Jul
18
TUIP: TRANS URETHRAL INCISION PROSTATE
July 18, 2009 | Leave a Comment
TUIP: TRANS URETHRAL INCISION PROSTATE
The TUIP is simply a pair of incisions made on the sides of the bladder neck that closes the bladder off from the urethra. The incisions are made through the urethra and is a simple procedure. Urologists are not sure why this works for the relief of BPH problems, but it does. Often urine peak flow is greatly increased, getting up at night is reduced and hesitation and some of the other less serious BPH problems are lessened.
This procedure is much like a TURP for the equipment used and the insertion. The electric knife makes only the two incisions and no removal of prostatic tissue is done. This is another option a patient with really bothersome BPH has to find relief
Jul
16
TRADITIONAL PROSTATE SURGERY.
July 16, 2009 | Leave a Comment
The electrical wire loop emerges from the end of the tube and is used to cut away the prostatic tissue. Power is applied to the electric loop by the use of a foot switch when the surgeon wants to cut.
As he does this, the surgeon is watching the procedure through a lens that is located just outside the end of the penis.
When bleeding occurs inside the urethra, another foot pedal is pressed and the bleeding part is sealed off by cauterization so it won’t bleed. During the surgery the entire area is washed by glycine.
After the surgeon decides that he has removed enough of the enlarged prostate, the chips and shavings of the prostate tissue are removed with the glycine wash and sent to a pathologist who studies them to see if there are any beginnings of cancer of the prostate.
The surgeon may elect to remove most or all of the prostate but he will not harm the prostate’s surgical capsule. This new hole that has been created through the overgrown prostate now becomes a urinary canal. This means that the prostate enlargement tissue was growing around the urethra gradually closing it down and narrowing it. The inner walls of the urethra have been cut away carving a new canal through the prostatic tissue growth.
After the cutting is done, a thin, flexible rubber or plastic tube is then passed through the penis and urethra and into the bladder so urine can be drawn from the bladder.
This tube remains in place for a few days because of some bleeding that may take place in the prostate. When the tube is removed, the patient will be able to urinate normally again.
This catheter, used after the TURP surgery, consists of three lumens or tubes. One is used to send in and remove a wash of saline solution, salt water, into the bladder to irrigate and clean it. This saline solution usually is used for twenty-four hours after surgery.
The second tube is used to draw off urine. The third usually has a small balloon attached and is inflated so the catheter will not fall out.
The catheter to draw urine from the bladder stays in place for two days after surgery.
Most patients feel good enough to get out of bed a day after surgery and are feeling much better after four days. Yes, you can walk and talk and sit down with the catheter in place. It usually comes out on the second day and no pain is involved.
The surgeon will deflate the balloon and the catheter can then simply slide out. The following day, most patients are discharged and sent home. Hospital stay: two days.
Most TURP patients get a prescription for antibiotics to be taken by mouth for one to two weeks after the surgery. This is a precaution to ward off any infection.
Post surgical suggestions from his urologists will probably advise the patient to take hot baths rather than showers for a while, drink lots of fluids, avoid spicy foods and watch out not to become constipated.
There won’t be any touch football games for a while, but most of the patient’s activities can be resumed, including driving, sitting at a desk and taking walks.
If there is any trouble it probably will be a slight burning during the first two weeks when he urinates, and even small amounts of blood in his urine. If this happens, the patient should call his urologist and report the problem just to be on the safe side.
When can you get back to work’? These are general guidelines. You’ll follow your doctor’s orders here. They will depend on the doctor, the patient and how well he recovers. Generally: If you do heavy manual labor, best to wait four to six weeks. Moderate labor will call for three to four weeks of vacation. The mental giant behind a desk or in a white collar position can get back in his harness after two weeks.
One caution. The TURP patient should hold off any sexual activity for six weeks after surgery. This will allow the canal through the prostate to heal completely.
The TURP surgery is performed about 400,000 times a year in the U.S. and the numbers probably are rising with the increase in percentage of our male population reaching the BPH age.
PROSTATE SURGERY
When you and your urologist decide that the best way to handle your BPH or other prostrate trouble is surgery, you have another decision to make. Which type of surgery will do the job that needs to be done?
Today, about 95 % of all BPH surgery uses the standard transurethral resection of the prostate, or TURP, as it is called.
Your urologist will explain to you in detail what this surgery involves.
The TURP is what surgeons call a closed operation. That simply means that there is no incision made in the body to get at the problem.
The TURP uses a surgical instrument that is inserted into the penis through the urethra. He’ll point out to you that this is done after the use of anesthesia. The instrument is a nonflexible hollow tube that extends into the narrowed portion of the urethra inside the prostate.
Inside this tube the urologist will insert a fiber optic micro-lens system that doctors call a resectoscope. This device includes a fiber optics light source, a lens and a electric wire element for surgery. The light inside the urethra lets the doctor see the problem and determine the severity of the problem.
Jul
14
HYTRIN IN PROSTATITE TREATMENT.
July 14, 2009 | Leave a Comment
HYTRIN …. AVAILABLE NOW
There is one drug on the market now, and available, that researchers at Abbott Laboratories of Chicago say will do the job of relieving BPH symptoms.
This is Hytrin, Abbot’s brand of terazosin, approved by the FDA in 1987 as a once-a-day pill for high blood pressure.
Dr. Atul Laddau, Abbott’s head of clinical research, says their own clinical tests of two years show that Hytrin relieves pressure on the urethra almost immediately and reduces other symptoms in about two thirds of the test patients with BPH. Some urologists are using Hytrin because it is now on the market, and because of the reported quick results. You don’t wait three months for relief here.
There are some unfortunate side effects with Hytrin. These are said to be dizziness, fatigue and occasionally fainting attacks. Even considering these side effects. Hytrin, with its two-thirds success rate and its availability, should be one of the drugs that you talk to your doctor about. There are other terazosin medications on the market beside Hytrin. Cost of these pills is said to be about $15 to $20 a month.
Jul
13
PROSCAR IN PROSTATITIS TREATMENT
July 13, 2009 | Leave a Comment
PROSCAR
One of the drugs of the future for controlling BPH may be a product now in final testing by Merck & Co. called Proscar. This drug blocks an enzyme that stimulates prostate growth. The Merck researchers say that the male hormone testosterone undergoes changes in the prostate gland and this is believed to be the primary factor in unwanted prostate growth when a man gets into his 40’s and 50’s and later.
By blocking this enzyme and refusing to let it change the testosterone, it would also stop the growth of the prostate.
Researchers say they are still in testing on the drug but it is in human clinical trials, one of the last of the procedures.
Using 350 patients in one clinical test, the drug reduced the size of enlarged prostates an average of twenty-eight percent. One third of the test patients also had a “dramatic improvement” in their urine flow.
Dr. John McConnell, assistant professor of urology at the University of Texas Southwestern Medical Center in Dallas, said: “The drug is highly effective from a biochemical point of view. It does shrink the prostate.”
He went on to say since only about one-third of the patients had an improvement in urine flow, the drug is not applicable to all men or all BPH cases.
One advantage of the Proscar treatment is that it has resulted in no side effects, at least so far in the testing. Side effects have been the killer of most prostate drugs so far.
Proscar is in final testing and with success should win the Food and Drug Administration approval for sale in the “early 1990’s”. That could still mean that it’s three or four years away.
One drawback to Proscar has been determined so far. It takes “about three months” before the prostate shrinks enough to help in urinary flow problems.
Merck is excited about the new product from a breakthrough standpoint, but also because it could have a great financial future. The market for such a medication that works, is said to be in the hundreds of million of dollars a year. The quickly expanding male population in the “prostate years” adds to this sales potential. This is one product to watch closely.
Some drug industry spokesmen say Proscar and Merck may be facing a problem: getting urologists to prescribe a medication that could cut their income by reducing the 400,000 prostate surgeries a year. Most urologists discount this saying they welcome another tool to fight prostatic disease.
Jul
12
PROSTATITIS: CAN DRUGS BE USED INSTEAD OF SURGERY? RELAXATION DRUGS.
July 12, 2009 | Leave a Comment
CAN DRUGS BE USED INSTEAD OF SURGERY?
Over the years there have been many attempts made to find a drug that would shrink the prostate gland. The scientists worked on the belief that the enlargement of the prostate had something to do with the male hormone production.
This led to the use of female hormones that did shrink the prostate and help the BPH problem and reduced or eliminated the symptoms. The only trouble was that it also reduced and eliminated the male sex drive and often led to sterilization and impotence of the patient.
After that the lab men worked on drugs that would simply block the production of testosterone produced in the testicles. They came up with Leuprolide (lupron) which blocks ninety percent of the body’s total production.
Another companion drug used at the same time, Flutamide (eulexin), eliminates the other ten percent of testosterone made by the adrenal gland.
What these drugs do is effectively castrate the man by chemical action. This reduces the male libido, his sex drive, and sterilizes him and makes him impotent. These are mighty tough side effects even for a man in his seventies just to shrink the size of the prostate.
These drugs are most often chosen when a man has an extreme case of BPH or cancer of the prostate, and his sexual life is no longer a factor in his life whether he’s 65 or 80 years.
For most men the sexual side of life is always a vital part of their existence. It’s like watching a shiny new bus stop at your corner. It’s nice to know the bus service is always there, even though you seldom use it any more.
RELAXATION DRUGS
Some urologists find that the use of a drug such as Minipress (prazosin hydrochloride) will relax the smooth muscles surrounding the prostate. The purpose here is to get these muscles to relax or loosen to allow the prostate to expand slightly outward and thereby ease the internal pressure on the urethra.
A second drug used for the same purpose of relaxation of the muscles around the prostate is Terazosin. It relaxes the muscles and greatly reduces the spasms that these muscles frequently have which slow or prevent urination.
BPH is a highly subjective ailment. What bothers one patient may be little more than a minor and unnoticed irritant to another. Some patients who use one of these drugs may report relief from some of their symptoms, while others say they have no effect whatsoever on their life style.
Tests have shown some urologists that the use of Minipress and Dibenzyline drugs have made specific improvement in patient symptoms. Studies have been done to measure the voiding flow rate and residual urine before and after the use of these drugs, with an average of 60% improvement.
Jul
10
NON MAJOR-SURGICAL BPH TREATMENTS
July 10, 2009 | Leave a Comment
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BPH TREATMENTS
Remember our typical early BPH patient example? Well your clock has swept around and you’re now 63, your minor BPH symptoms are more severe. You can’t get through a night without getting up three or four times to urinate. Everytime you wake up you leap out of bed and rush to the bathroom.
During the day you’ve had to hold up a board meeting while you went to the toilet. You can’t take a car drive of more than an hour without stopping. On your business flights you always get an aisle seat so you can hurry to the cramped convenience two or three times during a flight.
Besides that, sometimes it hurts like outrageous sin.
So, you go back to see your urologist. For the past eight years he’s been “monitoring” your BPH. At every examination he assures you that there are no hard lumps or irregular growth of the two side prostate lobes. He says that means you probably don’t have prostatic cancer.
What happens next? You want some relief, you want to feel better and be able to lead a more normal life. It’s a quality of life situation you’re talking about and you want some help, now!
Your urologist agrees and the two of you sit down to talk about the possible ways that your situation can be eased.
You realize that once the prostate starts to grow, nothing we know of now will stop it, except total sterilization. That’s out. What other remedies are there?
THE BALLOON METHOD
One of the new treatments now getting wider acceptance is the use of a balloon. Urologists have borrowed this technique from the heart surgeons. The physician inserts a small tube about the size of spaghetti into the urethra. On the far end of the tube is an un-inflated balloon.
When the balloon is in the proper position in the urethra within the enlarged prostate, the physician inflates the balloon. This inflation is held for different lengths of time. Some urologists use a ten minute period of pressure by the balloon within the urethra to force the urethra to expand back to its original position.
This forces the prostate tissues outward. In some cases the outer casing of the prostate is “cracked” or broken to allow the enlarged prostatic tissue to move in that direction and eliminate the pressure on the urethra.
Just who first developed this technique is not known, but Dr. Flavin Castaneda, a radiologist at St. Francis Medical Center at the University of Illinois in Peoria, is one of the pioneers in the use of this new technique. He says that seventy-five percent of the BPI I patients he has used the balloon treatment on have been symptom free for up to three years after the treatment.
In another part of the country, more than 60 patients have been treated with the balloon dilation method at the University of Minnesota.
For eighty percent of these patients the urination problem was eliminated or significantly eased. This was for patients with enlargement of the side lobes of the prostate. When the narrowing of the urethra was because of enlargement of the middle lobe, the success rate dropped to thirty to forty percent.
Dr. Israel Barken, a urologist in San Diego, California, has been using the balloon treatment.
He says for this procedure the patient is tranquilized and the urethra is numbed with a local anesthetic. Then a thin, flexible tube with a balloon on the tip is inserted into the urethra and guided to the narrowed portion. The balloon is then inflated. He says he uses a time of about 20 minutes. This is an outpatient treatment and no hospitalization is needed. If the patient wants the procedure done in the office or the hospital, he can be accomodated.
Dr. Barken says before this procedure is undertaken, tests are made to assess the extent of the obstruction and to determine its precise location. At this point other tests are done to be sure there is no cancer present or any prostatic infection.
A catheter is left in the bladder until the following morning and then removed.
Dr. Lester A. Klein, an urologist at the Scripps Clinic in La Jolla, California says that at first the balloon treatment was effective on only about thirty percent of the cases. But now with doctors screening out the patients with poor chances for success with the balloon dilation, Dr. Klein says there is a success rate of eighty-six percent.
Dr. Klein is the designer of one of the balloon devices used in the operation and does the procedure himself at Scripps.
Dr. Barken has developed a similar technique using the same principles as Dr. Klein, but without the use of the sophisticated multiple balloons. This helps bring the cost down tremendously.
At this point in mid 1990, urologists who use the balloon technique have praise for it. They say it is effective, and is easy to do with the least amount of stress and worry on the patient. It is non-surgical, and as of yet, there have been no side effects reported. These three factors make it a favorite with patients as well especially when contrasted with surgery.
Another factor is the cost. While few hard figures are obtainable, one Boston urologist said the average total cost for a balloon dilation in the hospital is about $3,600. For the same TURP operation the cost is about $12,000. TURP surgery is one of the operations that remove part or all of the growth in the prostate.
A medical writer in the Wall Street Journal estimated that more than 2,000 of these balloon treatments have been done. A CBS news report about the same procedure said that over 5,000 of them have been undertaken in the past two years.
Not everyone agrees with the use of the balloon dilation treatment. Dr. John W. Schumacher, M.D. from Minneapolis says that this ignores the 10 percent of those who do get a TURP operation and the pathologist find that they have prostate cancer as well. Dr. Schumacher says that if a hundred thousand balloon treatments are used for BPH, then ten thousand of those men who have Stage A or B Cancer won’t find out about it — perhaps until it’s too late to cure them.
Dr. William J. Somers, M.D., a urologist, agrees. He puts hidden cancer of BPH patients at twenty to twenty-five percent.
He says that the use of the balloon dilation or drugs to reduce BPH symptoms is actually doing those twenty-five percent of the patients with hidden cancer a disservice. Other experts say these hidden cancers are rarely fatal in nature.
He maintains that there is no accurate way of determining who has prostate cancer and who doesn’t. Biopsy and ultrasound can help, but he says unless shavings of the gland are examined in a pathology laboratory, the cancer can metastasize and no one will know about it until it’s too late.
Dr. Walter Desmond, Jr. Ph.D. and research manager at Hybritech in San Diego has a slightly different view of the evaluation of the scrapings from a TURP operation. His firm makes a test called the PSA to evaluate the prostate specific antigen level in the blood. A high level can indicate the strong possibility of a silent cancer in the prostate.
He says that some pathologists fail to examine all of the tissue taken out during a TURP operation. Those who don’t evaluate all of the scrapings are shortchanging the patient.
He says the odds are even greater that a hidden cancer may be missed because a proper TURP cuts out the central part of the prostate tissue. The great majority of small cancers start not at the center of the prostate but near or on the surface of the lobes of the prostate, and these areas are often never touched by the surgeon’s electric knife when he cuts out the new canal for the urine to pass through.
Dr. Desmond seems to be saying that if pathologists are finding small cancers in the ten percent, or as high as 30 percent by some scientific evaluations of the TURP scrapings, then the true figure must be much higher than that taking into consideration the two factors presented here.
His slant seems to be that a chemical test such as PSA offers a much better method to detect early prostate cancer than any other method.
Jul
9
YOUR PROSTATE
PLAN IT OUT AHEAD
There are other ways to live more comfortably with your BPH.
• A long car trip. Plan where you’re going to stop. Most car rides tend to stimulate the urinary tract. This may be partly due to nervous tension if you’re the driver. Figure out where you can stop at least every two hours.
This will allow you to gas up, have a snack and use the bathroom. Some patients with BPH say sometimes on car trips they have been stuck in big cities where there were no filling stations, and by the time they found one they nearly tore the door off the men’s room to get inside.
• Going to a scary or suspenseful movie? Again nervous tension can increase the need to urinate. Performers get this problem before they go on. A really wild movie can do the same thing to most men. Try to use the bathroom before the movie starts. As a precaution, don’t buy a large cola drink to go along with your popcorn.
Remember “a pint in, a pint out,” and often the “pint out” part won’t wait until the movie is over.
• Let’s say you waited too long, your whole crotch is burning and throbbing and you have to urinate so bad you’re almost upset to your stomach. When you at last get to a bathroom, try for the toilet stall. Simply close the door, drop your pants and sit down.
No one seems to know why, but sitting down to urinate relaxes some muscles or the sphincter muscle, or something, and it makes urination at these difficult times much easier. At stress times like this, many BPH patients say it’s taken them five minutes of standing at a urinal or at the bathroom at home before they can get even a drop of urine out.
Spasming of muscles seems to be relaxed, and the whole system simply works easier and much faster in these stress situations, if you can sit down and bend forward toward your knees.
At this point who cares why it works, it does and will work any time you have trouble getting a urine flow started as well. Don’t fight it, just try it!
COPING WITH YOUR BPH
You’ve known that you’ve been living with your BPH for what - a year, three years? You’re a short timer. Most urologists have had literally thousands of years of experience with BPH through their patients. Your doctor may have a dozen little hints and helps like those above that have worked for hundreds of his BPH patients. No, these are not big dramatic findings that can be reported in the New England Journal of Medicine or the Journal of the American Medical Association.
However, your own doctor or urologist may have a small gold mine of tips and hints that he’s picked up over the years to make a big difference in how you can live easier and more comfortably with early and more advanced stages of BPH.
The next time you’re in his office, ask him if he has any of these little gems of BPH trivia advice that might just fit some problem that you’ve been having. The best advice is: Always go to the expert: talk to your urologist.
Jul
7
PROSTATE PROBLEMS AND ALCOHOL, BEER AND COFFEINE.
July 7, 2009 | Leave a Comment
ALCOHOL AND BEER
You knew this was coming. Alcohol is not good for the human body. Alcohol is especially not good for men with BPH.
“Hell, give up beer and a few shots of bourbon and maybe a highball or two? Damn, I’d rather die!” Such typical comments by moderate and heavy drinkers is often answered with the assurance of: “You will die and probably sooner than you expected to.”
For years some urologists have said that alcohol irritates the prostate. It also can cause serious problems with the liver. Some of the flavorings in alcohol can affect the prostate to such a degree that it can cause a kind of chronic prostatitis
For a man with even early BPH, the sudden or overuse of alcohol can bring on a surprise attack of acute retention of urine. This condition results in a desperate need to urinate but it is impossible. A quick trip to a doctor’s office or the emergency room of a hospital for catheterization and draining the bladder follows.
Good old common sense dictates that a man with even early BPH should seriously consider his consumption of alcohol and its relation to his prostatic condition. At this point many men simply don’t want to take the risk or stand the pain and problems associated with alcohol and BPH and stop drinking.
Beer drinkers will be furious, but the pint-in, pint-out and the much used bathrooms at bars and taverns, indicate that it is well known that beer drinking is immediately followed by voluminous urination.
Here common sense leaps up again. Beer drinking in the afternoon may be easily tolerated by some men, but not by others. Late night beer drinking will almost surely trigger two or three additional night time trips to the bathroom that otherwise could have been avoided.
If you insist on drinking beer, use a little common sense so it doesn’t trigger more unpleasant BPH reactions.
COFFEE, COLAS AND CAFFEINE
Yes, caffeine is the big tiger on your back here. Caffeine is a stimulant to the urinary tract: it makes you urinate more and more frequently. For most well people this is no problem, not even a minor inconvenience. Over the years your body will adapt to the added caffeine.
But when you have BPH, it’s different. You don’t need any more stimulation in your urinary tract. Neither do you need any more volume.
The BPH coffee drinker who normally goes through twelve, eight ounce cups of coffee a day is going to have a much harder time living with his urinary tract, than the non-coffee drinker, or even the man who drinks twelve, eight ounces of non-caffeine fluids a day.
Ounce for ounce, coffee and tea contain twice the amount of caffeine that regular cola drinks do. Of course now most of the colas come in caffeine free types as well. This is one place where you can have your cola and not your caffeine.
In the same manner, there are many caffeine free coffee brands now on the market.
If you want to manage your body with a little more “smarts” give the caffeine free drinks a test in your own bathroom. You’ll probably be pleasantly surprised when you make the test.
Oh, the “Principle of the single differential”. When you make any of these intake tests, try to do everything else the same, except for the item you’re testing. If you have two differentials (variables) in your life style, you won’t be able to tell which one made the difference, if there is a difference. It’s an old principle from the physical sciences but it works.
If you drink caffeine fluids, take the test. Try the caffeine free types for a week, doing nothing else different. One BPH patient said it cut his nocturia risings down from two a night to one. After a few weeks you’ll even forget what the caffeine laced drink tasted like.
Don’t forget that many of the current pain pills for headaches, colds and hay fever also contain caffeine. While these aren’t taken often, you might look for some that don’t have caffeine in them, such as the ibuprofen medications.
Jul
7
HOW TO COPE WITH EARLY BPH. LIVING WITH BPH. Early Stages of an Enlarged Prostate.
July 7, 2009 | Leave a Comment
HOW TO COPE
WITH EARLY BPH
Living with the early stages of an enlarged prostate isn’t all that hard:
This is true. Remember, you had BPH for eight to ten years before it caused you any problems at all. You might have had some mild symptoms for another two or three years before you realized it and found out what was causing them. Now you know.
Now is no time to panic. So these problems caused by BPH area small inconvenience, they are something you can learn to live with. The alternative is not a happy thought.
Let’s go back to our typical case history. This gentleman is the one who is sixty years old and has the three most minor of BPH symptoms: a brief hesitancy when urinating, a slower, less forceful stream, and he usually gets up once a night to urinate.
The secret here is that you know what the cause is of these minor problems, which means you can learn to manage them. You have managed a lot of things in your life, right? First the other kids in your family, then a wife, then your own kids, then that business and all the people you had under you. Compared to that, managing early BPH is a breeze.
First the worry. The experts say again and again that BPH is not cancer, has no connection with prostate cancer, does not lead to cancer and is an entirely separate ailment. So get that out of your mind.
You don’t have prostate cancer, it’s only BPH.
Urologists fight this misconception all the time and gradually they’re winning. They point out that cancer of the prostate is almost always on the outside of the prostate lobes. The enlarged prostate grows inward and outward. There is absolutely no casual relationship between the two.
Now, one more concern with prostate cancer. When surgery is needed for BPH, usually at a much later time than in a man’s fifties or early sixties, there is a finding that about ten percent of the BPH prostates will be found to have a cancer.
Remember, cancer can strike any part of the body at any time in life. It has no connection to BPH. When these cancers are found they are not in the usual places where they could be easily diagnosed during your regular BPH exams. So in reality the BPH surgery is a stroke of luck since most of these cancers are just beginning and are caught quickly so they can be eradicated more easily.
So, from here on we don’t worry about BPH causing or being tied in with prostate cancer in any way. Clear?
LIVING WITH BPH
Urologists point out that the minor symptoms of BPH, often the initial ones, may be the only troubles a man suffers with BPH for as much as ten to fifteen years. That means you shouldn’t even be thinking about or concerned with any worry about prostate surgery or other treatment now. Dump it right out of your computer memory hard disc. Why worry about something that isn’t going to happen for ten to fifteen years? You’ll have plenty of time to fret and stew about it and discuss it with your urologist when the time comes. By then some even better treatments undoubtedly will be developed.
Concentrate on today, and how to make your life pleasant and interesting and fulfilling, right now! in spite of BPH.
We know that there is no “cure” for BPH. You can’t take a pill and like a headache your BPH will just go away. It isn’t that kind of a problem. Even with our miracle modern medical cures, there is nothing even on the drawing boards that will magically cure BPH. So we practice positive thinking and forget about that and move on to areas of behavior that we can and should do something about.
Plain old fashioned horse-sense. With the decline of the horse as the basic transportation unit of Americans, not much is heard anymore about horse-sense. Too bad. Horse sense has shaken down to “common sense”, which is almost as good.
For example, it makes no sense to drink two gallons of water a day when you know you’re going to have to urinate most of that water the same day. Don’t overload your urinary system. The less you drink the less you’ll have to urinate.
Don’t carry this to extremes. The body is at least 1,259 percent water. You need water, fluids, to survive. But there is a happy medium. Some doctors say a man should drink eight, eight ounce glasses of water a day. That’s half a gallon. Actually what they mean is that the body should intake that much fluid a day: coffee, water, milk, soup, colas, juice, any fluid should count.
Many other doctors say this is much more fluid than the average man needs. Your body will tell you when it wants a drink. As a common sense living-with-BPH, start cutting down on your fluids a little at a time. You’ll be urinating less, but still enough. Talk to your urologist or doctor about this and find out what the minimum daily need is for intake fluids for a man of your size and activity. It may be much less than you suspect.
If you do manual labor in the hot sun all day, you’ll need more water than if you’re in an air-conditioned office where you work on a computer. Your doctor will be able to help you here.
TIME YOUR FLUID INTAKE
If nocturia bothers you, and you’re getting up three times a night to urinate, try limiting your fluid intake in the evening. One doctor suggested not to drink any fluids for four hours before retiring. That way your body will have processed your fluids, and passed them well before your sleeping time.
Using a modified system such as this (some men have one small drink at dinner and nothing after that) many BPH patients can cut to once their nocturnal urination. Now that is a real blessing if you can go from three risings to only one a night. This is a prime example of how you can manage your own life to reduce the interference of BPH with your normal activities.
Jul
7
WHAT PROBLEMS CAN EXTREME PROSTATE
ENLARGEMENT CAUSE?
Silent Prostatism. Sometimes the prostate will enlarge and there are none of the usual symptoms. The urethra continues to close but somehow the man simply doesn’t realize the problem or decides that he’s just getting old and the “water works” sometimes doesn’t work right for him.
If this condition builds and builds, more and more urine can be left in the bladder that can’t be expelled in urination. This can result in a serious problem. The patient will become excessively tired and feel weak, he will be irritable and could suddenly collapse or even lapse into a coma.
When large amounts of urine are left in the bladder and it isn’t strong enough to expel the liquid through a narrowing urethra, serious damage can occur. This can lead to a serious backflow pressure of the urine on the kidneys. At the most serious, such a problem can cause kidney failure and a quick death.
In cases like this the patient needs to get to a hospital quickly so a catheter can be used to drain the bladder. With the emptying of the bladder, the patient will feel much better almost at once. Then the doctors will watch to see if any permanent damage was done to the kidneys and if so what additional treatment might be needed.
Depending on the seriousness of the situation, the patient’s normal kidney function should come back after a week to three months. At that time the prostate should be checked for size to see if prostate surgery or some other treatment is required.
CONGESTION OF THE PROSTATE
Sometimes after normal BPH symptoms in a patient, an urologist will find only a moderately enlarged prostate but one that is mildly congested. There often is no sign of infection. Typically there might be a minor amount of urine that can’t be drained from the bladder during urination.
Often there will be some form of obstruction at the bladder outlet which also restricts bladder emptying.
At this point there is no major problem for the patient and he would be put on a maintenance program to have his prostate checked regularly.
As the prostate grows and the bladder muscles are forced to work harder and harder to push the urine through the narrowing urethra, the bladder can become fatigued. In some cases the bladder will simply quit functioning and urine buildup occurs in the bladder.
This can form a place where bacteria can grow and multiply rapidly. When this happens the patient feels a burning pain when he urinates. Sometimes the urine will have a bad odor and traces of blood can show in the urine.
A danger here is urinary infection, which is usually signalled in the patient by a burning sensation when urinating, chills or fever and the intensification of his regular BPH symptoms.
Here, as in other early symptoms of BPH, the patient may go for several years without any more serious problems than his minor BPH problems.
On the other hand the congestion may increase, and if this happens the patient’s urologist may suggest a prostate massage. Here the prostate is massaged digitally through the rectum and the congested fluid is expelled. This makes the heaviness vanish and a more normal life returns.
The urologist may suggest that a patient have regular prostate massages to relieve the congestion. Or it may be relieved by regular ejaculations through intercourse or masturbation.
Some urologists never recommend repeated prostatic massages. But all suggest in situations like this that the patient should avoid long periods of exposure to intense cold weather, should avoid most spicy foods, should sharply reduce the use of alcoholic beverages, should avoid antihistamines, and they recommend the patient to take warm baths often.
Any shift or intensifying or change in symptoms of the BPH should be reported to the patient’s physician or urologist at once.