Jul
10
NON MAJOR-SURGICAL BPH TREATMENTS
July 10, 2009 | Leave a Comment
NON MAJOR-SURGICAL w5tbpqac7u
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
BPH SYMPTOMS. WHAT CAUSES BPH?
July 7, 2009 | Leave a Comment
WHAT CAUSES BPH?
No one knows what causes BPH. Just why the prostate starts to enlarge itself in the forty to fifty male years is not understood.
There are two significant factors in this mystery that have been tied down by medical research over the years. One is that a man who has been surgically or hormonally castrated, eliminating the male hormone from his body, never develops an enlarged prostate.
The other uncontested fact is that the onset of BPH is started only with the passage of time.
Castration at an early age to eliminate BPH is a totally unthinkable idea. The other alternative, death at an early age is equally ridiculous as a prevention of BPH.
Which leaves medical science still in kindergarten when it comes to determining the cause of BPH and the chances of scientifically developing a preventive drug or routine and this stops any work on a cure.
Many medical studies have been made in an effort to isolate some other common factor in BPH patients. So far all of these human factors have been ruled out: specific blood types, coronary heart disease, celibacy, hypertension, use of alcohol or tobacco, industrial and environmental conditions.
One constant has been determined: By the age of sixty years, fifty percent of all men will have, to some degree, an enlarged prostate whether or not it is bothering them. By the time American men reach their eightieth birthday, only five out of one hundred will not have BPH.
After broad studies involving Asian men, it was determined that as a group they had fewer cases of BPH and prostatic cancer. However Asian men who moved to the US for a period of time had a significantly increased rate of both BPH and prostatic cancer.
Since Asians typically have had a low cholesterol and low red meat diet, it is speculated that diet may have a larger impact on BPH and prostatic cancer than had been previously thought. With the current wave of anti-cholesterol and anti-fat foods including the campaign against red meat, American men could be experiencing a lower rate of BPH and prostatic cancer in the future.
Is a man’s sex life in any way connected with the cause of BPH or prostatic cancer? A man’s sexual life appears to have no bearing whatsoever on the development of BPH or cancer of the prostate. However, sudden surges in sexual activity, or sudden celibacy often does affect the prostate. These situations will be discussed in a later section.
SO WHAT HAPPENS TO ME NEXT?
Let’s say that you’re reading this book in the first place
because you had some questions about your general health,
or your urination, or your prostate, and after reading the
list of symptoms, bingo! you have three of the symptoms.
Let’s say that you have a hesitancy to start to urinate,
you have a noticeably reduced stream, and you’ve been getting up about three A.M. every night to urinate. What should you do next?
Pick up the phone and get an appointment with your family doctor or call a urologist. It’s time you found out just what’s going on and how serious your BPH really is.
Your next move is to have an examination by a medical professional or a specialist. Just how does a doctor examine you for possible BPH or other prostatic troubles?