BPH Treatment Options

This option is recommended for men who have minimal to mild symptoms that are not particularly bothersome, and after evaluation it has been determined that the bladder has not been compromised or damaged. Watchful waiting means just that; you will be examined most likely every six months to make certain you are not developing complications from BPH. Certainly this is the least invasive treatment and avoids the risks, costs, and side effects of medical or surgical treatment.

Treatment of BPH:

Men should be treated for BPH when the symptoms become bothersome. The American Urologic Association has created a symptom score index that totals from 0 to 35. (David can you insert a link to the test on the website here?) Higher scores indicate more severe symptoms. Scores less than seven are considered mild and generally do not warrant treatment unless evaluation indicates more bladder obstruction and damage than the patient may admit. It is common for many men to adjust their lifestyle as they develop symptoms such as restricting the amount of fluids they drink in the evening so they will not have to get up to urinate as often after going to bed. And many men just consider these symptoms to be a part of the aging process they must deal with. In reality these men should be evaluated; they may have a much more severe problem than they think.

Many men, especially as the get a little older, begin to contemplate the benefits of sterilization.  After all, the freedom to engage in sexual activities without the risk of pregnancy is pretty alluring.  Vasectomies are fairly inexpensive, simple operations.  The can be performed by the doctor at his office and take very little recovery time.  However, there are some drawbacks to getting a vasectomy that a man should at least be aware of before making the final decision to be sterilized.

Possible Sexual Side Effects

Once the vasectomy has been completed the testes remain in place in the scrotum.  The Leydig cells continue producing male hormones such as testosterone which is circulated by the bloodstream.  Though most studies indicate that as many as 90% of men experience no drop in sexual desire after getting a vasectomy, other studies place that number lower, suggesting that as many as 1 in 5 men will see a drop in their desire for sex after surgery.
Though not significant to many men, the volume of ejaculate is somewhat diminished after getting a vasectomy.  Sperm constitutes about 10% of the volume of normal ejaculate.  After getting a vasectomy, since the sperm is no longer present, the amount of ejaculate is decreased.  However, it has been indicated that getting a vasectomy does not significantly alter the appearance, texture, smell or taste of the ejaculate.

Changes in the Testicles

Once the vas deferens has been severed or clamped, the sperm can no longer exit the body via the penis.  Though the testicles continue to produce sperm, they cannot leave and so are reabsorbed by the body.  Most of the fluid content of is absorbed through the membranes of the epididymis.  The solid content gets broken down by macrophages which respond to its presence.  The broken down product is then absorbed into the blood stream.
Even in men who have not had a vasectomy almost half of sperm are reabsorbed in this manner.  After getting a vasectomy the membranes have to grow to be able to absorb twice as much fluid.  This can cause the immune system to respond by producing more macrophages for the purposes of breaking down the solid sperm to be reabsorbed.

Immune System Response

Within a year of getting a vasectomy, studies have shown that close to 70% of men begin to develop antibodies that attack sperm.  Some cases of vasitis nodosa, benign bodies within the ductular epithelium can result as well.  The buildup of sperm in the testicles can create pressure in the lower portion of the vas deferens and against the epididymis.  It has been reported that these structures can often rupture and become damaged.  Sperm ganulomas can also be form by the entry of sperm into the scrotum as the body attempts to trap the sperm that the body now views as foreign bodies.
Though most of these changes and side effects are slight, some can still pose an inconvenience.  Any man is well advised to understand these potential drawbacks before deciding if the benefits of getting a vasectomy outweigh the risks.

Prostate cancer is a serious issue that affect hundreds of thousands of men each year.  Prostate testing and screening is an important means of catch this deadly cancer in its early stages.  If you are diagnosed with prostate cancer there are a number of treatment options available.
Watchful Waiting
If PSA screening and testing indicates the presence of a very small or slow-growing cancer then your doctor may recommend passive therapy.  This consists of simply keeping a closer eye on the development of the cancer by repeated testing and observation.  This course of action is especially appropriate for those that are very elderly or who are in very poor health.

Hormone Therapy

Hormone therapy uses varying drugs to reduce the amount of testosterone in the body or to block testosterone getting to the cancer cells.  Testosterone can actually work against the body by causing the cancer to grow more quickly.  Hormone therapy can reduce the growth of cancer, but isn’t usually enough to kill the cancer cells.  This treatment is usually used in combination with another treatment to completely remove the cancer.

Chemotherapy

Chemotherapy is the use of chemicals that destroy growing cells in the body.  Like hormone therapy it is better suited to controlling cancer growth than in curing it.

EBRT

External Beam Radiation Treatment or EBRT uses high-powered x-rays to destroy cancerous tissue.  EBRT is performed over the course of a couple of months, usually on a near daily basis.  The procedure is painless, causes only minimal side effects and the individual sessions take very little time.

Radioactive Seed Implants

This form of treatment, also called brachytherapy, uses small radioactive pellets that are implanted into the prostate in the area of the cancerous growth.  The pellets emit high dose radiation for a lengthy period of time (usually depleting within a year).  These pellets are surgically implanted with a needle while the patient is unconscious and are not removed after losing their radiation.

Radical Prostatectomy

Radical prostatectomy is the complete surgical removal of the prostate gland.  This can be accomplished either by retropubic surgery (through and incision below the bellybutton) or perineal surgery (through an incision in the perineum).  This type of surgery can have significant effect on bladder control and sexual function.  Robot-Assisted Laparoscopic Radical Prostatectomy is a relatively new form of radical prostatectomy that uses remote control robots to perform the procedure in a more sterile and less invasive manner.

Multiple Approaches

Unfortunately, despite the many advances in the treatment of cancer, there still isn’t a miracle cure for prostate cancer or any other type of cancer.  Also, not all instances of cancer will respond the same way to the same treatments.  If, with treatment, your prostate cancer does not show signs of improving or if it seems to be progressing despite the treatment then your doctor may want to try other approaches.  There is no sure-fire way to beat cancer, but the early cancer development is caught and treatment is begun the better the chances of stopping it before it becomes life-threatening.

Bladder control problems effect many people, especially as they begin to get older.  Though incontinence is common, it is not something that “just happens”.  Incontinence is a symptom, not an independent condition.  Bladder control problems can indicate problems that vary from mild to severe and life-threatening.  Therefore, if you are experiencing difficulty with bladder control problems you should consult with your physician to determine the cause.
Most often the cause for incontinence is not life-threatening.  The loss of bladder control can be troublesome though.  There are things that you can do, on your own and at home to improve you bladder health.  Making some changes to your lifestyle can help reduce the effects of bladder control issues or even reduce your chance of developing those issues in the first place.

Fluids:  Friend or Foe?

You may think that reducing your intake of fluids will help you reduce your urine production and thus alleviate your bladder control issues.  Limiting some fluids certainly does help, but there can be some unpleasant consequences.  Reducing your fluid intake too much can lead to the growth of kidney stones.
Drinking 6 – 8 cups of fluids each day is about the optimal level for reducing bladder problems while avoiding creating other problems.  Not just any fluid will do either.   There are a number of liquids that should be greatly limited, if not cut from your daily routine altogether.
Diuretics are substances that increase the production of urine.  Examples of diuretics include caffeine and alcohol.  Limiting your caffeine intake can greatly reduce bladder problems.  If possible, avoid alcohol altogether.  Much more than being just a diuretic, it also relaxes the muscles of the bladder which could lead to a very awkward situation for you, depending on where you are doing your drinking.
Very acidic juices, such as orange juice or grapefruit juice can irritate your bladder as well.  Of course, their fruits from which they are derived can cause just the same problems for your bladder.  If you experience trouble with bladder irritation, systematically cut out juices and fruits so that you can isolate which ones give you bladder problems.

Lifestyle

There are other habits you can adopt that will help you reduce bladder control problems.  Try to get into the habit of urinating regularly.  Don’t try to hold it.  Train yourself to go often and especially to urinate if you know you will not have access to a facility for any period of time.
Getting plenty of exercise can help with bladder issues and contribute to a healthier bladder.  Excessive weight can make bladder issues worse.  Exercise can help shed that weight, plus there is cause to think that aerobic exercise, itself, helps promote bladder health.
Also, don’t be embarrassed to purchase absorbent pads or undergarments.  Purchasing such items is much less embarrassing than the situation caused by needing them and not having them.  Also make sure that you keep up with your personal hygiene to eliminate embarrassing and unpleasant urine smells.

Whether in their late 20s or late 30s, whether with a family of 6 kids or just an only child, at some point in every couples marriage they decide that their family is big enough.  When that time comes, the decision to get sterilized becomes a serious topic of consideration.  There just isn’t any better way to avoid an unwanted pregnancy.
Both tubal ligation for the female and vasectomy for the male reduce the chance of unintentional pregnancy to near zero.  Both options allow for unrestricted sexual intercourse without worry or fear.  However, when it comes down to the deeper considerations both may not be equal.

Tubal Ligation

Tubal ligation is the most common form of sterilization in the U.S.  The surgery is performed in an inpatient setting (requiring admission into a hospital).  Tubal ligation is a fairly invasive surgery and as such carries a significant amount of risk of infection, reaction to anesthesia and other complications often associated with surgery.  The failure rate of tubal ligations is about 2%.
Tubal ligation is a permanent means of sterilization but the success rate for reversal is fairly high.  The fallopian tubes are either severed and sealed or else they are clamped shut.  The recovery time for tubal ligation is well over a week in most cases.  There are a number of long-term complications that may follow tubal ligation ranging from recurrent pain to changes in menstrual cycle and hormonal issues.  Tubal ligation does decrease the risk of ovarian cancer and pelvic inflammatory disease.

Vasectomy

Vasectomies, though less common in the states are more common overseas.  This may be due to the fact that vasectomies usually cost about a quarter of the cost of tubal ligation.  A vasectomy can be performed in the doctor’s office under local anesthesia in less than an hour.  There is very little risk associated with the procedure.  The failure rate of vasectomies is about 1%.
Vasectomies are done by making a very slight incision into the scrotum to expose the vas deferens which is then cut or clamped.  The success rate for reversing a vasectomy is very low.  The usual recovery time is just a few days until being able to return to regular duties.  There are not any significant long-term health complications from vasectomies, though the chance of developing prostate cancer may be slightly greater.

The Comparison

When held up side by side for comparison, vasectomies are the more sensible solution in almost every way.  Vasectomies cost less and can be performed more quickly.  There is less risk associated with the procedure and vasectomies have a higher success rate.  The only points where vasectomies are less beneficial to a couple are in the slightly greater risk for the male of developing prostate cancer and the difficulty in reversal should the couple change their minds.
These are all consideration that should be discussed when a couple decides to seek a permanent means of contraception.  After all, the purpose of sterilization in such instances is to do what is best for the family and the couple.  As such, choosing the more sensible option is often for the best.

Prostate cancer is the number two cancer risk for men.  Because prostate cancer is such a prominent risk for men, many doctors urge getting regular prostate exams and testing after the age of 40.  There are a number of methods used to identify prostate cancer in its earliest stages when it is more easily treatable.

DRE

A digital rectal exam should be a part of any man’s yearly physical.  This exam allows the doctor to judge the health of the prostate, evaluate any enlargement that may be happening and to check for nodes that could be cancerous growths on your prostate.

Screening

If you doctor feels that you have a higher than average risk for developing prostate cancer then he or she may recommend cancer screening.  There are a number of factors that increase the chances of developing prostate cancer.  African-American men are the most susceptible.  Chances of prostate cancer also increase as you get older or if you have had prostate cancer in the past.
A screening test can help to catch cancer before it produces any symptoms and before it spreads.  Often by the time a patient experiences symptoms the cancer has already grown and spread to other organs.  However, just because your doctor recommends screening doesn’t mean that he or she necessarily thinks that you have cancer, only that you may be at higher risk for it.

What is PSA?

Prostate-specific antigen (PSA) screening is the type of screening most often used to help catch early-stage prostate cancer.  The prostate-specific antigen is a protein that is made by the prostate.  Most men have a fairly low PSA level.  When PSA levels rise it can be a red flag that there is a tumor affecting the prostate.  However a high PSA level does not necessarily mean cancer, it can also indicated a non-cancerous enlargement of the prostate.  PSA screening does not indicate cancer but can let your doctor know if further testing is needed.

Further Testing

If PSA screening shows elevated levels of prostate-specific antigens but there are no other signs of cancer then the doctor may simply recommend regular DREs and PSA screenings to monitor the prostate for changes.  However, if PSA levels continue to rise or if the doctor detects a growth during a digital rectal exam then there is cause for further testing.  These test can help discover if there is indeed a cancerous growth or if it is a non-cancerous issue with the prostate.
Testing to determine and diagnose cancer can vary.  The doctor may want to test to rule out non-cancerous causes first, such as doing a urine test to eliminate the possibility of a urinary tract infection.  Transrectal ultrasound, x-rays or cytoscopy can be used to get an image of the prostate to eliminate the possibility of non-cancerous enlargement.
If cancer is suspected the doctor will want to do a biopsy.  A tissue sample will be taken from the prostate using a needle.  It can then be examined under the microscope to look for abnormal cell growth (cancer).

There comes a time in every couples relationship when the no longer want to grow their family by having more children.  The decision to not have any more children does not mean a decision to not have any more sex.  With sex, however, there is always a risk no matter how careful you are.
To help minimize that risk so that a couple can continue to enjoy intimacy without worry about unintentional impregnation, a number of long-term and permanent sterilization techniques are available.  Most of the options are available for female contraception, with few options being open to men.  However, the male vasectomy remains one of the most common and effective means of male sterilization extant.

The Male Options

As any man knows, the options for male birth control are extremely limited.  There is the condom, which offers only a moderate chance of protection and success.  Condom’s are prone to breakage and may completely fail in their purpose at any time.  They don’t afford the user much of a sense of real security and they can diminish sensation during sex.
The only other option available to men is the withdrawal method.  This method of birth control is even less effective than condoms.  Since semen can exist even in the ejaculate fluid that escapes during arousal and assists in lubrication (often referred to as “pre-cum”), there is no assurance that pulling out at the moment of climax will be sufficient.
Only the vasectomy provides the assurance of near 100% effectiveness.  With a vasectomy there is no worry about whether the female forgot to take her oral contraceptive.  There is no worry about a condom breaking, nor is there the loss of sensation.  Vasectomies provide almost total protection within monogamous relationships.  The vasectomy cannot protect against STDs that may be contracted from the practice of having unprotected sex with multiple partners.

The Female Options

The options available to females are often less effective, more subject to human error and have a greater number of side effect than a vasectomy.  Pills can be accidentally forgotten, implants can go bad, and diaphragms can fail.  Hormonal birth control can have a major effect on females as well and is not always well received by the female body.
The only near comparable surgery for females can also have serious side effects and requires a much more invasive and risky form of surgery.  This surgery requires a much greater recovery time before being able to return to normal daily and sexual activity.  Given the choice, most men would much prefer to have the very simple process of a vasectomy performed than to put their loved one at risk.

The Choice

The decision to get a vasectomy should not be taken lightly.  It is a permanent procedure and, as such, should be considered with great care and discussed between partners.  Only if both of the partners are certain that they don’t desire to have any more children should a vasectomy be undertaken.

As they get older, bladder control problems impact the lives of many men.  In fact, almost all men are affected by bladder issues at some point in their lives.  As we age, subtle changes in our body can affect our ability to hold or control urination.  This can be an embarrassing and uncomfortable problem.  For many it significantly diminishes their quality of life.
Bladder problems can cause a number of unpleasant effects like unintentional dripping or leakage.  Bladder issues can also lead to an increase frequency in urination or a heightened sense of urgency in needing to urinate.  Bladder problems can come in different forms and from different causes.  Understanding bladder control problems is the first step in improving the health of your bladder.

Types of Bladder Control Problems

There are several kinds of bladder control problems that can affect men.  Urinary incontinence is a common form of bladder control problem that results in unwanted leakage.  Urine can accidentally be forced out when you sneeze, cough or perform any action that press down on the bladder.  Leakage can also follow a sudden, urgent need to urinate, or can even occur as a constant drip.
The condition referred to as an overactive bladder can also cause significant trouble.  An overactive bladder may force urine through the urethra at inopportune times.  Some symptoms of overactive bladder are the frequent need to urinate, frequent waking at night to urinate, sudden onset of an urgent need to urinate or dripping that follows that sudden urge to urinate.

Causes of Bladder Control Problems

Most bladder control problems are often caused by the enlargement of the prostate.  Bladder problems can also be cause by issues with the nerves that stimulate and control urination.  In the cases of overactive bladder sometimes the cause is not certain.

Prostate Issues

The prostate is the gland below the bladder.  It surrounds the urethra and supplies much of the fluid in ejaculate.  As men age it is very common for this gland to become enlarged, pinching the urethra and blocking the normal flow of urine.
When the  urethra is constricted it can produce symptoms such as a weak stream when urinating, sudden onsets of a feeling of urgently needing to urinate followed by dripping, the frequent need to urinate and waking at night to urinate.  There are several treatments for prostate enlargement.  Your urologist may recommend radiation treatment or surgery to reduce the size of your prostate to allow urine to flow more normally and allow you to regain control of your bladder.

Nerve Issues

Damaged or compressed nerves can also cause problems with urination.  These nerves can confuse signals, send false signals to the bladder telling it to release at the wrong time, or even fail to relay the conscious desire to release urine intentionally.  These types of nerve issues can be caused by injuries to the spinal cord, or by other health conditions such as a stroke or diabetes.  Nerve issues can be difficult to treat, but your doctor may prescribe medication to help alleviate the problem so that you can better control your bladder.