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.

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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

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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.

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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 .

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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.

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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.

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YOUR PROSTATE
PLAN IT OUT AHEAD
There are other ways to live more comfortably with your BPH.
•    A long car trip. Plan where you’re going to stop. Most car rides tend to stimulate the urinary tract. This may be partly due to nervous tension if you’re the driver. Figure out where you can stop at least every two hours.
This will allow you to gas up, have a snack and use the bathroom. Some patients with BPH say sometimes on car trips they have been stuck in big cities where there were no filling stations, and by the time they found one they nearly tore the door off the men’s room to get inside.
•    Going to a scary or suspenseful movie? Again nervous tension can increase the need to urinate. Performers get this problem before they go on. A really wild movie can do the same thing to most men. Try to use the bathroom before the movie starts. As a precaution, don’t buy a large cola drink to go along with your popcorn.
Remember “a pint in, a pint out,” and often the “pint out” part won’t wait until the movie is over.
•    Let’s say you waited too long, your whole crotch is burning and throbbing and you have to urinate so bad you’re almost upset to your stomach. When you at last get to a bathroom, try for the toilet stall. Simply close the door, drop your pants and sit down.
No one seems to know why, but sitting down to urinate relaxes some muscles or the sphincter muscle, or something, and it makes urination at these difficult times much easier. At stress times like this, many BPH patients say it’s taken them five minutes of standing at a urinal or at the bathroom at home before they can get even a drop of urine out.
Spasming of muscles seems to be relaxed, and the whole system simply works easier and much faster in these stress situations, if you can sit down and bend forward toward your knees.
At this point who cares why it works, it does and will work any time you have trouble getting a urine flow started as well. Don’t fight it, just try it!
COPING WITH YOUR BPH
You’ve known that you’ve been living with your BPH for what - a year, three years? You’re a short timer. Most urologists have had literally thousands of years of experience with BPH through their patients. Your doctor may have a dozen little hints and helps like those above that have worked for hundreds of his BPH patients. No, these are not big dramatic findings that can be reported in the New England Journal of Medicine or the Journal of the American Medical Association.
However, your own doctor or urologist may have a small gold mine of tips and hints that he’s picked up over the years to make a big difference in how you can live easier and more comfortably with early and more advanced stages of BPH.
The next time you’re in his office, ask him if he has any of these little gems of BPH trivia advice that might just fit some problem that you’ve been having. The best advice is: Always go to the expert: talk to your urologist.

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ALCOHOL AND BEER
You knew this was coming. Alcohol is not good for the human body. Alcohol is especially not good for men with BPH.
“Hell, give up beer and a few shots of bourbon and maybe a highball or two? Damn, I’d rather die!” Such typical comments by moderate and heavy drinkers is often answered with the assurance of: “You will die and probably sooner than you expected to.”
For years some urologists have said that alcohol irritates the prostate. It also can cause serious problems with the liver. Some of the flavorings in alcohol can affect the prostate to such a degree that it can cause a kind of chronic prostatitis
For a man with even early BPH, the sudden or overuse of alcohol can bring on a surprise attack of acute retention of urine. This condition results in a desperate need to urinate but it is impossible. A quick trip to a doctor’s office or the emergency room of a hospital for catheterization and draining the bladder follows.
Good old common sense dictates that a man with even early BPH should seriously consider his consumption of alcohol and its relation to his prostatic condition. At this point many men simply don’t want to take the risk or stand the pain and problems associated with alcohol and BPH and stop drinking.
Beer drinkers will be furious, but the pint-in, pint-out and the much used bathrooms at bars and taverns, indicate that it is well known that beer drinking is immediately followed by voluminous urination.
Here common sense leaps up again. Beer drinking in the afternoon may be easily tolerated by some men, but not by others. Late night beer drinking will almost surely trigger two or three additional night time trips to the bathroom that otherwise could have been avoided.
If you insist on drinking beer, use a little common sense so it doesn’t trigger more unpleasant BPH reactions.
COFFEE, COLAS AND CAFFEINE
Yes, caffeine is the big tiger on your back here. Caffeine is a stimulant to the urinary tract: it makes you urinate more and more frequently. For most well people this is no problem, not even a minor inconvenience. Over the years your body will adapt to the added caffeine.
But when you have BPH, it’s different. You don’t need any more stimulation in your urinary tract. Neither do you need any more volume.
The BPH coffee drinker who normally goes through twelve, eight ounce cups of coffee a day is going to have a much harder time living with his urinary tract, than the non-coffee drinker, or even the man who drinks twelve, eight ounces of non-caffeine fluids a day.
Ounce for ounce, coffee and tea contain twice the amount of caffeine that regular cola drinks do. Of course now most of the colas come in caffeine free types as well. This is one place where you can have your cola and not your caffeine.
In the same manner, there are many caffeine free coffee brands now on the market.
If you want to manage your body with a little more “smarts” give the caffeine free drinks a test in your own bathroom. You’ll probably be pleasantly surprised when you make the test.
Oh, the “Principle of the single differential”. When you make any of these intake tests, try to do everything else the same, except for the item you’re testing. If you have two differentials (variables) in your life style, you won’t be able to tell which one made the difference, if there is a difference. It’s an old principle from the physical sciences but it works.
If you drink caffeine fluids, take the test. Try the caffeine free types for a week, doing nothing else different. One BPH patient said it cut his nocturia risings down from two a night to one. After a few weeks you’ll even forget what the caffeine laced drink tasted like.
Don’t forget that many of the current pain pills for headaches, colds and hay fever also contain caffeine. While these aren’t taken often, you might look for some that don’t have caffeine in them, such as the ibuprofen medications.

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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.

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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.

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