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PROSTATE, BPH,KIDNEY FAILURE,PROSTATISM, UTI ……Read
all about it….! WELCOME TO DR MANI IYER'S PROSTATE KNOW- PAGE PROSTATE ENLARGEMENT IN MEN OVER 50 Know
Your Anatomy- follow the link to Prostate Prostate
is a chestnut shaped
gland, situated at the outlet of the bladder; during young age, it produces
secretions, which apparently contribute towards semen transport and
potentiation; beyond the 40's it starts enlarging slowly. At around mid 50's,
about 50 % men are suffering from prostate symptoms; in their mid 80's
almost 80% men suffer from some degree of Prostate symptoms. What are the
symptoms of Prostate Enlargement?
Increased Urinary frequency, burning sensation while peeing A DISTURBED PARTNER!! What if you
leave it alone?!! Infection of the bladder
Urine causing fever, back ache, severe BURNING What to do in case
of above symptoms?
Seek the attention of Your
family Physician/(who will guide you to a) UROLOGIST
The Specialist will perform a
detailed History taking, physical examination including your prostate and
advise a few investigations including blood and urine test (including a PSA which is
a specialised blood test to screen for prostate Cancer) At
the next visit a UROFLOW test
and an ULTRASOUND
scan will be requested. At the review he will put you through a detailed
symptom questionnaire, to assess the severity of your symptoms. On the basis
of all of the above you will be advised if you require treatment for the
Prostate and what mode of treatment if yes. (Follow above links to know about
the tests) WHAT
:TREATMENTS ARE AVAILABLE Some patients with very early
symptoms will require only ‘Wait & Watch’ MEDICAL: In some patients with early disease, in
absence of complications, the Urologist will prescribe one or two types of
medications. Most medications work in most patients but to different degrees.
Note: MEDICAL TREATMENT is usually LONG TERM and is not time limited!!!! Alpha
Blockers: These
are in fact Blood pressure lowering agents and MUST BE USED WITH CAUTION in
old and fragile patients and also in patients on BP medications. Your own
doctor must monitor BP before treatment can be undertaken. Dizziness,
blackouts, loss of energy, drive etc are not unusual. Finasteride
Group: (Proscar,
Fincar, Finast etc) these have no dangerous side effects except mild loss of
libido, mild breast pain/engorgement etc. Minimum 3 months required for onset
of action! Herbal/Alternative
#Remedies World
over there is a sudden uprising and a resurgence of herbal, ayurvedic and
homeopathic remedies. Few of these which have been scientifically researched
are good and free from side effects. BEFORE starting on any of these Alternative Medical treatments, it
is MANDATORY that you undergo conventional investigations to rule out
Prostate Cancer and any complications of Long Standing Prostatic Obstruction,
which CANNOT be cured by Alternative medical therapy Those of you who are not
suitable for or are beyond medical treatment will require: SURGICAL MANAGEMENT OF BPH 1. TUIP/BNI : Bladder neck incision is a endosurgical
procedure for small prostates and tight ‘bladder necks’ . Works wonders in
most cases but the same result might be possible by alpha-blockers (above) if
the patient can tolerate lifelong treatment without side effects. 2-3 days
hospital stay and a spinal or short
General Anaesthesia is required. 2. T.U.R.P: I am sure you must have heard this term time and again!!
It is an acronym for Trans Urethral Resection of Prostate. This is a more
major endosurgical procedure than above and is the most commonly performed
endourological treatment for BPH today. Involves scraping of the prostate
through the urinary passage and is
done under anaesthesia (spinal, epidural or General); involves 3-4 days stay
in the hospital and requires the patient to be somewhat fit to withstand
anaesthesia and fluid/blood loss, especially if the prostate is large. The Surgery in
stages. Also note that
after the TURP the semen will go back into the bladder and amount of
ejaculate will be nil or markedly reduced (dry ejaculate) LASER
ABLATION OF PROSTATE - Day case ablation in smaller glands, in selective
cases; requires anaesthesia; minimal or nil blood loss; ideal for medically
unfit patients who cannot withstand blood loss -Trans Urethral Needle Ablation (see Link) - Latest
in the rapidly advancing Hi-Tech minimally invasive treatment of
enlarged prostate - Case selection is important - Day care , may be done
under local or spinal anaesthesia. Boon for the young and active and
the not so young but young and willing - where it matters! For a better idea of the TUNA
Procedure go tunapic Patients
who have undergone TUNA leave the hospital the same day and are back on the
road next day. They could return to the Golf course!!! to complete the last
few holes which they had to leave to go for a leak- well now they can hold on
for longer and play on! As far as their sexual activity is concerned, they
happily get back to it within a week or so. There may be no long lasting
effect of the surgery on this very important faculty. FOR MORE DETAILS, WATCH THIS SPACE OR CONTACT THE AUTHOR!
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