Recent findings show that treatment with a specific alpha blocker helps reduce symptoms and improve quality of life for men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).  This alpha-blocker, called silodosin, works by selectively relaxing the muscles in the neck of the urinary bladder and prostate.  It has been approved in Canada, the United States, the EU and Japan to treat symptoms of another prostate gland condition, benign prostatic hyperplasia, which is commonly referred to as an enlarged prostate.

Although CP/CPPS is the most common form of prostatitis, it is the most misunderstood and difficult to treat because the symptoms are very similar to other conditions and requires a significant amount of testing and screening to identify.

Curtis Nickel, a professor in the Department of Urology, practicing urologist at Kingston General Hospital and Canada Research Chair in Urologic Pain and Inflammation, emphasized that antibiotics are commonly used as a treatment, but they are not typically effective.  This could be because CP/CPPS does not seem to be caused by a bacterial infection.

CP/CPPS is a debilitating condition; patients with this condition suffer from discomfort in the lower pelvic area including the bladder area, testicles, and penis.  Symptoms may be severe and can include painful and frequent urination and difficult or painful ejaculation.  The cause of CP/CPPS is not known.

In Dr. Nickel’s study, about 60 percent of men reported feeling better after treatment with silodosin as opposed to 30 percent of participants who were given a placebo.  These results for patients feeling better is higher than a similar study he conducted several years ago that tested the effects of a different alpha blocker.

Carlos Capitan, MD, and colleagues at the Hospital Universitario Fundacion Alcorcon, Universidad Rey Juan Carlos in Madrid have found that improvements in symptoms of benign prostatic hyperplasia are similar after treatment by transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP) by laser, and complication rates are the same.  Length of stay, however, is significantly shorter with laser treatment.  PVP results in a higher preservation of ejaculation than TURP.  The team published their findings in European Urology.

They used a randomized trial to determine the efficacy and safety of GreenLight HPS 120-W laser PVP compared with TURP in 100 patients with lower urinary tract symptoms due to BPH.

On average, hospital stay was 2 days shorter in the PVP group than in the TURP group.

At a two-year post-treatment follow-up, International Prostate Symptom Scores (IPSS) had dropped significantly and by almost the same degree in both groups, but improvements were seen more rapidly in the laser group.  Similar patterns were seen in changes of quality-of-life scores, which were nearly identical in both groups at two years.  The authors report that retrograde ejaculation was recognized in 65% of patients treated by TURP and in 34.7% of patients treated by PVP.

Complication rates were statistically equivalent in the two arms.  Three PVP patients were readmitted to the hospital, and two developed a urethral stricture.  In the TURP group, two patients were readmitted, six developed a urethral stricture, and two developed bladder neck sclerosis.

In summary, the team found that GreenLight HPS 120-W laser PVP is just as effective as TURP in symptom reduction, and the complication rate is about the same.

Are you a man age 50 or older?

Do you have to urinate frequently during the day and at night?

Do you have trouble urinating?

Are these and other urinary problems interfering with your life and your relationships?

If you answered “yes” to the above questions, you may be a candidate for the L.I.F.T. Study.

The L.I.F.T. Study is an FDA approved research study to evaluate the UroLift system to support a premarketing application to FDA. Its purpose is to determine the safety and effectiveness of the UroLift system for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). The study is being conducted at urology practices throughout the U.S., in Canada and in Australia.

BPH is a non cancerous condition that causes the prostate to enlarge as men age. When the enlarged prostate presses on the urethra, it can cause bothersome urinary symptoms. The UroLift System is a minimally invasive approach to treating BPH that lifts/holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. The goal of UroLift system treatment is to relieve symptoms so you can get back to your life and resume your daily activities.

The UroLift system is an investigational device as such is limited by Federal Law to investigational use only.

To find out more about L.I.F.T. Study and UroLift system treatment and study locations, go to www.neotract.com.

Is coffee good or bad for men’s health? A recent study suggests that coffee and caffeine may be safe (for now) in regards to prostate cancer, but components within coffee can negatively affect men who have benign prostatic hyperplasia (BPH).

For men who have BPH, drinking coffee can be detrimental because caffeine can stimulate an already overactive bladder, which means it can increase urinary frequency and urgency and may even result in urge incontinence. Caffeine acts on the bladder in several ways. First, it increases how fast the bladder fills up by increasing the rate of urine production. Second, caffeine enhances the sensation and contractility of the bladder, thus making the organ feel a potentially erroneous urge to empty.

Caffeine can also irritate the bladder because it is a theoxanthine, which is a family of drugs that includes theobromine (found in chocolate) and theophylline (found in tea). Theophylline also stimulates and irritates the bladder; however, tea contains half as much caffeine as coffee does, and green tea specifically contains even less.

The impacts of coffee on prostate cancer have piqued the interests of researchers worldwide. According to recent research conducted by Dr. Chang-Hae Park from the National Cancer Center in South Korea, there is no association between prostate cancer and drinking coffee, but there is still some controversy. Park and his team evaluated the results of 12 studies that compared coffee intake and prostate cancer risk. Eight of the studies were case-control studies and four were cohort studies.

The controversial part is that although the investigators found a significant harmful association between coffee consumption and prostate cancer risk in seven of the eight case-control studies, they also explained that the studies had severe limitations that affected the outcomes. None of the cohort studies showed any significant association between coffee consumption and prostate cancer. Therefore, while Park and his team reported there is no evidence that coffee consumption has an effect on prostate cancer, further prospective cohort studies are needed.

The journal Molecular Nutrition and Food Research published a study in 2009 in which researchers evaluated the impact of coffee and tea on prostate health. The investigators’ results showed that no apparent relationship with prostate cancer existed; however, the evidence from animal and in vitro studies suggested that tea, especially green tea, is a healthier choice than coffee for prostate health.

A study at Umea University in Sweden analyzed the effects of both filtered and boiled coffee on the incident of cancer. From a study population of more than 64,000, there were 3,034 cases of cancer, with up to 15 years of follow-up. The investigators did not find an association between consumption of filtered or boiled coffee and all types of cancer combined, or for prostate or colorectal cancer in particular.

Another large study conducted by Harvard evaluated 50,000 men. Researchers used data from the Health professionals’ follow-up study to determine if there was an association between the consumption of regular and decaffeinated coffee and prostate cancer. The investigators found that over two decades, 4,975 cases of prostate cancer were diagnosed. According to Kathryn Wilson, Ph.D., from Harvard Medical School and the Harvard School of Public Health, she and her team “specifically looked at different types of prostate cancer, such as advanced vs. localized cancers or high-grade vs. low-grade cancer.” They found that men who had the highest intake of coffee had a 60 percent lower risk of advanced prostate cancer. Wilson noted: “Our results do suggest there is no reason to stop drinking coffee out of any concern about prostate cancer.”

Coffee and caffeine have an impact on other aspects of your health outside of prostate health. Some studies suggest that consuming coffee and caffeine is associated with a reduced risk of certain diseases. One study published in Cancer Causes & Control in January 2011 found that drinking three or more cups of coffee daily was associated with a 44 percent reduced risk of developing liver cancer in a group of older Chinese adults.

In addition, the Journal of Alzheimer’s Disease reported the results of a recent review study that explored a relationship between coffee and dementia. The investigators concluded that coffee drinking may be associated with a reduced risk of dementia and Alzheimer’s disease.

But despite these positive studies, a combination of coffee, caffeine, and stress can be very unhealthy. Here are some reasons why these three don’t always mix well.

1. Coffee raises stress hormone levels. Elevated levels of stress hormones, including norepinephrine and especially cortisol, are responsible for raising heart rate and blood pressure. When you combine coffee/caffeine with stress, you place your stress hormones on high alert, which in turn puts your heart rate and blood pressure in unhealthy states as well. Elevated stress hormones also weaken your immune system. If you reduce your coffee/caffeine consumption, you will lower your stress hormone levels, blood pressure, and heart rate, and help preserve your immune system health.

2. Coffee contributes to weight gain. The higher cortisol levels associated with coffee consumption are also linked to insulin resistance, increased appetite, and cravings for fatty foods. High cortisol levels can also contribute to fat deposits in the abdomen, which is a risk factor for heart disease.

3. Coffee plus stress may equal heart attack. Coffee consumption can increase stress, which is a known risk factor for heart attack, heart palpitations, and elevated homocysteine, another risk factor for heart disease. If you are stressed, coffee is not a health beverage for your heart.

4. Stress and coffee affect the brain. Stress has a detrimental effect on the parts of the brain responsible for planning, decision making, and reasoning. When you add caffeine, your mental abilities, mood, and memory can suffer, because caffeine interferes with blood flow to the brain. To keep mentally sharp, reduce your use of coffee and caffeine.

5. Stress and coffee disrupt sleep. Stress and worry can keep you awake, and the stimulating effects of caffeine can disrupt your ability to sleep. If you eliminate coffee, you may regain the ability to sleep.

6. Stress and coffee irritate your GI tract. Coffee and caffeine are highly acidic, which can increase the risk of heartburn, ulcers, and irritable bowel syndrome. Reduce your coffee intake, and reduce your risk of these gastrointestinal problems.

An occasional cup of coffee will not likely have a negative effect on prostate health or your overall health. But if you have BPH, coffee consumption should be limited. If you want to enhance prostate health and general well-being, however, the better choice is green tea.

Urology is the surgical specialty of urinary tracts and the male reproductive system. Nearly forty-three million men are affected by some form of urological disorder, whether it is bladder incontinence, urinary tract infections, benign prostatic hyperplasia, cancer, or congenital abnormalities. Some urologists will further specialize to treat either non-surgical conditions or the surgical conditions. This is generally uncommon in smaller hospitals and practices, but found in large urban centers.

This year, urologists across the country are expressing concern over urological health. Several factors have been specifically noted, such as urology demographics, a weak economy and aging population, and healthcare reform.

In regards to the growing concern over demographics, the National Kidney Foundation, NKF, has stated that over 5% of the United States population is affected by urologic disorders. And more than 260,000 deaths from these urological problems are reported each year. Ethnic populations are at a higher risk, and age is one of the largest contributing factors.

With the worsening economy, paired with an aging population, the field of urology has witnessed an overburdening effect. Many patients have lost jobs and their access to healthcare, and a significant number of doctors are refusing new Medicare patients. As a result, urology clinics are over flooded with patients with little to no insurance. Emergency medicine, urgent care, family practice, and internal medicine specialties are also witnessing this effect.

And as the baby boomers age and reach retirement years, a severe influx of older patients will be seen. Urological problems are a huge problem for patients over the age of 45. Urologists document that 90% of men over the age of 70 are afflicted with benign prostatic hyperplasia alone.

More urologists will be needed. If economic principles are taken into account, the supply-demand curve will indicate a rise in services as more patients will be seeking relatively few urologists. Because higher prices will be associated with urological visits and treatments, many patients will begin to ignore urological disorders far longer than they should. Permanent damage will ensue, leading to even more costly and intensive treatments. The already flooded emergency rooms will continue to increase its burdens.

Finally, healthcare reform will also be affecting most urology specialists. The reforms suggested will deem Medicare patients unprofitable. Potential physicians will reconsider going into the medical field, and those who are already in the field may look to other careers as they can no longer afford their practices. The quality of care for Medicare patients will decrease because of the overburdening effect from too few physicians compared to the number of Medicare patients. Urologist specialists, as well as other specialists in the medical field, may specifically be hurt because of the preferential treatment of certain specialties like internists and family practitioners. Internists and family practitioners will automatically receive 5-10% increases in reimbursements under the healthcare reform plan, and the remaining specialties will only qualify for the reimbursements if 50% of their patients are Medicare patients.

Overall, the urologists and specialists in this country fear for their careers. Not only are their jobs and profits on the line, but also their patients may experience a decrease in the quality of their care. This year has truly been a telling year for the field of urology.