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The prostate is a small gland that surrounds the neck of
the bladder and urethra in men. It creates semen. The prostate
gland may enlarge over the years because of hormonal changes
and some nutritional deficiencies. It can then create pressure
on the urethra.
A frequent need to urinate, difficulty in completely voiding
(in other words, many minutes to finish a pee), incomplete
emptying of the bladder, waiting a while before the flow of
urine begins, and disturbed sleep because of the need to urinate
are some prime symptoms of BPH (benign prostatic hyperplasia),
with negative impact on a man's lifestyle. Anyone suffering
from any of the described symptoms should see a doctor for
a proper diagnosis.
Enlargement is a symptom which can develop with age. Half
of all 50-year-old men have BPH, 30 million in America alone.
It is not cancerous although your urologist will make checks
to ensure that it is not prostate cancer which is the second
biggest man killer after heart failure (and causes 50% more
deaths than are caused by breast cancer). Your doctor can
do this quite simply in the first place with a simple finger
examination of the rectum, checking for lumps and hardness
of the prostate. He will also give a PSA, prostate-specific
antigen, blood test. This can be an indicator of possible
cancer but a high PSA is not always a certain indicator.
Drugs to treat BPH can cause side effects, as we note below.
Drugs are used either to reduce the prostate, or to improve
urine flow.
Alpha blockers relax the urethral muscle to improve urinary
flow. Most well-known brands are Hytrin, Minipress, Cardura.
Flomax (containing tamsulosin hydrochloride) is the one alpha-blocker
specifically designed for the job.
The most widely used drug to shrink the prostate is finasteride,
a 5-alpha-reductase inhibitor, and the best known brand is
Proscar. As finasteride blocks a sex hormone it can also have
the side-effect of a loss of sex drive.
Some physicians, particularly in Europe, recommend herbal
products which can reduce the prostate without side effects.
Of these, clinical studies have been mainly focussed on saw
palmetto, which can reduce the level of symptoms of BPH as
well as the size of the prostate. One research found that
10.7% of finasteride patients discontinued treatment because
of side effects, including loss of libido, compared to only
1.8% of those taking saw palmetto.
There is no room for doubt that supplements can help the
condition. A review of studies, published in the Journal of
the American Medical Association, concluded that saw palmetto
extract was as effective as finasteride (Proscar?) . The clinical
effectiveness of saw palmetto has been shown in trials lasting
six months to three years. Saw palmetto - like other natural
remedies - can be even more effective if blended with other
natural ingredients which have also been clinically proven
to help the prostate.
If a doctor decides surgery is necessary, until now TURP
(transurethral resection of the prostate ) has been the "gold
standard" treatment. It provides instant relief of BPH and
improved urination. The surgeon removes the obstructing tissue
a piece at a time. However it presents a risk of retrograde
ejaculation in the majority of cases. There is also the possiblity
of impotence, or incontinence. Because of these side effects
"watchful waiting" with regular medical check-ups have been
the keywords for a bph condition.
A more recent innovation has been the use of laser technology
instead of the original TURP system of cutting the prostate
piece by piece, to remove obstructing tissue. One was Holmium
Laser Prostatectomy. The most promising may be the Laserscope
system. The Laserscope vaporizes tissue: see http://www.laserscope.com/contactus/index.html
and also visit the sci.med.prostate.bph newsgroup where there
is always a lively discussion on the merits of this procedure
- most valuably by men who have undergone the treatment.
Read our advice about controlling BPH by natural means. You'll
find it here.
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