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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7 Common Symptoms of Kidney Stone and Treatment Options

The symptoms of kidney stones are largely determined by the size of the stones. For small kidney stones, the symptoms may be mild. In fact, small stones may go undetected and pass out of the body painlessly during urination. The most common symptom of kidney stones is pain which begins as a vague sensation then becomes sharp and severe as ureter muscles contract and relax around the stones. Initially, the pain is felt on the flanks or on the sides of the body, between the pelvis and ribs, including the lower back and upper abdomen. Later it moves to the groin or testicles as the kidney stone moves through the urinary tract.

Generally, the symptoms of kidney stones follow the migration of the stone across the urinary tract. The symptoms will depend on whether the stone gets stuck in the kidney, begins to travel down the ureter, or causes an infection.

Therefore, depending on the size of the stone, symptoms may include:

  • Sharp, persistent and severe ache in the side and back, often below the ribs
  • Pain which spreads to the groin and lower abdomen
  • Pain occurring in waves and with fluctuating intensity
  • Pain when passing urine
  • Restlessness and inability to lie still
  • Nausea and vomiting
  • Red, pink or brown urine
  • Foul smelling or cloudy urine
  • Urge to pass urine more often than usual
  • Urinating small quantities of urine
  • Chills and fevers if there is an infection

Blood in urine, often caused by the stone scratching the ureter or kidney
A kidney stone may cause an infection when it has blocked the ureter, preventing waste products from passing the blockage and resulting in bacterial build-up. It is the infection that causes symptoms such as fever, chills and shivering, diarrhea, foul smelling and cloudy urine, and fatigue.

Symptoms of Kidney Stone and Treatment OptionsIf you have these symptoms, it is important to see a physician, preferably a urologist. The doctor will perform a medical and symptomatic history, give a physical exam and order the necessary tests to confirm the presence of kidney stones and determine their size, location and appropriate treatment. The tests may include blood tests (like uric acid, calcium and phosphorous), tests for stone-forming salt crystals, infections, blood cells and stone factors, kidney function tests, and imaging tests (kidney ultrasounds, CT scans, MRI scans, abdominal X-rays and intravenous pyelograms). The urologist will recommend appropriate treatment after confirming the presence of stones.

If small, less-troublesome stones are detected, the urologist may recommend drinking 8-16 cups of water to flush them out. Along with the recommendation to drink plenty of fluid, the urologist may prescribe pain relievers such as ibuprofen, naproxen sodium or acetaminophen. In some cases, the urologist may offer a medication to help pass small stones from the kidney. The medication, called an alpha blocker, helps to relax ureter muscles and allows the stones to move quickly and painlessly out of the urinary tract.

Large stones are accompanied by various symptoms and should be treated using stronger measures. The urologist may use sound waves to break up the stones, a procedure called extracorporeal shock wave lithotripsy (ESWL). In some cases, the urologist will use a scope (a thin lighted tube equipped with a camera) to remove the stones. The urologist may also opt for percutaneous nephrolithotomy to surgically remove large stones, or even parathyroid gland surgery when necessary.

At St Pete Urology, we have experienced urologists and state-of-the-art facilities to ensure prompt diagnosis and effective treatment of kidney stones. If you have questions about this condition, visit St Pete Urology in St Petersburg for quality medical care.

What happens during a vasectomy procedure and how does it work?

Vasectomy is considered a permanent birth control method because it prevents the release of sperm during ejaculation. During a vasectomy, the tube (vas deferens) from each testicle is carefully clamped, sealed or cut to prevent the mixing of sperm with ejaculated semen. The testicles will continue to produce sperm but the female egg cannot be fertilized without sperm in the semen. Since the tubes are sealed off before the seminal vesicles and prostate, a man will still ejaculate the same amount of fluid.

So what happens during a vasectomy?

  • (a) The testicles and scrotum are first cleaned with antiseptic and may be shaved.
  • (b) You may be given an intravenous (IV) or oral medicine to minimize anxiety and make you sleepy. If given the medicine, you may not remember much of what happens during the procedure.
  • (c) The urologist will locate each vas deferens by touch and then inject a local anesthetic into the area.
  • (d) The doctor will make 1 or 2 small openings on the scrotum. Then through an opening, the 2 vas deferens tubes are cut, tied and stitched, or sealed. Scar tissue from the operation will help block the tubes.
  • (e) The urologist will then replace the vas deferens inside the scrotum and close the skin with stitches that dissolve on their own. A vasectomy procedure takes 10-30 minutes and can be done in a clinic or office of a urologist, general surgeon or family medicine doctor.

How does vasectomy work?

The scrotum will be numb for 1 to 2 hours after the surgery. You are expected to apply cold packs to the area and get as much rest as possible while lying on your back. Wearing a jockstrap or snug underwear will protect the area and ease the discomfort. You may experience minor pain and swelling for a few days, but rarely anything more serious. After two days you can resume light work, but must wait for at least a week for heavy lifting and strenuous work.

While you can resume sexual intercourse as soon as you feel comfortable, waiting for a week is advisable. Remember, your sperm count will not be zero and you can still get your partner pregnant, so use an alternative birth control method such as condoms until follow-up sperm count tests show no sperm in the semen, usually two months after the procedure.

Vasectomies are 99.85% effective, with only 1 or 2 women in 1000 getting pregnant after their partners have undergone the procedure. It will not interfere with your sex drive, sensation of orgasm, ability to ejaculate or ability to have erections. However, it is a permanent birth control method that must only be considered by those who do not want to have children in the future. For more information on vasectomies, visit St Pete Urology in St Petersburg, Florida.

Women’s Health: Do Women See A Urologist?

It is a common mistake to believe that only men see urologists. In fact, women are more likely than men to have a urinary problem at some stage of life. When it comes to a condition affecting the urinary tract, bladder or kidneys, a urologist is the expert who can offer the best treatment. Urologists see women, men and children to treat common disorders of the urinary system.

Women’s Urological Conditions

(a) Overactive bladder: A woman with an overactive bladder experiences a sudden, frequent or hard-to-control urge to urinate, wakes up more than once at night to urinate, or urinates eight or more times in 24 hours. A urologist will perform various tests to diagnose the disorder and then recommend treatment according to the cause.

(b) Urinary incontinence: Characterized by a loss of bladder control that often results in accidental leakage of urine, urinary incontinence affects up to 57% of women between 40-60 years and requires the attention of a urologist.

(c) Urinary tract infections (UTIs): Urinary tract infections can cause serious complications if they spread to the kidney. They require prompt and effective treatment. Since women are more susceptible than men to UTIs because of their anatomy, they should see a urologist if they have frequent or persistent infections.

(d) Fallen bladder: Because the bladder is held in position by the pelvic floor, it may drop onto the vagina when the pelvic floor is weakened or stretched due to obesity, menopause, aging or prior pelvic surgery. A woman should see a urologist with experience in female urology to correct a fallen bladder.

(e) Painful bladder syndrome (interstitial cystitis): Interstitial cystitis (IC) comes with lower belly and bladder discomfort, a feeling that the bladder is always full, and a sudden and severe urge to urinate (even up to 60 times per day), which can interfere with everyday activities. Some women have been forced to skip social events or avoid travelling away from home, while some find sex uncomfortable or painful due to the condition. Women who have the disorder need to see a urologist.

(f) Urinary stones: Urinary stones are hard masses that form in the kidneys, bladder or ureters. While drinking 2-4 quarts of water in 24 hours may help to move a urinary stone, a urologist can break them apart with ultrasound-based treatment or remove them surgically.

(g) Cancer: Women can have cancer in the bladder, bladder lining, kidneys or urethra. The cancer may show signs such as pain during urination, lower back pain, blood in urine and frequent visits to the bathroom. Seeing a urologist may help to detect and treat the cancer early.

Ideally, women should see a urologist when experiencing:

  • Pelvic pain
  • Burning sensation or discomfort when urinating.
  • Frequent urination
  • Blood in urine
  • Pain in the back or sides
  • Leaking urine

At St Pete Urology, we have specialized urology services that cater to the unique needs of women. We deal with many urological conditions affecting women, including incontinence, pelvic organ prolapse, bladder infection, overactive bladder, kidney stones and cancer. Male or female, feel free to contact St Pete Urology when you have a urine or bladder issue.

3 Main Causes of Erectile Dysfunction and Treatment Options

Erectile dysfunction (ED) occurs when a man is incapable of having an erection firm enough for sexual intercourse. While occasional inability to have an erection is considered normal, frequent or prolonged difficulty to get or keep an erection, along with reduced sexual desire, is classified as erectile dysfunction. The condition often leads to an unsatisfactory sex life and may result in other problems such as low self-esteem, embarrassment, anxiety, depression and relationship problems.

Causes of Erectile Dysfunction

Erectile dysfunction is caused by physiological (physical) factors, psychological (mental) factors, or a combination of both. Generally, psychological problems are more likely to cause ED in younger men while physical problems are often the cause in older men.

The major psychological causes of ED are:

1. Depression

2. Stress at work or home

3. Worries about sexual performance with a new sexual partner or new situation

4. Unresolved relationship conflicts

5. Fatigue

6. Temporary issues such as loss of a job, studying for exams or financial concerns

7. Deep-rooted negative attitudes about sex, intimacy, or strict religious beliefs

8. History of sexual abuse

For a man to have a normal functioning erection, it helps to have self-confidence and arousing behavior or thoughts while being free of anxiety. If at least one of these conditions is chronically absent, a man’s inability to perform sexually can become a lasting issue.

The major physiological causes of ED are:

1. Diseases such as diabetes, liver disease, kidney disease, multiple sclerosis, high blood pressure, atherosclerosis, chronic alcoholism, neurological disease, and vascular disease.

2. Drugs for treating hypertension (high blood pressure), depression, anxiety and psychosis, and regular consumption of alcohol, marijuana, cigarettes and other recreational drugs.

3. Injuries such as spinal cord injury and nervous system injury (like pinched nerves due to slipped vertebral discs).

4. Atherosclerosis (hardening of arteries due to a buildup of fat/cholesterol deposits inside arterial walls).

5. Hormonal imbalances such as low testosterone levels or due to diseases of the pituitary, adrenal or thyroid gland.

6. Cigarette smoking.

The main risk factors for erectile dysfunction are:

1. Age over 50

2. Lack of exercise

3. Diabetes (high blood sugar)

4. High cholesterol

5. High blood pressure

6. Smoking

7. Obesity

8. Cardiovascular disease

9. Drug and alcohol abuse

10. Cancer radiation therapy

11. Prostate surgery

12. Medicines such as antihistamines, antidepressants and blood pressure drugs.

Men spending a lot of time bicycling are also at risk of ED because bicycle seats can damage the nerves and blood vessels involved in erections.

Treatments for Erectile Dysfunction

The treatment for erectile dysfunction depends on the cause. Often, the urologist will suggest a change of certain habits or recommend that you stop smoking, using drugs or stop alcohol use. The urologist may also recommend treatments for emotional problems, depression, performance anxiety or relationship conflicts.

The most common treatments for ED are:

1. Oral medications (erection pills) such as Cialis (tadalafil), Levitra (vardenafil), Stendra (avanafil) and Viagra (sildenafil).

2. Counseling and psychotherapy if your ED is related to psychological problems.

3. Injection of drugs in the penis: If oral medications fail, the urologist may recommend the injection of Caverject (alprostadil) in the penis. Suppositories of the same drug may also be placed in the urethra as an alternative to injection.

4. Vacuum erection devices: These devices create a low-pressure vacuum around erectile tissue, resulting in erection.

5. Testosterone replacement therapy may be recommended for a man with below-normal testosterone hormone.

6. Surgery: Surgery is usually recommended by a urologist when other treatments fail to improve the ED. The operation is performed to either fix blood vessel issues or for penile implants (like inserting penile prostheses, bendable implants or inflatable implants).

7. Penile arterial revascularization: A surgery for men under 45 years of age who have pelvic or penile injuries, helping to fix blocked or injured blood vessels in the penis.

8. Venous ligation surgery: Aimed at improving the firmness of the penis, this surgery corrects leaky penile vessels that cause softening of the penis during an erection. This technique is rarely used for correcting ED due to its low success rate of around 5%.

Are you having difficulties with sexual performance? Talking with an experienced urologist at St Pete Urology might help you solve the problem. For more information on dealing with erectile dysfunction, visit the website of St Pete Urology in St Petersburg, Florida.

Debunking 4 Myths about Urinary Incontinence

Urinary incontinence is an embarrassing condition affecting more than 200 million people globally. Characterized by bladder leakage, painful urination, strong urge to urinate and incomplete emptying of the bladder, the condition can negatively impact the quality of life of affected individuals by restricting their ability to participate in various activities. Riddled with several misconceptions and accompanied by considerable stigma, bladder leakage is a highly misunderstood condition that even those affected do not want to talk about. Yet by debunking some of the myths associated with the condition and establishing a clearer understanding of the problem, affected individuals can get on the right track for healthy and happy bladder management. Here are four of the more common myths about urinary incontinence:

Myth 1: Only the elderly experience urinary incontinence.

Even though the risk of urinary incontinence increases with age, virtually any person can experience incontinence at any stage of life. For instance, bladder weakness typically affects 1 in every 3 women above the age of 18 with many young women experiencing sensitive bladder symptoms after pregnancy and labor. Urinary incontinence can also result from an enlarged prostate, nerve damage, weakened pelvic muscles, medical conditions such as obesity, onset of menopause in women due to a drop in estrogen levels, infection, and as a side effect of certain medications.

Myth 2: Reducing fluid intake reduces urinary incontinence.

Limiting fluid intake may sound like a brilliant idea since drinking plenty of water increases the frequency and urgency of urination. However, it has been shown that drinking adequate amounts of fluid in small doses throughout the day helps to prevent leakage. In fact, severe limitation of fluid intake can make urine more concentrated, increasing the risk of bladder irritation and worsening urinary incontinence. Drinking enough water also helps to reduce odors. Doctors recommend that you sip water between meals, avoid fluids for two hours before bed, and reduce or avoid citrus juices, caffeine, carbonated beverages and alcohol.

Myth 3: Surgery is a necessary treatment for urinary incontinence.

While surgery is one effective treatment for incontinence, it comes with more risks than other treatment options. For instance, invasive surgical procedures such as sling surgery and retropubic suspension have associated risks such as difficulty urinating and worsened incontinence. Therefore, affected individuals should always be offered the option of trying nonsurgical treatment first and only opt for surgery when nonsurgical options fail. In fact, for most people, simple lifestyle changes, medications for relaxing the bladder and treating urinary infections, medical devices like pessaries, weight loss, dietary changes, and pelvic floor muscle exercises provide considerable improvement in symptoms. Surgery should only be considered as a last resort.

Myth 4: Delaying urination strengthens the pelvic floor.

While many think that delaying going to the bathroom can help to strengthen the pelvic floor, the truth is that this can overstretch the bladder, resulting in a flaccid and dysfunctional bladder. Therefore, for a person living with urinary incontinence, it is important to avoid actions that may weaken your bladder and instead seek immediate medical treatment. Remember, urinary incontinence may be a symptom of an underlying medical condition that requires a prompt visit to a urologist. So stop living quietly with urinary incontinence and thinking that you can crudely wish it away. Talk to your doctor about what could be causing the problem and what might be the best individual treatment option for you. For more information on managing urinary incontinence, visit the St Pete Urology website or make an appointment for a consultation with a urologist.

Technological Innovations in Urology

Technological innovations in urology have resulted in far-reaching improvements in patient care. At St Pete Urology, the implementation of new technologies and innovations has improved diagnostic accuracy, enhanced the safety and quality of treatments, and streamlined patient information systems. For example, the use of advanced imaging technologies has enabled urologists to visualize and diagnose different conditions more precisely while minimally invasive surgery results in significantly reduced pain and quicker recovery and convalescence.

Laparoscopic Surgery

Our urology specialists use laparoscopic surgery when applying miniature instruments inserted using a small tube (known as a laparoscope) through small incisions in the patient’s body. We use novel biological sensors, techniques and instruments to ensure less pain, faster recovery and better outcomes for urologic problems. For example, we offer minimally invasive laparoscopic surgery for kidney stones, pelvic organ prolapse, live donor nephrectomy, uretal stricture, uretopelvic junction obstruction, renal cysts, renal cell carcinoma, prostate cancer and more. Our urologists in St Petersburg have also refined laparoscopic surgery for use in children to remove dysfunctional or malformed kidneys, correct blocked ureters and treat undescended testicles.

Robotic Surgery

At St Pete Urology, every urologist is trained in the use of robotic surgery to perform operations with more precision. Robot-assisted surgery is a minimally-invasive operation similar to laparoscopy (performed through smaller incisions than open surgery), but in which small surgical tools are mounted on a robotic arm controlled by the surgeon using a computer. The urologist makes tiny incisions for inserting the instruments into the body then uses an endoscope to view enlarged 3-D images of the affected area during the operation. Our urology clinic boasts of the da Vinci machine, the world’s most advanced surgical robot, enabling our specialists to conduct operations with better vision, precision and control.

External Beam Radiation Therapy (EBRT)

Also called Image Guided Radiation Therapy (IGRT), this form of treatment has been implemented at St Pete Urology with great success for prostate patients. Our state-of-the-art imaging enables urologists to direct radiation with more precision to the area of the prostate that requires treatment. With better preparation and planning, this technology ensures more accuracy and allows the urologist to target the same area of the prostate for all additional treatments. In fact, EBRT ensures less radiation and pinpoint accuracy for better outcomes and reduced side effects associated with radiotherapy.

Cryosurgery and Cryosurgical Ablation

We have implemented new cryosurgical technologies for treating prostate cancer, making it easier for our urologists to map cancerous cells more precisely, and freezing and killing cells not reachable by means of radical prostatectomy surgery. Similarly, we use cryosurgical ablation to destroy diseased tissues and eradicate prostate cancer in patients who decline radical surgery (involving prostate removal). Our cryosurgical procedures can be performed on an outpatient basis and without incisions, ensuring minimal blood loss or side effects.

Selecting the Best Technologies

In a world with seemingly endless urology innovations and technologies, we have carefully selected and implemented only those that are effective and appeal to both patients and doctors. This means that all technologies at St Pete Urology have a proven efficacy, cause the least discomfort to patients, and can easily be performed by every urologist. For more information on safer and effective use of the latest technological innovations in the treatment of urological conditions, make an appointment at St Pete Urology in St Petersburg, Florida.

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.

Urology Patient Testimonial

Dr. Graves is the kindest, most thoughtful, genuinely caring doctor I have ever encountered in my entire life; and my brother had cancer when we were three and mom had a triple by-pass at twelve. I grew up in hospitals, but I have not spent much time in them for myself since very recently. I would rather pass a stone at home-and have twice- than have the kidney stone blasted at the hospital because of the pain afterward from endometriosis. Dr Graves called me HIMSELF to check on me. Choose him. – Kendra Burke

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