Tag Archive | "bph"

Alpha Blocker Improves Symptoms of Chronic Prostatitis

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.

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Resection and Vaporatization Treatments for BPH about Equally Safe

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.

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Alternative Procedure is Available for Treating Enlarged Prostate

According to Dr. Joao Martins Pisco, lead author of a study presented on March 29, 2011 at the annual meeting of the Society of Interventional Radiology in Chicago, a new treatment called prostatic artery embolization (PAE) may be used in certain patients with prostates larger than 60 cubic centimeters and who have serious lower urinary tract symptoms and weakened urinary stream.

Enlarged prostate, also known as benign prostate hyperplasia, is a non-cancerous condition that affects millions of aging men.  This condition occurs when the prostate gland slowly enlarges and presses on the uretha, which constricts the flow of urine.  It is characterized by unpleasant symptoms including a weak or slow urine flow, a constant and urgent need to urinate, not being able to fully empty the bladder, and having to get up repeatedly at night to urinate.

The surgery that has generally been used to treat enlarged prostate, transurethral resection of the prostate (TURP), is used for men whose prostates are smaller than 60 to 80 cubic centimeters.  The procedure requires general anesthesia and a hospital stay.

In contrast, there is no size limitation for PAE, which requires only local anesthesia.  Researchers say that the procedure lowers the risk of other side effects including blood loss and retrograde ejaculation, which happens when semen leaks into the bladder.  PAE can also be an outpatient procedure.

According to the study, PAE helped the majority of 67 patients who received the treatment.  Sixty-six of the men who had not responded to medications experienced improvements in symptoms and a reduction in prostate volume.  After nine months, none of these men experienced sexual dysfunction, and a quarter continued to report improvements.

PAE, however, remains controversial and few doctors are trained in this procedure.  Authors of the study reported that there was not a great an improvement in improved flow rate of urine in patients who underwent PAE, which would indicate the performance of the bladder and urethra, as those who underwent TURP.

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Research Study for Treatment of Lower Urinary Tract Symptoms (LUTS) Due To Benign Prostatic Hyperplasia (BPH)

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.

Posted in Chronic Prostatitis, Prostate Inflammation, Prostate TreatmentComments (3)

Label Switch in Pfizer Drugs

There is a possible label switch in two of Pfizer’s drugs – an antidepressant and a drug used to shrink the prostate. This prompted Pfizer to do a subsidiary recall on both drugs.

The affected drugs are both in generic formulation – Citalopram is an antidepressant and Finasteride is used to treat benign prostatic hyperplasia (BPH).

It is said that only one lot was affected. Bottles labeled as Citalopram Lot # F10510058-A may contain Finasteride. The lot number involves Citalopram in 100-count bottles of 10-mg tables and Finasteride In 90-count bottles of 5-mg tablets.

Greenstone LLC, the Pfizer unit selling the products stressed that patients taking the wrong medications may be at risk for serious side effects. Patients who discontinue Citalopram abruptly may experience withdrawal symptoms and/or worsening depression. Women who are, or may become pregnant, should not take or handle Finasteride due to possible risk of abnormalities to the external genitalia of a developing male fetus.
Patients should check their bottles of either drug with this lot number on the label should return the products to the pharmacy.

The recall stemmed from the possibility that incorrect labels have been placed on the bottles by a third party manufacturer.

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Coffee and Prostate Health: Is it Bad for You?

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.

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Side Effects of Avodart—A Benign Prostatic Hyperplasia Drug

One of the most common drugs prescribed for benign prostatic hyperplasia, or BPH, is Avodart.  Avodart may be used as the sole medication or may be prescribed in combination with other common drugs used for the same condition.  The active ingredient in Avodart is dutasteride, which inhibits the conversion of testosterone to dihydrotestosterone (DHT).  Researchers have found that the symptoms of BPH, specifically the enlargement of the prostate gland, are a result of increased levels of DHT in the blood.  Therefore, Avodart has been engineered to prevent the unwanted growth of the prostate and, in fact, shrink the gland.  This, in turn, will alleviate such BPH symptoms as poor urine flow, frequency and hesitancy of urination, and inability to completely empty the bladder.

Currently, Avodart is available in capsule form.  But due to its chemical make-up, it has the ability to irritate the mucosa.  For this reason, the capsule must be swallowed whole without breaking up or chewing the casing.  Further, if a patient is allergic to any ingredients either in the drug itself or the capsule, Avodart may not be the correct treatment of choice for benign prostatic hyperplasia.

One of the long standing reasons to avoid taking drugs such as Avodart is the fact that it and other drugs like it remain in the patient’s blood for up to six months after the final dose.  Those who have opted for Avodart treatment are recommended to not donate blood.  This recommendation is extremely important as researchers have revealed that Avodart can cause birth defects if taken during pregnancy.

The most common side effects of the drug deal with general allergic reactions.  This includes itching of the skin, hives, swelling of the lips, tongue, face, and throat, and breathing difficulties.  If you are taking Avodart and are experiencing any of these symptoms, immediately discontinue taking the medication and seek medical treatment to prevent any progression of the symptoms.

Given the main function of Avodart, which is to inhibit the production of DHT, another specific side effect related to taking the medication is linked to reduced levels of DHT.  With reduced levels of DHT in the body, a loss of libido, lack of sexual drive, impotence, or erectile dysfunction may ensue.  Also, reduced amounts of semen production during the time of ejaculation, breast enlargement, and breast tenderness have been reported.  Report any of these side effects to your physician as soon as possible.

As its name suggests, benign prostatic hyperplasia is a benign growth of the prostate gland.  Diagnosis does not indicate prostate cancer or increase risk for cancer.  Medications such as Avodart are prescribed by many doctors, despite their many side effects.  Patients have begun to look toward natural supplements, which do not carry adverse side effects, to treat symptoms of common urological problems like BPH.  If you are interested in alternative, safer routes toward alleviating symptoms, talk to your doctor about clinically tested, effective natural supplements.

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HistoSonics for Benign Prostatic Hyperplasia

Nearly three out of four men over the age of 50 suffer from benign prostatic hyperplasia.  This condition, though benign, can be extremely frustrating to deal with as the symptoms include anything from increased frequent, urgent feelings to urinate, decreased urine flow force, and obstructed urine stream, to frequent waking in the night to urinate.  And despite the large number of men who do suffer from BPH, many men still feel uncomfortable talking about their prostate health and possible treatments for benign prostatic hyperplasia, which includes surgery, medication, or natural supplements.

Currently, 400,000 men are referred to surgical treatments every year for their enlarged prostates.  But men who suffer from BPH may soon have an alternative to surgery.  The company HistoSonics, Inc. is developing what is called the Histotripsy system.  This system is an image-guided, robotic-manipulated procedure that uses ultrasound to excise and mechanically homogenize tissue without heat.

Histotripsy is licensed from the University of Michigan and was developed by scientists in the Department of Biomedical Engineering and the Department of Urology.  The co-inventors consist of Charles Cain, Ph.D., Brian Fowlkes, Ph.D., Tim Hall, Ph.D., Zhen Xu, Ph.D. and William Roberts, MD, all from the University of Michigan.  Its researchers and developers pride the technology on its non-invasive, office-based function, and they fully believe that it will be fast, effective, and cause fewer adverse effects than any existing BPH surgical treatment.

While most of the ultrasound products used today use heat to destroy unwanted tissue, Dr. Cain and his colleagues decided to research cavitation for Histotripsy treatment.  Cavitation is the production of tiny energetic bubbles to create a surgical scalpel that liquefies tissues without heat.  Dr. Cain explains, “The conventional wisdom was that cavitation should be avoided, but no one could tell me why.  So I decided to study it as a possible mechanism for non-invasive surgery.”  The ultrasound component is used to monitor the treatment in real time.

Due to the promising nature of the Histotripsy method, funding has not been a problem for the founders and co-inventors.  Dr. Cain and Dr. William Roberts obtained funding from the Coulter Foundation to develop this novel treatment for BPH.  Histotripsy quickly attracted the attention of Tom Davison, Ph.D., who is the co-founder of UltraCision and co-inventor of the Harmonic Scalpel and Shears, the most successful commercial device that employs therapeutic ultrasound technology.  Davison notes, “I was most impressed with the solid scientific foundation and broad platform potential to create a significant company based on Dr. Cain’s Histotripsy technology.”

“We think HistoSonics’ novel non-invasive ultrasound procedure has the potential to be a huge game-changer in treating BPH now and many other tumors in the future,” stated Jim Adox, Managing Director and head of the Ann Arbor office for Venture Investors.  Men with benign prostatic hyperplasia may soon look forward to the Histotripsy treatment in doctor’s offices across the United States.

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Prostate Cancer: Symptoms

If you have prostate cancer, you may not show any symptoms. However, if you do show symptoms, the most common symptoms include:

Urinary problems:

-          Inability to pass urine

-          Difficulty starting or stopping the urine flow

-          Needing to urinate frequently, especially at night

-          Weak urine flow

-          Burning, pain, or discomfort during urination

-          Urine flow that starts and stops suddenly

-          Blood in the urine

Sexual problems:

-          Difficulty having or maintaining an erection

-          Blood in the semen

Aches and pains

-Frequent, recurring pain in the hips, lower back or upper thighs.

Usually, these symptoms are not caused by cancer. It’s also possible that you are experiencing symptoms

of benign prostatic hyperplasia (BPH), or an infection. If you experience any of these symptoms, visit your doctor right away for a diagnosis and treatment plan.

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Urologists’ Growing Concern for 2010

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.

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