What is the best medicine for enlarged prostate?

Treatment options for benign prostatic hyperplasia (BPH) have increased significantly in recent years. A few years ago, men suffering from BPH only had surgery as the main treatment option. This has changed as drug-makers have developed a number of drugs to offer more choices for alleviating the symptoms of an enlarged prostate. In fact, medicines now have become the most common treatment method for men with mild-to-moderate BPH. When administered, the drugs can calm bladder and prostate muscles, shrink the prostate, stop prostate growth or relieve symptoms of BPH, such as weak urine streams or the need to urinate several times per day.

Here are some drugs commonly used to treat BPH. Before using any drug, make sure to speak with your doctor to find out which medicine is appropriate for you.

1. Alpha blockers

When diagnosed with an enlarged prostate, your doctor may recommend that you take alpha blockers to ease your symptoms. These drugs relax bladder and prostate muscles and make it easier to pass urine. While they do not alter prostate size, they are effective in promoting urine flow and will prevent the need to urinate frequently or urgently. They work right away so you will not wait too long for the results.
Some alpha blockers that your doctor may suggest include:

  • (a) Doxazosin (Cardura)
  • (b) Alfuzosin (Uroxatral)
  • (c) Tamsulosin (Flomax)
  • (d) Silodosin (Rapaflo)
  • (e) Prazosin (Minipress)
  • (f) Terazosin (Hytrin)

Alpha blockers are very effective for men with both BPH and high blood pressure because they remedy both conditions. However, the drugs should not be taken by men planning to go for cataract surgery as they may cause problems during the surgery.
Side effects of alpha blockers include:

  1. Tiredness/fatigue
  2. Fainting
  3. Dizziness
  4. Lightheadedness
  5. Headaches
  6. Low blood pressure

Alpha blockers also can cause retrograde ejaculation, a condition in which sperm moves backward into the bladder instead of moving forward through the penis. While the condition is not harmful, it means that the fluid ejaculated may not contain sperm. Therefore, men with BPH should keep this in mind particularly if they still desire to have children.

2. 5-Alpha reductase inhibitors

In order to prevent the prostate from growing or just to shrink it, the urologist may recommend that you take a 5-alpha reductase inhibitor. Such drugs stop the body from producing one of the hormones necessary for prostate growth and enlargement. As a result, the drugs improve urine flow and relieve the symptoms of BPH. The 5-ARIs are most effective in men with very large prostates.
The two major 5-alpha reductase inhibitors recommended for BPH are:

  • Dutasteride (Avodart)
  • Finasteride (Proscar, Propecia)

Apart from shrinking or stopping the growth of the prostate and relieving BPH symptoms, the 5-ARIs have two other benefits:

  1. They reduce the chances that BPH will result in other complications, like bladder damage.
  2. They eliminate the need for surgery as treatment for BPH.

The full effects of 5-alpha reductase inhibitors may take up to 6 months to be realized. So you must continue taking the medicines for as long as necessary.

Side effects of 5-ARIs

5-alpha reductase inhibitors are not supposed to be used by women. In fact, pregnant women must never be exposed to the drugs as they can cause birth defects in male fetus. Other side effects of 5-ARIs include:

  • (a) Lower sex drive/libido
  • (b) Erectile dysfunction
  • (c) Retrograde ejaculation

Some of these side effects may improve as the body gets used to the drug.
The 5-ARI drugs also may reduce the levels of prostate-specific antigen (PSA) in the blood. PSA levels are used to screen for prostate cancer, so a drug-induced drop makes it impossible to use the PSA test. It is advisable to have the PSA test done before you start these drugs. The FDA now requires that the labels on 5-ARIs must include a warning that they may increase the risk of having aggressive (high-grade) prostate cancer.

3. Phosphodiesterase-5 inhibitors

In some cases of BPH, the urologist may recommend the use of phosphodiesterase-5 inhibitors, which are drugs that smooth the muscles of the prostate and bladder and help to relieve BPH symptoms. While there are many types of phosphodiesterase-5 inhibitors, only tadalafil (Cialis) has been approved by the FDA for treatment of BPH. Tadalafil is not prescribed as often as other drugs, but when doctors are dealing with cases in which BPH and ED occur together, then it is often a viable option.
The side effects of Tadalafil include:

  • (a) Headaches
  • (b) Muscle and back pain
  • (c) Stomach upset (after eating)
  • (d) A stuffy nose
  • (e) Vision problems
  • (f) Redness, warmth or burning on the neck, face and upper body

4. Combination therapy

When a doctor realizes that a single medication may not effectively relieve BPH symptoms, a combination of two or more drugs may be considered. The most common drug combinations for treating BPH include:

  • (a) Tamsulosin and Dutasteride, comes in one pill called Jalyn
  • (b) Doxazosin and Finasteride
  • (c) Alpha blocker and an antimuscarinic (a drug for treating overactive bladder)

Drug combinations are generally more effective than single drug treatments. However, the combinations also come with greater side effects than those of single drugs.

Are you or your loved one suffering from the symptoms of BPH? Would you like to receive accurate information and effective treatment for an enlarged prostate? Or do you want someone to to talk to about any other urological problem that you may have? If so, then St Pete Urology is the right place for you. For more information on the diagnosis, treatment and care for BPH, visit the “St Pete Urology site.

What is The Prostate and Prostate Enlargement?

The prostate gland (commonly called prostate) is a small, chestnut-sized organ in men located beneath the bladder and in front of the rectum (back passage). The urethra, the tube that passes urine from the bladder to the penis, runs through the prostate. By producing a fluid called prostatic fluid that makes up around 15-30 percent of the total volume of semen, the prostate plays a significant role in the function and viability of sperm cells and is critical for a man’s fertility.

Prostatic fluid contains citric acid, zinc, spermine and prostate-specific antigen (PSA), which protect and enrich sperm and reduces acidity of the vaginal canal. Muscles of the prostate usually press into the urethra during ejaculation, helping sperm to move through the urethra.

What is prostate enlargement?

While the prostate is usually a small gland, it typically grows bigger with age. In fact, from birth to early 20s, the prostate grows by around 8 times its initial size. Then from around the age of 25 to early 50s the prostate doubles in size and continues to grow gradually. It is this second phase of growth of the gland which, in later years, results in a non-cancerous condition called benign prostatic enlargement (BPE) or benign prostatic hyperplasia (BPH).

As the prostate grows larger, it causes the muscles at the base of the bladder to become thicker and pressures the urethra to become narrower. By squeezing the urethra more tightly, the enlarged prostate makes it difficult to urinate. The bladder also may become more sensitive, causing a need to pass urine more frequently and suddenly. In some cases, prostate enlargement may cause a blockage that triggers repeated urinary tract infections, bladder or kidney damage, and acute urinary retention (sudden inability to pass urine).

How common is prostate enlargement?

Although prostate growth continues almost throughout a man’s life, the resulting enlargement does not usually cause serious problems until late in life. An enlarged prostate hardly causes symptoms before the age of 40, but some symptoms occur in half of men in their 60s and in up to 90 percent of men in their 70s and 80s. In the United States, as many as 14 million men experience lower urinary tract problems related to benign prostatic hyperplasia while at least 400,000 annual hospital stays involve a diagnosis of prostate enlargement.

You are more likely to have BPH if:

  • You are 40 or older.
  • You have a family history of BPH.
  • You lack physical exercise.
  • You have erectile dysfunction.
  • You have medical conditions like type-II diabetes, obesity, circulatory and heart disease.


Common symptoms of prostate enlargement include:

  • Urinating 8 or more times a day (urine frequency).
  • Inability to delay urination (urine urgency).
  • Trouble starting to urinate.
  • A weak or interrupted urine stream.
  • Inability to empty your bladder completely (urine retention).
  • Dribbling at the end of urination.
  • Accidental leakage of urine (urinary incontinence).
  • Pain during urination or after ejaculation.
  • Unusual color or smell of urine.
  • Blood in urine.

Most of these symptoms are not specific to benign prostatic enlargement and may be caused by bladder problems, prostatitis, urinary tract infections (UTIs), or a more serious problem such as prostate cancer. Therefore, men with such symptoms should seek immediate medical attention.

Diagnosis and treatment of prostate enlargement

When you visit a GP or a specialist such as urologist, various steps will be taken to determine the cause of your symptoms. The doctor will take your medical, personal and family history, ask questions about the symptoms and their effect on your life and conduct a physical examination to check the size, feel and shape of your prostate. The urologist also may request tests such as prostate-specific antigen (PSA) and ultrasound scan to rule out any serious complications.

There are many treatment options for BPH. For instance, the doctor may recommend lifestyle changes, bladder training exercises or medications (such as muscle relaxants and hormone blockers). The doctor also may perform surgery to correct the problem.

At St. Pete Urology, we have a highly skilled team of urologists with a great deal of experience diagnosing and treating BPH and other urinary problems. We fix these issues quickly, safely and effectively, helping you to resume your normal life and activities. For more information on treatment of benign prostatic hyperplasia, visit the site, St Pete Urology.

When Should You Get A PSA Test?

When should you take the Prostate-Specific Antigen (PSA) test? The question of screening is typically a personal and complex issue that requires a consultation with a urologist. Currently, the medical community does not share a unanimous opinion regarding the benefits of prostate cancer screening.

Most physician-led groups, like the American Urological Association and the American Society of Clinical Oncology, insist that PSA screening ought to be considered within the context of a man’s life expectancy and level of risk given other prior or existing medical conditions. Other groups have advised that PSA screening for healthy men under 40 comes with a risk of harm that may outweigh the benefits depending on the patient’s medical history.

When should you start screening?

The decision on when to start screening should depend on your overall health, level of risk, life expectancy, and desire for treatment should you be diagnosed with prostate cancer. While the time to start screening depends on individual factors, the age of 40 years is a reasonable time to begin, particularly for those with genetic predispositions or a family history of cancer. Likewise, for healthy men at high risk, such as African American men with a family history of prostate cancer, starting at age 40 is advisable.

For men at average risk, a urologist may recommend the initial DRE or PSA test at age 40 or 45, while some urologists may recommend starting at age 50. In general, most men have discussed PSA testing with their doctor by the time they reach age 50. This means that men above 40 years should consider discussing PSA screening with their urologist to determine if and when the test is right for them. All men should develop a proactive prostate health plan based on their family history and lifestyle.

When should you visit a urologist?

The above recommendations are specific to prostate cancer screening for healthy men showing no symptoms. If you are diagnosed with prostate cancer and a confirmation is made using a biopsy, your urologist may recommend routine PSA testing for risk assessment and post-treatment monitoring.

The right time to start PSA screening is an individual decision that depends on your risk level and family history. Visit your urologist to discuss the timing of this important medical test for men. For more information on the screening and treatment of prostate cancer, visit St Pete Urology in St Petersburg, Florida.

Promising New Procedure for Men With Enlarged Prostates

A minimally invasive procedure designed to shrink prostate tissue with a series of nine-second blasts of steam offers men a new treatment for urinary symptoms commonly associated with enlarged prostates.

The procedure, called Rezūm (pronounced “resume”) and developed by NxThera Inc. of Maple Grove, Minn., became widely available in the U.S. in the second half of 2016. Thermal energy in the form of steam is applied to the prostate with a needle. As it cools it releases heat energy into the tissue, killing cells and shrinking the prostate overall by about a third, says Bob Paulson, NxThera’s chief executive.

Some 50% of men over the age of 50 have enlarged prostates, which can produce symptoms such as increased urgency to urinate during the day and frequent urination, which disrupts sleep at night. Sufferers often must choose between surgery or medication, both of which have side effects, including sexual dysfunction.

The NxThera therapy is the second major innovation in recent years for men with enlarged prostates. The other, an implanted device called UroLift, was introduced in the U.S. in 2013 by NeoTract Inc. of Pleasanton, Calif.

After years of little improvement in the minimally invasive treatment of enlarged prostates, men now have two new options “that leave your sexual function intact,” says Claus G. Roehrborn, a professor and chairman of the department of urology at the University of Texas Southwestern Medical Center in Dallas and a co-author of published studies on both treatments.

Middle ground

Physicians say Rezūm can be used on a wider range of prostate anatomies than the UroLift implant. The procedure, which costs about $2,000 and generally is covered by insurance, can be done in a doctor’s office in just a few minutes. To dull pain, lidocaine may be injected into the prostate, and most doctors will offer a sedative for patients who want one. After the procedure, most patients need to wear a catheter for two or three days but can return to daily activities immediately.

While the results of a two-year clinical trial published by Dr. Roehrborn and colleagues show that Rezūm provides significant relief from symptoms, it isn’t clear how long the improvement will last.

“The durability issue is what’s going to sink or swim this procedure,” says study co-author Kevin T. McVary, chairman and professor of urology at Southern Illinois University School of Medicine, in Springfield, Ill. Both minimally invasive options are likely less effective than surgery, Dr. Roehrborn says, because surgery removes the most tissue.

Still, for many men, the steam treatment offers an appealing middle ground between the risk of surgery and the hassle and side effects of taking daily medication, which can cause dizziness and fatigue.

“I tried Flomax for about two years but the side effects were too annoying,” says Stephen Gooding, a 60-year-old utility supervisor from Grayson, Ga., who says the drug made him dizzy and constipated. He had the Rezūm procedure in October, and now “I feel like I did 30 years ago.”

In the two-year study of 197 men, funded by NxThera and published online in the Journal of Urology in December, patients who had the Rezūm procedure showed a significantly greater improvement in symptoms at three months compared with patients who had a sham procedure. At the end of two years, patients treated with Rezūm showed a 51% reduction in urinary symptoms (as measured by a seven-question survey), compared with the beginning of the study.

Over the two years, about 4% of the patients who underwent Rezūm had to have a repeat procedure or surgery to treat their condition. Early in the trial, physicians were new at performing the procedure and didn’t always remove enough tissue, says Cindy Ogden, vice president, clinical affairs at NxThera.

So far, Rezūm appears to spare men sexual side effects. In the surgical procedure known as transurethral resection, 70% to 80% of men generally get a condition called retrograde ejaculation, also called dry orgasm, says Dr. McVary.

In the Rezūm study, about 3% of the patients who underwent the procedure experienced no ejaculatory volume afterward, and 5.3% experienced a decrease in ejaculatory volume, according to data provided by NxThera. Ejaculatory volume can fluctuate over time in men with enlarged prostates, so it isn’t clear the reductions were caused by the procedure, Dr. McVary says. Overall in the study, there was no average change in ejaculatory volume, he adds.

Larger prostates

A major advantage of Rezūm is that it can be done on most types of anatomies. UroLift isn’t approved by the Food and Drug Administration to treat the median, or middle lobe of the prostate, which contributes to symptoms in about 10% to 30% of patients, Dr. Roehrborn says.

The FDA hasn’t cleared Rezūm or UroLift for prostates weighing more than 80 grams. So NxThera can’t market its procedure for larger prostates, though doctors can legally use it on such patients if they choose.

Early results in clinical practice on large prostates appear “promising” and a study on prostates up to 150 grams is expected to begin later this year, says Ricardo Gonzalez, a urologist at Texas Medical Center in Houston, who will be a principal investigator on the research. About a quarter of men seeking treatment for prostate-related urinary symptoms have prostates greater than 80 grams, he says.

Business executive Jim Bracke, 69, says that, with just a Tylenol and the lidocaine shot, discomfort from Rezūm’s steam blasts felt no more intense than “warm water spilled on the groin.” He drove himself home after the procedure, and says he’s thrilled that he no longer needs to check out a bathroom the moment he arrives at a restaurant. And as long as he doesn’t overdo it, he adds, “I can have beer, and coffee and chocolate and still sleep through the night.”

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Should You Take Medicine for Treating Enlarged Prostate?

As a man ages, his prostate may become larger, a disorder known as Benign Prostatic Hypertrophy (BPH). While an enlarged prostate is neither a serious nor a life-threatening condition, it can cause urinating problems in men aged 50 years and older. Men with urinary problems should immediately see their doctor for a prompt and accurate diagnosis because symptoms of BPH are similar to those of prostate cancer. A patient should also see a doctor immediately when experiencing fever, chills, back pain, side pain, abdominal pain, bloody or cloudy urine, or pain when urinating.

Treatment of Enlarged Prostate

After a diagnosis of prostate enlargement, the urologist evaluates the severity of symptoms before recommending treatment. You are expected to participate in the decision making process to ensure you get the best treatment possible. Generally, no medications are prescribed for enlarged prostate unless the symptoms are severe, bothersome or accompanied by problems such as bladder stones or bladder infection. In fact, around 4 out of 10 men usually have no symptoms or have their symptoms improve without medications or surgery and only require lifestyle changes to manage BPH. Conversely, 1 in 4 men in their late 50s, 1 in 3 men in their late 60s, and 1 in 2 men in their late 70s and beyond can expect to have bothersome symptoms that require medications or even surgery.

Watchful Waiting

Should you take medications for treating enlarged prostate? After the diagnosis of BPH, you will have to choose either watchful waiting or medicine as your primary treatment, though surgery is sometimes necessary for serious symptoms. The best treatment option for men with minimal and less bothersome symptoms is watchful waiting. It involves combining lifestyle measures that prevent or relieve symptoms of BPH with visits to the urologist at least once a year for physical examination, testing and symptom status review.

Men managing BPH through watchful waiting must limit the amount of fluid they consume at any given time, avoid drinking fluids after 7 p.m., avoid beverages containing caffeine, avoid delaying urination, cut back on salty or spicy foods, limit alcohol intake, engage in regular physical activity and Kegel exercises, avoid cold weather and keep themselves warm, control their weight, control their blood sugar level, eat diets rich in vegetables, and avoid over-the-counter antihistamines (decongestants).

You should opt for watchful waiting if:

  • (a) You experience mild and less bothersome BPH symptoms.
  • (b) The side effects of the medicine may bother you more than the mild symptoms of BPH.
  • (c) You can attend regular medical checkups (at least once a year).
  • (d) You can effectively use special bathroom techniques, cut back on your fluid intake and change your lifestyle.

Medicines

If your symptoms are severe or worsen during watchful waiting, you should consider taking BPH medications. The three types of drugs commonly used for treating enlarged prostate are alpha-blockers, 5-alpha reductase inhibitors and phosphodiesterase-5 inhibitors. Alpha-blockers are fast-acting drugs that relax prostate muscles and relieve urination problems within a few days or weeks. They include terazosin (Hytrin), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), Alfuzosin (UroXatral) and tamsulosin (Flomax). Drugs called 5-alpha reductase inhibitors such as dutasteride (Avodart) and finasteride (Proscar) cause shrinkage of the prostate and improve symptoms, albeit after several months. Phosphodiesterase-5 inhibitor called tadalafil (Cialis for daily use) has also been approved for use in treating BPH.

When using a prescription for managing enlarged prostate, you will take the pills every day for life, have regular medical checkups, and use special bathroom techniques such as relaxation and double voiding. The medicines will reduce the risk of urinary retention, relieve symptoms and minimize risks of future surgery. However, prescriptions are often expensive and come with certain side effects such as trouble getting an erection, diminished sex drive, tiredness, dizziness, and stuffy nose.

Conclusion

When you have problems urinating, you should immediately see a doctor as you may have an enlarged prostate. At the urology clinic, the doctor will perform a physical exam and run a few tests to find out if you have BPH. If BPH is confirmed, the urologist will explain to you the treatment options available, such as watchful waiting, medications and or surgery for serious cases. The treatment option chosen will depend on the severity of symptoms and your desire to improve the quality of your life. You should consider watchful waiting if you have mild symptoms and want to avoid the adverse effects of drugs. However, in case of severe BPH symptoms, you should take medications to relieve symptoms and possibly prevent the need for surgery in the future. For more information on treating an enlarged prostate, visit St Pete Urology in St Petersburg, Florida.

Green Light Laser Surgery For Prostate Enlargement

This is a minimally invasive surgical procedure that uses green light laser energy to treat an enlarged prostate gland. Unlike traditional surgical procedures, this new mode of treatment uses specific rays that, once directed to the prostate gland, evaporate the enlargement. An enlarged prostate is likely to cause urine problems so your urologist may recommend this procedure as a solution to urinary symptoms. The green light surgical procedure heals faster and has fewer complication. For these reasons, it is becoming a preferred method of treating an enlarged prostate in cases where medication is not working. […read more]

Enlarged Prostate – The Apple Analogy Explained

As the Prostate Gland increases in size, it puts pressure to the neighboring organs specially the urethra, resulting into the constriction of the urethra passage. [Read Full Article…]

What is Prostate Enlargement?

Prostate Enlargement or Benign Prostatic Hyperplasia is a common condition that affects men ages 60 and above. As men grow older the prostate gets larger thus constricting Urethra limiting the urine passage. For more info on Prostate Enlargement call us at (727) 822-9208 or visit our urologist at St Petersburg, FL.