Treatment for Prostate Problems

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Benign prostate hyperplasia (BPH) is a common, age-related condition in which the prostate swells, impeding the flow of urine through the urethra. A treatment called trans-urethral needle ablation (TUNA) involves heating the prostate with radio waves emitted by a needle-like antenna inserted within the gland. TUNA requires only local anesthesia, and is up to 70 less costly and just as effective as conventional surgery.

Recovery Time:

One day (compared to three to four days for conventional surgery).

For the Enlarged Prostate

Men with enlarged prostates find it easier to urinate following laser surgery. Laser prostatectomy clears away unwanted tissue just as effectively as standard surgery, in which the surgeon uses a wire loop or scalpel to remove prostate tissue...yet it causes virtually no bleeding and requires less anesthesia. The laser "cooks" the part of the prostate that encircles the urethra. This tissue disintegrates and is passed in the urine.

Best Time For Prostate Test

A prostate-specific antigen (PSA) test is best performed at least 48 hours after having sex. Ejaculation can make a PSA reading jump. The test might then indicate possible prostate cancer. PSA readings return to normal 48 hours after ejaculation.

Prostate Test Schedule

Men are typically advised to get their first annual prostate-specific antigen (PSA) test at age 50. But new evidence suggests that it's better to have the first test at age 40, followed by another at age 45 and then every other year starting at age 50.

Best Treatments for Prostate Enlargement

Prostate cancer gets lots of media cover-age-but prostate enlargement is far more prevalent. Technically known as benign prostatic hyper-plasia (BPH), the condition affects more than half of men over age 50.. .and 80 of men by age 80. The prostate is a walnut-sized gland that surrounds the urethra at the base of the bladder.

It produces one component of seminal fluid and helps propel the fluid through the urethra during orgasm. For unknown reasons, the prostate often begins to enlarge around age 40. The enlarged tissue presses against the urethra, often leading to urinary problems...

Mild Symptoms:

Difficulty in starting the flow of urine.. .a weak urine stream.. .stopping and starting during urination... and dribbling afterward.

Severe Symptoms:

An urgent need to urinate up to several times an hour... a constant feeling of fullness in the bladder.. .and frequent awakening at night to go to the bathroom.

Diagnosing BPH

Although BPH is unrelated to a man's risk of developing prostate cancer, it's prudent to see a urologist if you're experiencing any urinary difficulties.

Reason:

BPH and prostate cancer produce similar symptoms. Also, untreated BPH can lead to urinary tract infection or even bladder or kidney damage. After reviewing your symptoms and medical history, the urologist should take a urine sample to check for infection. Then he/she should perform a digital rectal exam to feel for prostate enlargement. The doctor should also test your blood level of prostate-specific antigen (PSA). A high level suggests prostate cancer.

For mild BPH, the doctor will probably recommend watchful waiting.

Caution:

Antihistamines and decongestants can worsen your symptoms. If you have BPH, ask your doctor about avoiding these drugs.

Prostate Medication

Alpha-blockers such as terazosin (Hytrin) and doxazosin (Cardura). These drugs-also used to treat high blood pressure-relax the prostate muscle.

5-alpha reductase inhibitors such as finasteride (Proscar). It shrinks the prostate by blocking the prostate-stimulating effect of dihydrotestosterone.

If Your Prostate is Enlarged:

Finasteride may help by shrinking it. It may need to be taken for six months to a year before symptoms begin to improve.

Side Effects:

Impotence occurs in fewer than 5 of men taking finasteride. Potency generally returns when medication is stopped.

If Your Prostate is of Normal Size:

It doesn't help to shrink it. The treatment of choice is an alpha-blocker.

Side Effects:

Weakness, dizziness and drowsiness occttr in up to 10 of men taking an alpha-blockec. To avoid these problems, ask your doctor about adjusting the dose and taking the drug at bedtime.

Prostate Surgery

If drugs fail to bring relief, surgery can help. The "gold standard" for surgical treatment of BPH-the one considered most effective-is transurethral resection of the prostate (TURP). In this procedure, the surgeon inserts a tiny lighted instrument called a resectoscope into the urethra. Excess tissue from the prostate's "inner ring" is chipped away bit by bit. If the prostate is of normal size, the surgical treatment of choice is transurethral incision of the prostate (TUIP).

As in TURP, a resectoscope is inserted through the urethra. But instead of chipping away tissue from the inner ring, the surgeon makes two tiny cuts in the muscular portion of the prostate. This relaxes its grip on the urethra.

More Surgical Procedures

Two newer procedures destroy excess prostate tissue via heat administered via catheter...

Transurethral needle ablation (TUNA) uses radio waves to produce heat.

Transurethral microwave thermal therapy (TUMT) uses microwaves.

TUNA and TUMT have real advantages over TURP and TUIP. They can be done on an out-patient basis, for instance, and the risks of retrograde ejaculation, impotence and incontinence are smaller.

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