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
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
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
CHRONIC PROSTATITIS. NONINFECTIOUS PROSTATITIS.
July 14, 2009 | Leave a Comment
CHRONIC PROSTATITIS
Sometimes the condition will be cleared up, or seem to be back to normal, only to have it flare up again alternative to levaquin .Cases like this are called chronic prostatitis.
At least this time the patient knows what he has and can get to the doctor quickly for early medication ingredients zyrtec .If the drug used before didn’t completely kill off the bacteria causing the problem, there is little chance the same medication will do any better during the next attack pamelor make you gain weight .Doctors watch for newly developed medications they hope will solve the problem bodybuilding pump with viagra .But so far there is no drug that will completely eliminate the chronic prostatitis problem.
Some urologists maintain that regular prostatic massage is one effective treatment forchronic prostatitis testosterone and hair growth .Other urologists never use the massage treatment how to inject tramadol .Some urologists suggest masturbation if sex with a partner is not available lowest price lipitor .Almost all urologists will agree that the best way to empty the prostate of fluid is regular sexual activity of any type leading to ejaculation.
As with many of the ailments of the prostate, the old favorite treatment of the sitz bath, simply a hot tub bath, is well received by prostatitis sufferers halfing zyprexa tablets .The heat from the water increases the circulation in the under-water area and that can help a number of problems.
Chronic prostatitis is not a good candidate problem to be corrected with surgery barqs caffeine .It would be a case of overkill, like throwing out the baby with the bath water.
Urologists say that even if surgery were performed, the inflammation and pain could still come back in the prostatic capsule itself, even after most of the prostate had been removed drug amoxil .A prostatectomy also can bring up a whole new set of problems that the patient didn’t have before.
NONINFECTIOUS PROSTATITIS
When a man gets serious pains and the urologist rules out infectious prostatitis, there has to be another cause depakote er migraine .This might be from a whole group of problems and the doctors call this malady, noninfectious prostatitis.
The symptoms usually include lower-back pain, burning during urination, pain or slight discomfort after ejaculation, pelvic discomfort, and sometimes a slight but obvious bleeding during ejaculation.
The urologist will check the patient’s prostate and often he’ll find it to be filled with prostatic fluid, boggy and soft evista dosage .It may or may not be enlarged and may or may not have any hard lumps or nodules.
For this problem, there are few simple answers, no easy solutions and no absolutes hctz 25 mg compared to diovan .The medical experts say that this non-infectious prostatitis could be caused by some kind of bug we can’t see or don’t know about yet, or it could be some form of inflammation that isn’t infectious.
One constant seems to be that a prostatic massage will cause the patient to expel a great deal of prostatic fluid through the urethra and the penis testosterone for body building .This often brings immediate relief to the patient.
Urologists aren’t exactly sure why this works metronidazole male breast .They say that most men with normal prostates secrete a small amount of prostatic fluid every day gout use zantac .Most of this is passed off through the urine without the man being aware of it.
Upon sexual arousal this secretion can increase ten fold to do its job of helping to carry the sperm cells out the urethra and from the penis upon sexual climax.
When a man becomes aroused, and then frustrated and there is no orgasm, all of that extra prostatic fluid remains in the prostate liver damag and ibuprofen .If this happens occasionally, the fluid is soon discharged a little at a time through the urine zyprexa borderline .But repeated frustrations after arousal, can mean a large buildup in the prostate and this will soon lead to some of the symptoms described above.
There are cases where a man can produce more prostatic fluid that he normally ejaculates during an orgasm harmful side effects of boniva .This again will create a buildup of the fluid and can result in problems cipro and screwdriver .What this is saying is that there can be prostatic problems that have a direct relationship with a man’s sex life, and this includes too little as well as too much sex.
There are cases where there are symptoms of prostatitis, but absolutely none of the usual causes are present naproxen sodium and gout .Some urologists feel that such a problem can come about entirely from stress green tea and amoxicillin .Some doctors say that there may be a lack of tone in some of the perineal muscles and this could result In the buildup of prostatic fluid allegra high blood pressure .Nobody knows for sure.
This leads into the suggestion that there could be psychological reasons why some of these cases of prostatitis develop when there is none of the usual physical causes hair loss zoloft fatigue .Anxiety or stressful tensions dealing with sex, a man’s job, his spouse, school or family — about almost anything, are now thought to be sufficient in some men to create symptoms of prostatitis even without any of the usual physical causes.
In some cases antibiotics seem to be helpful, even though there is no known bacteriological cause digitek and gynecomastia .Urologists are always aware of the placebo factor, especially in cases like these that may be partly stress or psychologically based.
Simply giving a man a pill and telling him that this will
help his condition, often will help his condition lipitor cholesterol lowering drug .This is what doctors mean by the placebo effect buy olanzapine .Placebos have traditionally been sugar pills with absolutely no curative powers whatsoever order tramadol no prescription cod payment .However when a doctor gives the placeboes to a patient and assures him that this should cure his problem after ten days, it often works.
This merges into the psychological and the psychosomatic aspects of healing, and in this area no one is right or wrong.
What works, works, there is no reason to question it hydroxyzine withdrawal .Doctors and urologists say that the placebo effect must never be underestimated.
They point out in double blind clinical tests, the patients who are given the placeboes without knowing it, often show a strong rate of improvement purchase fluconazole online with out a .The sugar pill certainly didn’t do it, the placebo effect did club soma .The patient thought he would get better, and somehow, he did get better.
In the chapter on case histories, we’ll show several actual cases of both infectious and non-infectious prostatitis, and how the problems were resolved.
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
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
11
PROSTATITIS: LASER MINOR SURGERY AND OTHER NON MAJOR SURGICAL APPROACHES.
July 11, 2009 | Leave a Comment
LASER MINOR SURGERY
Yes, the laser is now finding its way into prostatic surgery. For some patients the balloon treatment doesn’t open the urethra enough. To help these patients, Dr. Roger S. Warner, a urologist at New York University in Manhattan, wields his laser to remove some of the offending tissue around the urethra, and then follows that up with the use of the balloon dilation. Dr. Warner said this treatment helped twenty-five out of twenty-nine patients treated.
Other doctors say that laser surgery, first used in medicine in the 1970’s, is only scratching the surface of its potential. In the future they say there will be a much greater use of the laser. Lasers can also be used to vaporize benign and malignant growths, and it’s all done quickly and simply without the patient trauma of an open surgery.
The role of laser surgery in urology is limited but it has a great potential. Dr. Israel Barken, a urologist in private practice in San Diego, and a researcher at University of California at San Diego Medical School, has a patent on a device to use in laser surgery of the prostate.
Intrasonix Company from Boston in conjunction with the Lahey clinic has developed a new device by the name of TULIP. They have used it in operations on 25 dogs so far with promising results.
In the future, from mid 1990, you may wish to ask your urologist about the possibility of having laser surgery by your urologist. Right now it’s still experimental, but work is going on in three places aroud the world.
OTHER NON MAJOR SURGICAL APPROACHES
Dr. Terrence R. Malloy, chief of urology at Pennsylvania Hospital in Philadelphia, attacks the enlarged prostate tissue with ultrasound waves. The tissue is turned into a pulp and dislodged and then sucked out of the body by an aspirator.
Some research is now being done with microwaves. They are aimed directly at the enlarged prostate. Testing is now underway to see what results are of attempts to shrink the enlarged prostate tissue, thereby relieving the pressure on the urethra.
Another experimental type of minor surgery is the use of cryogenics. This utilizes a probe through the penis and urethra and into the heart of the enlarged prostate. The probe then releases liquid nitrogen into the enlarged tissue.
This intensely cold fluid freezes and shrinks the tissue and destroys it which relieves the pressure on the urethra. More experiments and results of this type of cryosurgery will be reported in the first half of the 1990’s we are sure.
Another new development in the opening of the urethra through the prostate is the insertion of a spring like spiral device that mechanically keeps the urethra open. This is a new technique and while some urologists have the springs available and can insert them, we expect much development in this area of the open urethra in the coming years.
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
ACUTE URINE RETENTION. BHP.
July 7, 2009 | Leave a Comment
ACUTE URINE RETENTION
In this busy, busy world of ours, many men are working so hard and going so fast that they don’t take time for regular physical checkups. Some never think about prostate problems until it’s almost too late.
Again the symptoms of BPH can slip up on a busy man. He simply figures that by sixty-three he should be urinating more often and he’s heard other men talk about needing to get up at night once or twice. He thinks nothing of it.
Then one day he needs to urinate but can’t. He stands there waiting and then straining but he can’t pass even a few drops and he’s hurting like crazy. Soon the pain is so agonizing that he calls his doctor or rushes down to a hospital emergency room to find out what’s the matter.
A catheter drains the urine from the distended bladder and relieves the problem. Some patients with acute urine retention might be holding as much as a quart of urine. Most patients will look much better within minutes and feel fine in an hour or so.
A sudden attack of acute urine retention can happen to almost any man who has some obstruction already in his urethra. There are also conditions that can bring on such attacks.
Prolonged exposure to the cold, especially if you are not used to it can sometimes bring on such an attack. Drinking alcohol by someone not used to it. The sudden use of antihistamines is also a culprit in this case.
Such an attack is usually enough for the patient to have his prostate checked critically by an urologist who will advise him if any treatment or surgery is needed — as well as suggestions about how to prevent such an attack in the future.
So, there is your primer on BPH, its symptoms and some details about the problems it brings up. Now, is there a way to live with these problems during that time when the doctor recommends no major treatment is needed. We’ll look at that in the next chapter.