged prostate gland can impact a man’s quality of life. Nearly all men can achieve relief from this common medical problem.

There are several effective treatments for prostate gland enlargement. In deciding the best option for you, you and your doctor will consider your particular symptoms, the size of your prostate, other health problems you may have and your preferences. Your choices may also depend on what treatments are available in your area. Treatments for prostate gland enlargement include medications, lifestyle changes and surgery.

Medications are the most common treatment for moderate symptoms of prostate enlargement. Medications used to relieve symptoms of enlarged prostate include:
Alpha blockers. These medications relax bladder neck muscles and muscle fibers in the prostate itself and make it easier to urinate. These medications include terazosin, doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral) and silodosin (Rapaflo). Alpha blockers work quickly. Within a day or two, you’ll probably have increased urinary flow and need to urinate less often. These may cause a harmless condition called retrograde ejaculation — semen going back into the bladder rather than out the tip of the penis.
5 alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. They include finasteride (Proscar) and dutasteride (Avodart). They generally work best for very enlarged prostates. It may be several weeks or even months before you notice improvement. While you’re taking them, these medications may cause sexual side effects including impotence (erectile dysfunction), decreased sexual desire or retrograde ejaculation.
Combination drug therapy. Taking an alpha blocker and a 5 alpha reductase inhibitor at the same time is generally more effective than taking just one or the other by itself.
Tadalafil (Cialis). This medication, from a class of drugs called phosphodiesterase inhibitors, is often used to treat impotence (erectile dysfunction). It also can be used as a treatment for prostate enlargement. Tadalafil can’t be used in combination with alpha blockers. It also can’t be taken with medications called nitrates, such as nitroglycerin.

Laser surgeries use high-energy lasers to destroy or remove overgrown prostate tissue. Laser surgeries generally relieve symptoms right away and have a lower risk of side effects than older surgical procedures such as the TURP or transurethral resection of the prostate that require 3-4 days of hospitalization and requires a catheter for several days after the procedure. Some laser surgeries can be used in men who shouldn’t have other prostate procedures because they take blood-thinning medications.

The laser used in my practice is the green light laser (GLL). It is performed in the hospital or a one-day surgery center. Men go home after the 30 minute procedure with a catheter which is usually removed the day after the procedure.

Less than 1% of patient will experience erectile dysfunction after the procedure, and 1/3 of the patients have retrograde ejaculation after the procedure. Some of the common side effects include mild burning with urination. Although incontinence can occur with this procedure, it is very uncommon, especially when it is performed by an experienced urologist.

For more information on managing the enlarged prostate gland with the green light laser, please view my video on YouTube: http://www.youtube.com/watch?v=r4Qh_mStsUw