Jul
19
RETROPUBIC PROSTATECTOMY w5tbpqac7u
In this surgery the same type incision is made as in the suprapubic operation. The muscle is separated and the sac containing the intestines is moved away from the bladder.
Now the surgeon makes an incision into the prostate capsule and removes the enlarged gland. The tissue removed is tested by a pathologist to determine if there is any cancerous growths present.
Now the surgeon sutures or cauterizes the bleeding vessels and the catheter with the three way tube is placed into the bladder. This catheter is usually the same type as used in a TURP operation. Next the balloon is inflated to keep the catheter in place.
All that is left is for the surgeon to “close”. The prostate capsule is sutured shut and the muscles, fascia and skin are put back in place and stitched closed.
This operation differs from the previous one since the bladder itself was not opened. It’s slightly simpler with less violation of the body. This means there is no need for the second catheter through the belly to drain the bladder.
The draining and irrigation of the prostate needed can be done with the usual three-way catheter. Most urologists say that this operation is less stressful to the patient since the bladder is not cut open, so it doesn’t have to recover.
General recovery procedures and time is about the same for either type of operation. Which type your urologist might suggest would be determined by the individual patient’s condition and sometimes the doctor’s preference.
In surgery for the prostate, the general rule is that a medium sized enlarged prostate and smaller ones can be successfully removed by the TURP method. However when the gland swells in size to over fifty to sixty grams, the urologist will usually do one of the other operations because of the difficulty in scraping out that much tissue and drawing it out of the urethra.
In these cases the larger prostate removal by the retropubic or suprapubic is simply the most efficient method to be used for the well being of the patient.
OTHER TYPES OF PROSTATE SURGERY
Perinea) prostatectomy is another kind of open surgery for the prostate but it is seldom used today. This procedure is quick and simple to do, but almost always severs the nerve bundles that control erection and leaves the patient Impotent.
Doctors back in the 1930’s often used a two stage operation for the prostate. The first stage was opening and draining the bladder. Then two weeks later they would go in and remove the prostate. It is seldom used today.
With the new treatments now coming into focus for the prostate, particularly BPH, there may be a general slowing in the number of surgeries needed. Any surgery has risks but with the prostate the risks seem to be reasonable in regards to impotence and incontinence, the two problems most men fear the most.
With the development of the new drugs, we may see products that will cause the enlarged prostate to shrink without objectionable side effects. With the increased use of the balloon as at least a temporary treatment for BPH, and other inventive methods, some experts are predicting that the use of surgery will not be required as often in future years as it is today. Only time will tell. As the public learns more about the male prostate and BPH, more men will demand non-intrusive treatments whenever possible. Right now a lot of men are hanging their hopes on the new drugs Hytrin and Proscar.
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
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
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
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
EXAMINATIONS TO CONFIRM BPH
The first exam will be the digital one. Since the prostate is right next to the rectum, it can be palpitated. In this slightly uncomfortable digital exam, the doctor is checking to see if your prostate feels enlarged. He is also finding out if there are any hard spots or lumps or nodes on the two lobes he can touch.
The healthy prostate is smooth, elastic and about the size of a walnut. If there is BPH, the prostate will still feel about the same way but it will be obviously enlarged.
Most urologists say that a digital examination can’t confirm 100 per cent the presence of BPH. They point out, however that with such an exam showing the prostate is soft and rubbery, that there is an enlargement outward of two of the prostate lobes, and that the patient reports three symptoms of BPH, there is sufficient evidence to diagnose BPH.
In the fast paced routines in many HMO’s these days, a patient with these workups may very well be told he has BPH, be shown a video tape concerning the problem, and be told what to do to make living with the condition easier.
He’ll be told that in the early stages of BPH, a patient is not a good candidate for surgery or other regular treatment. Rather he will be put on a “maintenance” program where he is checked by a urologist yearly for any progress of the condition.
Many doctors and urologists say this is the proper course of care. They show histories of men in their fifties who have been on maintenance care for ten, even fifteen years before the prostate enlarged to such a point that surgery or one of the new treatments was necessary.
Another test your urolgist may make is a peak flow test. This can be done with an instrument that will record the flow much as the charts below show.
The first chart shows a more or less normal rate of flow with a peak about half way through and stopping quickly. The lower chart shows a much weaker flow and over twice to three times the length of time. This usually means some serious blockage in the urethra and the urologist will want to follow up with other tests.
Some urologists use a stop watch and a timed urination into a glass to approximate the same results.
25 ml/s Flow Rate
Results of UROFLOWMETRY
T100 17 s
TO 17 s
TOmax 7 s
Qmax 24.0 ml/s
Qave 14.1 ml/s Vcomp 247 ml
0 10 20 s
25 ml/s Flow Rate Results of UROFLOWMETRY
I
T100 60 s
TO 51 s
TQmax 8 s
Qmax 10.2 ml/s
Qave 4.1 ml/s Vcomp 211 ml
I T I
10 20 30 40 50 60 70 s
ARE ANY OTHER TESTS AVAILABLE?
Yes, there are several other tests that urologists can use with the prostate. Some of these are used when prostatic cancer is suspected.
However, since some ten percent of all surgery done to relieve BPH results in finding early stages of prostatic cancer development, some men ask for additional tests. They want to make sure that their prostate is not cancerous as well as having BPH.
These tests in effect become Negative Testing, to assure the patient that there is no cancer in the prostate lobes that can’t be felt by the digital exam.
One of these routines is a simple blood test called the prostate specific antigen (PSA) test. If this test shows an elevation of the antigen, it is a positive factor that cancer possiblyy is present in the prostate. A companion test, the PAP test for prostatic acid phosphatase, may show if the cancer has spread outside the prostate to other parts of the body.
A biopsy could be performed on the prostate, but it would be done only if the doctor found hard lumps and suspected spots on the outer lobes when he examines them digitally.
ULTRASOUND TESTING
One of the newer tools of the urologist is the use of ultrasound. This is sometimes called sonography. It simply uses high-frequency sound waves to examine a specific part of the body and make a record of it.
The record can be a sonogram on special film or on paper, or the whole process can be recorded on video tape for critical examination later, and as a record for comparison later of any growth or changes or condition of the examined areas.
The test is quick, simple and painless. A wand instrument called a transducer is passed back and forth over the area being examined. The wand transmits sound waves that are echoed back to it much like a radar does.
The echoes are electronically transmitted to the recording or viewing device.
When examining the bladder and prostate with ultrasound, the bladder needs to be full of urine. Then the test is repeated after the man has urinated to see what urine remains in the bladder.
Ultrasound is becoming more and more popular with urologists and most hospitals have it available. Many urologists now have ultrasound capability as a part of their office equipment for use when needed.
Another use of the ultrasound system is called a transrectal probe. It can be used in conjunction with a surface sonogram.
Many urologists recommend the transrectal. In this test a probe, covered with a rubber balloon which is then filled with water, is inserted into the rectum. This creates an ultrasonic image of the prostate and bladder area that can be recorded and at the same time viewed on a screen.
Some urologists say the transrectal sonogram will show many false leads that are not really cancer. Others say it is a fine method to determine if there is an area that seems to be a cancer and calls for more investigation.
MAGNETIC RESONANCE IMAGING
MRI is an expensive testing method that is painless and quick and can produce a three-dimensional cross section of any part of the body. Users say it is even more detailed than the images produced by a CAT scan.
This test is non-invasive and has no radiation. It uses radio waves in a magnetic field to produce the picture. This test is almost always done in a large hospital.
These days, all testing is expensive. If you have the three-symptom case of BPH, and the digital examination has led to a diagnosis by the physician that as far as he can feel there is no sign of cancer, then it is up to you to decide if you wish to have any more tests to prove to yourself that you are cancer free. Some of these tests, such as ultrasound, are not covered by some of the insurance companies.
One patient was adamant about receiving more tests. He had the three symptom BPH, felt fine, but had a friend who was dying of prostatic cancer. It was well worth it to him to have a $200 sonogram taken that showed no noticeable sign of cancer in his prostate. He was still concerned about the 10 percent of BPH surgery that reveals prostatic cancer. His doctor pointed out to him that such surgeries were performed at a much later point in life than he was. The doctor also said that such BPH problems were much farther developed and had been growing for a greater length of time than his had.
He understood the logic of the urologist. He had been living with his BPH for only about five years. He left the office but a week later called for another appointment. When he came in he said he wanted to take the two blood tests that could reveal the presence of cancer in the prostate, the PAP and PSA tests. Both were made and both showed up negative. Another sign that he did not have prostatic cancer.
The patient was now convinced. He told the urologist that he was not showing disrespect for his qualifications or his skills, but he wanted a little more assurance that he didn’t have cancer than the simple digital examination by the doctor.
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?
Jul
7
BENIGN PROSTATIC HYPERPLASIA (BPH). SYMPTOMS OF AN ENLARGED PROSTATE.
July 7, 2009 | Leave a Comment
SYMPTOMS OF AN ENLARGED PROSTATE
Do you have any of the symptoms of an enlarged prostate? Here is a list of those problems that relate directly to BPH. Study the list critically. Have you experienced any of them?
• A slowing of your urinary stream and its force.
• A slowness to begin urination. You say “start now,” but it may be a few seconds before your stream begins.
• A problem with stopping urination. You tighten the muscles to stop the flow or to prevent any more, but you get a series of continuing dribbles.
• A sensation that your bladder is not completely empty when it should be.
• Frequent urination. You may not notice this during the day, especially if you’re near a bathroom. But at night this is much more evident. Doctors call this nocturia, and it may get you up two, three, four times a night.
• In extreme cases, urinary retention — when you simply can’t urinate. The discomfort and pain can be tremendous.
• Nausea, dizziness, unusual sleepiness brought on if retention has caused kidney damage.
A SIMPLE TEST YOU CAN GIVE YOURSELF
Below is a chart with the symptoms listed above. Some of them are worded differently. At the top are the points to be given for each symptom and its severity. Along the left side are the symptoms.
TOTAL SCORE
POINTS 0 1 2 3 4
STREAM Normal Variable Weals Dribbling
Abdominal
VOIDING No Strain strain or re”
HESITANCY None Yes
INTERMITTENCY None Yes
BLADDER Don’t know Variable Incomplete Single Repeated
EMPTYING or Complete retention
Yee ii ,Wd .9 INCONTINENCET— =
URGE None Mild Moderate Savers
tlmo-d~)
NOCTURIA 0-1 2 3-4
DIURIA ci>llh q2-3h qt-2h ci<lh
Intermittency means that your stream starts, stops and starts again once or more before you feel empty. Incontinence means that you can’t stop urinating when you want to, or you dribble, or pass some water when you don’t want to.
Diuria, means how often your need to urinate during the day. Zero points for three hours or more and 3 points for the need to void each hour during the day.
Mark down what you think your symptoms are. If your score reaches 10 or more, you should probably see your doctor soon about the chances you have BPH.