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 Annual 2008

Annual 2008


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For Men Only

Dealing With BPH

    The acronym BPH stands for Benign Prostatic Hyperplasia (or Hypertrophy), which translates into an enlarged prostate that restricts the flow of urine from the bladder.
    Although it is noncancerous, the effects of BPH can be extremely uncomfortable and, left untreated long-term, can lead to life-threatening physical reactions. According to the American Urological Association, half of all men in their 50s and 80 percent in their 80s experience some symptoms of BPH.
    “It’s called ‘benign,’ but it’s not benevolent,” says Dr. Kenneth E. Roth, who specializes in adult male and female urology at the Northern Californian Urology Medical Clinic, based in Pleasanton.
    The prostate, which functions as part of the male reproductive system, is a walnut-sized, O-shaped gland that is located just below the bladder, where urine is stored. The prostate also surrounds the urethra, the canal through which urine passes out of the body.
    Roth explains that there are two periods of time in a man’s life when the prostate grows—puberty and around age 30. It is unclear why there is a second growth or why there is such an enlargement that causes problems. It’s some time following this second growth phase that the growth causes the prostate to push on the urethra, and as it grows, it squeezes, creating tremendous pressure on the bladder, and complications ensue. It’s often difficult for men to talk about the situation, given the personal nature of the functioning of the prostate and the symptoms of BPH, which include: a frequent need to urinate; a sudden need to urinate; interrupted sleep because of a need to urinate; a weak, variable or dribbling stream; a need to strain or push the bladder to urinate; difficulty beginning urination; pain or burning during urination; the sensation that the bladder is not completely empty after urination.
    Roth says many men try to live with the conditions of BPH, but notes there are several courses of treatment and therapy that can ease the discomfort and eliminate the symptoms.

    One solution is traditional surgery, using anesthesia and making an incision, called an open prostatectomy. The surgeon cuts open the bladder and scoops out the built-up cells (prostatic adenoma) in order to free the blockage.
    Another type of surgery, called transurethral surgery, requires no external incision, making it less traumatic and requiring a shorter recovery period. After giving anesthesia, the surgeon reaches the prostate by inserting a probing instrument through the urethra. The most common of these procedures is called transurethral resection of the prostate, or TURP, and is used for 90 percent of all prostate surgeries done for BPH. Another surgical procedure is called transurethral incision of the prostate, or TUIP. Instead of removing tissue, as with TURP, this procedure widens the urethra by making tiny incisions in the bladder neck and in the prostate gland itself.
    In addition to these more familiar surgeries, there are a number of newer, FDA-approved laser surgeries available to treat BPH. Some require anesthesia and a hospital stay but offer such benefits as little blood loss and a quicker recovery time. There are newer outpatient laser treatments, called interstitial laser coagulation surgery, ILC, available, as well.

Minimally Invasive Treatment
    Many treatments for BPH are considered minimally invasive. Transurethral microwave thermotherapy, or TUMT, uses microwaves to heat and destroy excess prostate tissue. Radio frequency thermotherapy, called transurethral needle ablation, TUNA, is performed by placing interstitial radiofrequency needles through the urethra and into the lateral lobes of the prostate, causing heat-induced coagulation necrosis. In other words, the procedure uses low-level radio waves to heat and eliminate the tissue.

Drug Therapy
    Over the years, urology researchers have worked to find a way to shrink or at least stop the growth of the prostate without using surgery. The FDA has approved a number of drugs to relieve common symptoms associated with BPH. When it comes to any of the solutions, patients should consult a doctor to determine the most appropriate treatment.

Closer to Home

The Prostate Awareness Foundation, www.prostateawarenessfoundation.org, (415) 675-5661

Kaiser Permanente interactive BPH diagnosis tool: http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=tf6834

Prostate Institute of America, www.pioa.org, (888) 234-0004

General Resources

Dr. Peter Scardino’s Prostate Book: The Complete Guide to Overcoming Prostate Cancer, Prostatitis, and BPH by Dr. Peter Scardino and Judith Kelman

Health Agencies and Web Sites
American Urological Association, www.auanet.org, www.urologyhealth.org

American Foundation for Urologic Disease, www.auafoundation.org, (866) 746-4282

National Kidney and Urologic Diseases Information Clearinghouse, kidney.niddk.nih.gov

The Prostate Institute, www.prostateinstitute.org, (800) 782-9200

Related Resources
John Hopkins Health Reports: Guide to BPH, www.johnshopkinshealthalerts.com

Medtronic Inc., www.medtronic.com

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