Prostate Health » Treatment and Diagnosis

Transurethral Resection of the Prostate (TURP)

admin — Tue, 11 Aug 2009 10:57:12 +0000

An enlarged prostate can cause numerous problems, including problem urinating and recurring urinary tract infections. It the prostate becomes too large and starts creating problems, it may need to be removed.

One of the most common and proven ways to remove the prostate is transurethral resection of the prostate or TURP.

TURP is performed using spinal or general anesthesia. A tube-like instrument called a cystoscope is inserted into the penis through the urethra and up to the prostate gland. This tube is called a resectoscope and is about 12 inches long and 3/8 of an inch in diameter. The tube has a light and an electrical loop to remove the tissue.

The surgeon uses this tubing to remove the obstructing tissue in pieces. Then the irrigating fluids carry the tissue pieces to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time.

After the surgery, an electrical current is used to stop the bleeding during surgery. This is called cauterization. You must remain in the hospital for approximately 3 days, while a catheter will be used to drain your urine. A liquid solution may be attached to the catheter to flush the area and keep the tube from becoming clogged with blood or tissue. The bleeding will gradually decrease, and the catheter will be removed within 1 – 3 days.

During the recovery period, patients are advised to

avoid heavy lifting, driving, or operating machinery;
drink plenty of water to flush the bladder;
eat a balanced diet;
use a laxative if necessary to prevent constipation and straining during bowel movements.

As this surgery is somewhat evasive, some men will not return to work for about a month. There are some possible complications that may occur.

Blood in the urine (hematuria) is common and usually resolves by the time the patient is discharged. However, bleeding also may result from straining or activity. Any postsurgical bleeding should be reported to the urologist immediately.

Additionally, some individuals have initial discomfort, a sense of urgency to urinate, or short-term difficulty controlling urination. These conditions slowly improve as recovery progresses.

Another common problem may be difficulties with sexual function, as many as 30% of men have problems. The complete recovery of sexual function may take up to 1 year. The most common long-term side effect of prostate surgery is retrograde ejaculation or dry climax. In this situation, the semen enters the bladder instead of being expelled through the penis, causing sterility but not affecting the man’s ability to experience sexual pleasure. This complication is not an issue for most men requiring prostate surgery.

What Kind of Treatment will You undergo for Prostatitis?

admin — Sat, 25 Jul 2009 09:00:23 +0000

Prostatitis is a disease of the prostate gland. Prostatitis treatments can vary greatly depending on the type of disease.

One of the main causes of prostatitis is bacteria; therefore, a treatment may be as simple as antibiotics.

The diagnosis of acute bacterial prostatitis is an infection of the prostate that is often caused by some of the same bacteria that cause bladder infections. The signs and symptoms that you have acute prostatitis include: high fever, chills, vomiting, and a general ill feeling.

Therefore, acute bacterial prostatitis is treated with antibiotics. If you have severe symptoms, you may be hospitalized to receive injections of the drug. After your condition has improved, you will continue with oral antibiotics. The total course of treatment is usually two to four weeks.

Similarly with chronic bacterial prostatitis, it is also treated with antibiotics. The duration of treatment is often longer and may need to be repeated if the infection returns. The symptoms for chronic prostatitis are chronic urinary tract infections. Therefore, you may have symptoms that may come and go.

If you have chronic prostatitis, you may have to take regular medications. These may include alpha blockers or simple pain relievers. Alpha blockers are medications used to bladder and the muscle fibers where your prostate joins your bladder. The medication may lessen symptoms, such as painful urination. Pain relievers such as aspirin or ibuprofen may make you more comfortable.

Along with chronic prostatitis, you may experience pelvic pain. This is difficult to treat, as the cause is unclear. However, the goal will be to reduce symptoms such as pain. The doctor may recommend physical therapy, anxiety medications, exercise and stress reduction. A change in diet may also be helpful. This would include avoiding alcohol, caffeine and spicy foods, as they may increase your condition.

Another possible treatment is a prostatic massage. This is performed by your doctor using a lubricated, gloved finger. This is similar to a rectal exam. This procedure has been used for years; however, the effectiveness is in dispute.

To date, there are other treatments that are being used on a trial basis. These include heat therapy and natural treatments.

Finally, along with medications and other treatments, it is possible to use home remedies to decrease your symptoms. One possibility is a sitz bath, which uses hot water to relieve pain. On the opposite side would be using ice. You can place ice packs or ice cubes on your rectum and it will relieve pain. And the best remedy is water. It is always important to drink plenty of water. This will decrease your risk of a bladder infection.

BPH – Diagnosis and Treatment

admin — Wed, 15 Jul 2009 15:20:03 +0000

BPH, also known as benign prostatic hypertrophy, is a condition in which the prostate gland becomes very enlarged and may cause problems associated with urination.

BPH does not usually cause problems until later in life, usually not till the 60s.

One you are diagnosed with BPH, your treatment will be determined by your physician based on your age, overall health, medical history and extent of the disease.

When the prostate gland is just mildly enlarged, treatment may not be needed. Regular checkups are important to watch for developing problems. Your physician will continue monitoring your condition.

There are surgical and non-surgical treatments for BPH. A surgery would involve the removal of the enlarged tissue that is pressing against the urethra. There are three types of surgery: transurethral, laser and open.

The transurethral surgery is done without any external incisions. The surgeon will reach the prostate with an instrument inserted into the urethra. One example of this surgery is a transurethral resection (TRUP). A resectoscope is inserted through the penis and the wire loop on the scope is used to remove the obstructing tissue. The tissue is carried by the fluid into the bladder and flushed out when the surgery is complete. Another form of this surgery is a transurethral incision of the prostate (TUIP), which is a procedure that widens the urethra by making some small cuts in the bladder neck and in the prostate gland itself.

A possibly less evasive form of the prostate gland removal is a laser surgery. In this procedure, a laser is used to vaporize obstructing prostate tissue.

Finally, there is an option for an open surgery, which would require an external incision. This is usually done when the gland is very enlarged, when there are complicating factors, or when the bladder has been damaged and needs to be repaired.

There are also numerous non-surgical treatments. These include the following:

A balloon urethroplasty – this procedure involves a thin tube with a balloon that is inserted into the opening of the penis and guided to the narrowed portion of the urethra. At that point, the balloon is inflated to widen the urethra and ease the flow of urine.

A transurethral microwave thermotherapy (TUMT) – this involves a device that heats and destroys excess prostate tissue to reduce urinary frequency and urgency.

Medications – can be used to shrink or stop the growth of the prostate without using surgery.

What is Transurethral Needle Ablation (TUNA)?

admin — Sat, 11 Jul 2009 05:18:17 +0000

There are many different treatments for an enlarged prostate. These treatments include medications, transurethral resection of the prostate (TURP), transurethral microwave therapy (TUMT), laser surgery, and open prostatectomy. The treatment that you will undergo will depend on the extent of your enlargement, your age and your health.

Transurethral needle ablation or TUNA is an outpatient procedure to treat urinary problems and prostate enlargement.

TUNA is also called radiofrequency therapy. It can reduce symptoms caused by an enlarged prostate. TUNA uses radio waves to destroy the part of your prostate that is blocking urine flow.

TUNA works best for men who have a mild to moderate blockage of the urethra. It does not work for men with very large prostates or for men who have obstruction caused by enlargement of the central part of the prostate that rests against the bladder.

A local anesthetic may be used to help control pain and you may have intravenous (IV) sedation. With IV sedation, you’ll be drowsy but conscious.

Shortly before the procedure begins, you will be asked to urinate so your bladder is empty and you may be given an enema to clear your bowels and rectum.

During the procedure, your doctor will insert a numbing gel inside your urethra and may numb the prostate area with an injection into your rectum. Next, your doctor will use a visual instrument called a cytoscope to place tiny needles into your prostate. Once the needles are placed into your prostate, radio waves pass through them to heat and destroy excess prostate cells. You may feel a little pain or discomfort.

This entire procedure can take less than an hour. It is usually done as an outpatient procedure, so you can go home the same day.

After the procedure, you may not be able to engage in any strenuous activities, such as heavy lifting, for at least three to five days. You will also not be able to engage in any sexual activity until your doctor approves it, which usually is about a week or two after.

Additionally, you may need to have a catheter inside your penis to allow urine to pass from your bladder after the procedure. If you’re unable to urinate after the tube is removed, your doctor may give you catheters you can insert on your own a few times a day until you can urinate again. Your doctor may also prescribe antibiotics to prevent infection and medications to reduce pain.

The common side effects from this procedure are blood in your urine for a few days following; irritating urinary symptoms such as painful urination or difficulty urinating; and inflammation of the prostate.

Prostate Health: Prostatectomy

admin — Fri, 10 Jul 2009 13:12:05 +0000

Prostate problems are very common in men. These can usually be treated with medications; however, if the prostate is greatly enlarged, if the bladder has been damaged, or if the patient has complications prohibiting other procedures, a prostatectomy may be necessary. This may also be performed if cancer is detected.

A prostatectomy is sometimes the best and safest approach.

A prostatectomy is performed under general or regional anesthesia. The surgeon makes an external incision in the lower abdomen or in the perineum (area between the rectum and the scrotum).

If the surgeon accesses the prostate from the abdomen, the procedure is called suprapubic or retropubic prostatectomy. If the surgery is performed through the perineum, it is called perineal prostatectomy. Once access is gained, the prostate is removed.

After prostate surgery, a urinary catheter is inserted to ensure bladder emptying. Although you will only stay in the hospital for 2 to 3 days, you may keep the catheter for a week or two. At this time, urine output and color and continuous bladder irrigation are monitored.

Blood in the urine is an expected side effect of prostate surgery. The bladder irrigation is used to maintain the effectiveness of the urinary catheter, remove blood clots, and cleanse the surgical area. If bladder spasms occur, the surgeon should be notified.

Once you have been discharged from the hospital, you should abstain from sexual intercourse for 6 weeks after surgery. Strenuous activity and lifting is to be avoided throughout the recovery period, which can take up to 8 weeks.

There are possible risks from this surgery, which could include incontinence and impotence. Depending on the procedure, stress urinary incontinence may result when pressure is put on abdominal muscles.

Another risk is impotence, it is shown that up to 80% of men experience erection problems after this surgery. The nerves that control a man’s ability to have an erection are right next to the prostate gland. They can be damaged or removed during the surgery. It is possible that after months or years even, men with erection problems may regain their ability to obtain an erection.

When considering whether to undergo a prostatectomy, you should consider your personal wishes, age, other medical conditions you may have, the stage and grade of your cancer, and your PSA level. Your age and overall health will make a difference in how treatment may affect your quality of life, especially since you may experience urinary problems and sexual problems.

What is PSA?

admin — Fri, 10 Jul 2009 02:59:40 +0000

PSA is your prostate specific antigen. It is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in the blood. To do this test, the doctor takes a blood sample, and the amount of PSA is measured in a laboratory.

PSA levels are important to determine if you have prostate problems, particularly prostate cancer.

There are three different conditions which can affect your PSA levels. These include:

Prostatitis and Lower Urinary Tract symptoms can elevate PSA
BPH (benign hypertrophy or enlargement of the prostate) can elevate PSA
Prostate cancer often elevates PSA — but not always. Some of the most aggressive types of prostate cancer do not show high levels of PSA.

It is normal for men to have a low level of PSA in their blood; however, prostate cancer or benign (non cancerous) conditions can increase a man’s PSA level.

A PSA test is recommended for men over the age of 50 along with a rectal exam. The main reason for this is to test for prostate cancer. Regular screening is usually recommended. However, if you have a family history of cancer, a PSA test may be recommended around the age of 40.

How will your PSA test be read?

PSA is reported as nanograms of PSA per milliliter of blood. The normal levels may vary from doctor to doctor and lab to lab, but it may be around 4.0 ng/ml. It has been shown that 25 to 35 percent of men who have a PSA over 4.1 and up to 9.9 have undergone a biopsy of their prostate and cancer has been found.

Unfortunately, as stated, there are no normal levels. The PSA level can fluctuate even with inflammation, infection, age or prostatitis. If you have one abnormal PSA test, this does not mean you need a biopsy or have cancer. If the PSA level is high and continues to rise, it is more likely cancer is possible. If this is the case, additional tests may be needed.

Prostate cancer can also be present in the complete absence of an elevated PSA level, in which case the test result would be a false positive. In this case, other testing would be used in determination of the possibility of cancer and another PSA test may be conducted.

How is Prostatitis Diagnosed?

admin — Fri, 10 Jul 2009 01:13:47 +0000

Prostatitis is a disease of the prostate gland. It can cause pain in the groin, pain with urination, difficulty with urination and other related problems. So what exactly does the prostate do? The prostate gland produces components of semen. It is about the size and shape of a walnut and sits directly below the bladder and surrounds the urethra, the tube that transports both semen and urine to the penis.

Prostatitis is a group of disorders with related symptoms.

To diagnose prostatitis, you must rule out other conditions that may be causing your symptoms and determining what kind of prostatitis you have. You will undergo an evaluation which may include a general physical exam and a series of diagnostic tests. Some of the diagnostic tests are:

First, a symptom questionnaire which will give you a score of various factors such as pain, discomfort, urination, frequency and the impact of these symptoms on your body. Your doctor will determine your total score in making a diagnosis and devising a treatment.

Second, you may have to undergo a digital rectal exam, in which your doctor manually examines your prostate gland. To do this, your doctor will place a lubricated, gloved finger into your rectum. He will be able to feel the surface of your prostate to determine if it is enlarged, tender or inflamed.

Another test could be a urine and semen test. Your doctor may want to evaluate samples of urine and semen for bacteria and to determine your white blood cell count. Your white blood cells are important to your immune system and can help establish a diagnosis of prostatitis. You may have three samples taken, before, during and after massaging your prostate with a lubricated, gloved finger.

For a more extensive examination, the doctor may perform a cystoscopy, in which a cystoscope is used to examine your bladder and urethra. This cystoscope is a small tube that in inserted through the urethra and into the bladder. It contains a magnifying lens or camera and allows the doctor to view any problems and rule out conditions.

Finally, your doctor may order an urodynamic test, which is used to check your bladder and its ability to empty. Again, this can help your doctor identify other disorders or understand how prostatitis is affecting your ability to urinate.

In performing these various exams, your doctor can rule out any conditions and narrow down your symptoms of prostatitis. After a diagnosis is made, a treatment will be determined.

Prostate Health: What medications are available?

admin — Thu, 09 Jul 2009 02:26:17 +0000

There are two main types of medications for BPH: alpha-blockers and 5 alpha-reductase inhibitors. Alpha-blockers relax muscles near the prostate while 5 alpha-reductase inhibitors shrink the prostate gland.

These medications when combined can improve your symptoms.

Alpha-blockers help treat benign prostatic hyperplasia (BPH) by relaxing smooth muscle tissue found in the prostate and the bladder neck. The relaxing of the muscles near the prostate relieves pressure and lets urine flow more freely, but doesn’t shrink the size of the prostate.

5 alpha-reductase inhibitors, known as finasteride or dutasteride, can help shrink the prostate. This can relieve symptoms by blocking an enzyme that acts on the male hormone testosterone to boost organ growth. When the enzyme is blocked, growth slows down. This helps to:

Shrink the prostate
Reduce blockage
Limit the need for BPH surgery

You may need to take 5 alpha reductase for at least 6 months to a year before you can increase urine flow and reduce the symptoms of BPH. It seems to work best for men with very large prostates. Unfortunately, this medication must be taken continuously to prevent symptoms from coming back.

5 alpha-reductase inhibitors can cause the following side effects in a small percentage of men:

Decreased interest in sex
Trouble getting or keeping an erection
Smaller amount of semen with ejaculation.

It is important to note that taking this drug can lower your prostate-specific antigen (PSA) test levels. There is also evidence that finasteride lowers the risk of getting prostate cancer, but whether it lowers the risk of dying from prostate cancer is still unclear.

In general, these medications are usually taken by mouth one to two times a day. Most men will notice a significant improvement within the next couple days, but definitely in the first two weeks.

It is important to use a combination of an alpha-blocker with a 5-alpha reductase inhibitor, which may help your symptoms more than either medicine alone.

If your bladder is completely damaged, the medications may not be effective and surgical intervention may be required. If possible medications should be attempted before an evasive surgery.

There are also many prostate medications for prostate cancer treatment. With cancer, you may undergo hormone therapy. Hormones are drugs that can affect the growth of prostate cancer cells. This therapy may be used with radiation treatment or surgery to make sure the cancer cells are destroyed.

Prostate Health » Treatment and Diagnosis

Transurethral Resection of the Prostate (TURP)

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What Kind of Treatment will You undergo for Prostatitis?

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BPH – Diagnosis and Treatment

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What is Transurethral Needle Ablation (TUNA)?

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Prostate Health: Prostatectomy

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What is PSA?

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How is Prostatitis Diagnosed?

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Prostate Health: What medications are available?

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