Jul
18
THE SUPRAPUBIC PROSTATECTOMY.
July 18, 2009 | Leave a Comment
THE SUPRAPUBIC PROSTATECTOMY
In this surgery an incision is made below the navel and to a point just above the pubis. An alternative may be an incision just above the pubic hair. The incisions will be from four to six inches long.
The surgeon goes in here cutting through skin and its lining. The patient’s muscles covering the bladder are carefully separated and the sac covering the abdominal wall is pulled back. Then an incision is made in the bladder.
Now the surgeon removes the prostate gland and the tissue is examined for any evidence of cancer. Cauterization or sutures close off all bleeding vessels. The stitches will dissolve later.
When bleeding is controlled, the surgeon inserts a catheter in the penis and up through the urethra into the bladder to irrigate it. The bladder is then emptied.
Now a second catheter is inserted directly into the bladder. It will leave the body just below the navel. This catheter is used to drain urine and irrigation fluids from the bladder after the operation. It is larger than the one in the penis and more effective.
Continuous irrigation of the bladder and the prostate area is continued for two days. The large catheter is removed in a day or two but the penile catheter is left in for six or seven days. This allows urine to be removed from the bladder and lets the prostate area heal.
After the catheter is removed the patient usually can urinate normally.
Jul
16
OVER THE COUNTER DRUGS FOR PROSTATITIS
July 16, 2009 | Leave a Comment
OVER THE COUNTER
Just what does the March, 1990 publicity release by the FDA mean? Will there still be over the counter preparations designed to help with BPH problems by the end of the year, or into 1991? Only the FDA knows.
A check of health food and nutrition specialty stores in mid 1990 showed at least five products on the market. Many of these tend to be regional and there well could be twenty or fifty more out there. These are shown as examples of what’s on the market now. We do not judge any of them but present them here as another element of the BPH real-life picture for the layman.
Prostate Plus
This product came to our attention through a multi-page tabloid type newspaper mailed to a name and address (or current occupant). It was a national mass mailing and held a 3/4 page story and advertisement for Prostate Plus.
Prostate Plus was described as a “Total nutritional support for a healthy prostate.” It went on to say that it: “provides every nutrient known to benefit a healthy, well-functioning prostate gland.” Since it is advertised as a nutritional supplement and not a medical treatment, perhaps it will get around the FDA broadsword.
What’s in it? I-Glycine, I-Alanine, I-glutamic acid, zinc, raw prostate, saw palmetto, pumpkin seed concentrate, vitamin E, golden rod, and flaxseed oil.
Ninety capsules cost you $14.95 in the store.
Prostone
Prostone comes from the Enzymatic Therapy people in Green Bay, Wisconsin. The Prostone No. 190 is described this way: “The nutrients in this formula including zinc, Vitamin A, essential fatty acids and amino acids, are vital for proper prostate function.”
What’s in it? Oil concentrate from wheat germ and safflower seeds, linoleic acid from safflower seed oil, intrinsic glandular lipids, lecithin, L-Glutamic acid, L-A Ian i fie, Amenoacetic acid, Prostate tissue, Vitamin B6, Vitamin A from fish liver oil, Zinc chelate, bee pollen and saw palmetto berries extract.
Sixty capsules will cost you $11.95.
Raw Prostate With Gaba
This product is made up exclusively of raw bovine prostate and gamma amino butyric acid. That’s about all we know about it except that it comes from Country Life, a large maker of health food additives and products. It’s on the market. Glad they told us it was bovine prostate. Ninety tablets will cost you $13.00
Prostatrophic Concentrate
This one is made up entirely from raw bovine prostate. One such ingredient indicated it had been freeze dried. Here 100 tablets are priced at $8.00.
Search
This small bottle of sixty tablets was priced at $10 and the ingredients were listed as raw bovine prostate.
So, we’ve talked about the non-surgical, minor surgery and drug type of treatments for BPH. Where do we go from here? If none of the other methods are right for you, your urologist may suggest traditional surgery for your BPH. What’s that? Move right on to the next chapter and find out.
Jul
15
OVER-THE-COUNTER,
THROUGH THE MAIL REMEDIES
Up to two years ago there had been a thriving over the counter and through the mails business of selling non-prescription compounds and “cures” and treatments for BPH.
Several years ago the Post Office Department began challenging many of these products sold through the mail on grounds that they were advertised misleadingly, and that they did not do what they claimed to do. Simple misrepresentation which could ban them from the mail.
That campaign by the U.S. postal authorities put a lot of people out of business who were selling various mail order non-prescription products to treat the prostate.
In March of 1990, the Food and Drug Adminstration said it would ban the sale of all non-prescription drugs used to treat enlargement of the prostate gland. The FDA said their review of the products found little evidence that any of them eliminated, arrested or treated the condition called benign prostatic hypertrophy. There was no date given for enforcing the ban or activating it.
The FDA, evidently not keeping up with current developments in the field, said surgery was the only effective treatment for BPH. A lot of urologists and specialists in the drug field will argue long and hard with their dictum with the various minor-surgical techniques we’ve discussed so far and the new drugs being developed.
What the FDA order does is ban non-prescription products that are advertised for the treatment of the prostate. They did not, and can not ban the sale of certain chemicals or compounds that have been considered by many since the Feinblatt/Gant study in 1958, to be beneficial to reduce BPH symptoms. These chemicals, mainly amino acids, are used in many of the soon to be banned products.
The study was conducted by Dr. Henry M. Feinblatt and Dr. Julian C. Gant and reported in the Journal of the Maine Medical Association in March of 1958, Volume 49, Number 3.
The study deals with the “Value of glycine, alanine and glutamic acid combination,” in the treatment of BPH.
These three chemicals have generally been used by dozens, perhaps hundreds of non-prescription compounds aimed at the general public since 1958.
Were these remedies straight out of the Wild West’s Medicine Man’s wagon of hokkum, or do they have some beneficial results that the traditionalist medical men on the FDA panels refuse to recognize?
Let’s look at the Feinblatt/Gant study that started it all.
The doctors had been using these three amino acids to treat their allergy patients. One of the patients mentioned that his urinary problems had improved since he’d been taking the medications from the doctors.
This stirred their imagination and the two medical men decided to try the three way amino acid combination on a group of non-allergy patients. The tests proved that these BPH sufferers had a dramatic relief from their urinary and BPH symptoms.
They moved from there to a clinically stringent test. A group of 40 patients with benign prostatic hyperplasia were treated with glycine-alanine-glutamic acid capsules for three months.
The patient age range was from 37 to 75 years and weigh from 101 to 192 pounds. BPH complaints ranged in duration at the start of the test from one to six years by various patients.
Placebo capsules were given to half of the patients and the amino acids to half. The patients response results over three months were charted. (Understand here that most such tests should be conducted over six months for best reliability.)
Results of the clinical tests were published in this way. For the control group taking the amino acids, the doctors said the size of the prostate was reduced in 92% of the cases. Nocturia was relieved in 95% of cases. Urgent urination was relieved in 81% and frequency in 73%. Discomfort was reduced in 71% of the cases. No such results were observed in the placebo taking control patients.
Other medical authorities have conducted tests along the same lines to confirm or deny the Feinblatt/Gant findings.
In the Journal of the American Geriatrics Society in 1962, Dr. Frederick Damrau of New York City reported such a test. His conclusions were similar. He said the combination of the three amino acids were used in a controlled cross-over test in forty cases of BPH. After three months on the test the patients reported nocturia was relieved or reduced in 95% of cases, urgency down in 81%, frequency lowered in 73% and delayed urination in 70%. Dr. Damrau said there were no adverse side effects or adverse reactions to the amino acids.
Other evidence the FDA ignored or discounted comes from Japan where a series of nine clinical tests were conducted at the department of urology of Kyoto University in Kyoto.
Some of these tests were double blind, which means there was no way the participants could have any idea if they were receiving the test material or a placebo.
The tests were published in the Acta Urological Japonica, volume 14, 1968.
Results for the amino acids therapy for hypertrophy of the prostate showed that the glycine-alanine-glutamic acid capsules were administered to thirty six cases of diagnosed uncomplicated BPH. The capsules gave satisfactory results in relieving subjective and objective symptoms and no side effects were observed in any of the patients.
In another of the tests, statistical results showed that improvement of symptoms were as follows:
• Urinary frequency reduced in 77.7%
• Nocturia relieved in 68.4%. Difficulty of urination relieved 77.3%
• Feeling of residual urine relieved in 71.4% Side effects were found in only one case and that was relieved with a gastrointestinal drug.
Now, one of the obvious questions is this: If these amino acids are so good, as these tests tend to show, why hasn’t one of the huge pharmaceutical giants leaped on the band wagon and brought out a tested, recognized and approved by FDA combination of these amino acids for the prostate sufferers?
The logical answer could be that their own testing did not match the results of the tests shown above. Or, the situation may be that the amino acids would not be a “proprietary” compound that they could patent, protect and profit from. It would be similar to spending millions to test a salt pill, and bring it out only to find that every othercompany could make the same salt pill.
Jul
14
INFECTIOUS AND NONINFECTIOUS PROSTATITIS
July 14, 2009 | Leave a Comment
INFECTIOUS AND
NONINFECTIOUS
PROSTATITIS
Prostatitis is an inflammation of the prostate gland and it is one of the most common of men’s diseases keflex tape . There is no age limit here — prostatitis attacks any man from teenager to grandfather in his nineties celebrex half life .
How do you know if you have it? You’ll be absolutely certain that something is wrong inderal for cats . Prostatitis is not subtle omeprazole and irritability . A case of acute prostatitis may bring on a sudden fever, chills, nausea and vomiting besides urgency of urination, hesitancy, burning pain during urination and even pus or blood in the urine apoe quinapril .
Most family physicians who diagnose acute prostatitis will suggest the patient go to a specialist, the urologist fosamax tumors .
Prostatitis can be caused by infection, irritation and congestion or a combination of these problems geodon msds . Many urologists will tell you that sometimes there is no apparent cause of the condition viagra teens teenager .
This ailment does respond well to treatment, even if it is a bit slow sometimes menopause high testosterone .
The infectious type of prostatitis results from some microorganism or bacteria that has invaded the prostate jitters from celexa . With its tough outer shell, the prostate is hard to get into dipyridamole allergic reaction . But it can be infected through the bloodstream, the lymph system, and the urine motrin package insert .
A lot of the infections come from bacteria from the colon prilosec long . However, antibiotics now can be used to knock out this type of infection before it gets serious effexor side effects headaches .
Bacteria can get into the prostate from sexual contact amoxicillin price overnight . The yeast infections as well as gonorrhea can be sexually transmitted order tetracycline . This danger is just another reason to be safe in your sexual life, wear a condom evanescence lithium guitar tab .
Some people can develop prostatitis simply by eating or drinking certain foods or beverages drug-herb interraction metoprolol aconite . On the avoidance list for some people are coffee, gin, red wine and Scotch whiskey arv efavirenz . Aromatic oils are used to flavor these drinks and that is what irritates the prostate and sets it to complaining leg lipitor pain .
We mentioned gonorrhea as one problem ibuprofen and benedryl . At one time it was the most prevalent infection of the male urogenital tract floxin otic . But now with the better antibiotics, this sexually transmitted social disease can usually be cured quickly benadryl prednisone interactino . A fast cure has the added benefit of stopping the infection before it can travel to the prostate avapro micardis .
Sometimes abscesses do develop in the prostate from gonorrhea unichem laboratories rimonabant conterfiet . This is often because the man has an antibiotic resistant strain or did not get prompt enough treatment to kill off the disease quickly effexor side affects uses . The abscesses result in the same usual symptoms of acute prostatitis evista and respiratory infections .
A urine sample usually shows up minute amounts of the prostate emissions and microscopic examination of the emissions will help the doctor determine what bacteria have made their attack and that will determine what treatment is prescribed does metformin help in getting pregnant . Most prostatitis clears up quickly with the proper medication 3v lithium fishing battery .
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
7
BENIGN PROSTATIC HYPERPLASIA (BPH)
Benign Prostatic Hyperplasia, sometimes called Hypertrophy, is the medical way of saying that the prostate gland has enlarged. In early stages this enlargement may not cause any problems. As it enlarges more and more with a man’s increasing age, it may squeeze the urethra smaller and smaller.
This reduces the force and size of your urine stream, and if left untreated, BPH could lead to the closure of the urethra resulting in severe sickness and even death.
Doctors say that in BPH the glandular tissue within the prostate capsule enlarges, grows, and no one seems to know why it happens or how to prevent or stop this growth.
This is a benign growth. That means it is not cancerous, it does not spread to other parts of the body or attack other tissues or cells. If it were malignant, as in cancer of the prostate, it would destroy and attack other tissue or cells and spread.
In the drawings here, notice how the urethra is fully open in the first one. It passes through the prostate allowing normal flow of urine from the bladder through the urethra and out the penis.
In the second drawing, the darker growth of benign tissue has begun and already has taken the bulge out of the urethra. In the third drawing, the BPH tissue has almost closed the tube the urine must pass through, making urination extremely difficult and bringing on all sorts of BPH symptoms and problems.
We come back to the apple example. Your prostate is like an apple with the core taken out. Through the core goes the urethra. The size of the urethra may begin to shrink when the prostate starts to enlarge when most men are about forty to forty-five. Often by the time a man is in his fifties he’s noticing some changes in his urination pattern.
It is just outside the urethra where the benign growth of the prostatic tissue begins, and it usually grows in both directions, which at once impacts the size of the urethra.
The growth of the tissue usually is not uniform or consistent all along the urethra. It may develop in one section and not in another, so the urethra is not compressed all along its length, at least not at first.
However, as with any tube or a garden hose, pressure at any one spot can shut off the tube entirely and cause all sorts of problems.
The new growth in the prostate consists of the same types of tissue as the normal prostate gland has, but in different proportions. The new, benign growth is going to have more of the glandular type of tissue.
The new growth in the prostate usually develops in both an inward and outward direction, toward the urethra and toward the exterior of the gland. When it grows outward it compresses the normal prostatic tissue against the sturdy outer capsule of the prostate.
When this outer growth takes place in the two lobes of the prostate nearest the rectum, a specialist can feel this with a digital examination. The outward growth does not narrow the urethra so there would be none of the usual BPH symptoms.
In most cases, however, when there is an outward growth of the tissue, it also grows toward the inside as well. Now we get the narrowing of the urethra over the years, and the normal symptoms of BPH.
The prostate has several sections, and digital examination can touch only the back part of the prostate. The sections that can’t be felt can harbor benign or malignant growth. This is one of the reasons for other tests for prostatic cancer that we’ll explain in detail later.
Jul
7
WHAT IS MY PROSTATE? THE GENITOURINARY SYSTEM, PROSTATE, COMMON PROBLEMS
July 7, 2009 | Leave a Comment
WHAT IS
MY PROSTATE?
In the male of the species, the prostate is situated directly below the bladder and in front of the inner wall of the rectum. The bladder stores urine produced in the kidneys. A tube going from the bladder to the penis is called the urethra. The urethra passes through the middle of the prostate something like an apple core is in the center of an apple.
Urinary bladder
Pubic bone Prostate gland
Penis Urethra
Rectum
Bulbourethral
gland
Anus
Coccyx
THE GENITOURINARY SYSTEM
The prostate is both muscle and gland, so it’s called musculoglandular. It is made up of true prostate tissue and of a harder, fibrous material on the outside called the prostate capsule.
This roughly triangular shaped gland is one to one and a half inches in width, and can weigh between fifteen and twenty grams, depending on the size of the man. That means the prostate gland in most men normally weighs less than an ounce.
When you were born, your prostate was about the size of a medium garden pea and grew gradually. At puberty, the prostate takes a spurt of quick growth. This growth continues at a slower pace until a man is about thirty. At this point the prostate reaches its full adult size.
Striated voluntary muscle
Arteries, veins and venous sinuses
Striated muscle On the surface of the prostate
Urethra
Sinus
pocularis Ejaculatory ducts
Longitudinal cross section of ducts leading from the
lobules of the prostate gland
LONGITUDINAL CROSS SECTION OF PROSTATE
SHOWING THREE DISTINCT LOBULES AND
CENTRAL URETHRAL AREA
Urinary bladder
Striated voluntary muscle
in the bladder
Ejaculatory ducts
into urethra
Prostate gland external
muscular wall
Levator ani
(pelvic diaphragm)
Internal portion of the prostate gland
Pubic bone
Bulbourethral gland Urethr
Crus of penis Skin
Bulb of the penis
Glans penis
Foreskin
From thirty to fifty years of age, most men’s prostates remain about the same size, but after fifty, for some unknown reason, the prostate in most men begins to enlarge. Medical experts say this growth may be the result of a change in the male hormone balance in the system, or it could be some other result of age sneaking up on us that we don’t know about yet.
The prostate gland itself is a complex one. It is made up of muscles, glands and fibrous tissues. The many small glands in the prostate are where the fluid is produced that is emptied into the prostatic urethra.
This fluid is injected into the urethra. At the same time the tube that brings the spermatozoa from the testes also emits its product into the urethra. These two fluids, plus one from the seminal vesicles all are combined in the urethra and then ejaculated by the spasmodic contractions of muscles surrounding the urethra.
Which is all to say that the prostate has a big role to play in the male animal, and his ability to function normally in sexual intercourse. So most men are afraid that anything that disrupts the normal operation of the postrate can have an adverse affect on their sex life. This is true only in some cases, and we’ll get to those points as we move along.
Many men go through a serious change in life, in lifestyle, perhaps in their work and relationships with others at this fifty-year-old time period.
The enlargement of the prostate and its resulting problems can have a bad psychological effect on a man already burdened with other life problems.
Some men have a sharp decline in their sexual performance about this time. Others might be having work or career problems. A man’s wife might be having her own changeof-life difficulties and the children often are drifting away from a close family unit about this time.
When things start to happen to his “water works”, and he isn’t sure how this will affect his performance in bed, many men become over sensitive about prostate and prostatic problems.
The extent of this enlargement during the fifties and later often is accompanied by three gradually developing habit patterns: there is a decrease in the force and stream of urine. This sometimes is accompanied by a hesitancy to begin urination. Another early symptom that something is wrong is what doctors call nocturia, or simply the need to get up once, twice, or three times a night to urinate.
These minor difficulties are not horrendous, and you can learn to live with them with little disruption of your normal daily activity. Many men live through their fifties and sixties with few of the symptoms of BPH. These letters will be used a lot in this book. They stand for Benign Prostatic Hyperplasia. That simply means a non-cancerous enlarge-ment of the prostate gland.
In the seventies and eighties in most men, more problems can occur and other prostate ailments and dysfunctions can arise. We’ll be dealing with them in detail later on.
One expert said that sixty percent of all men over sixty years of age have some BPH, and more than ninety-five percent of men in their eighties have some BPH problems.
What we’re saying here is that BPH is simply a factor of older age, like balding heads and weakening muscles. BPH is a fact of life that almost all of us are going to have to learn to live with. The more we can know about it, and the other prostatic problems now, the better we’ll be able to cope with it when it becomes serious about hitting us where it hurts.