The prostate usually begins to enlarge in almost all men in their forties. Researchers suggest that once growth starts, it does not stop as long as life goes on. Eﬀects of this growth vary from almost unbearable misery to minor annoyance, The general rule is that one in four men over age sixty will become so burdened by BPH that he will need physical relief. The prostate begins to enlarge through a process of cell multiplication called benign prostatic hyperplasia (BPH).
The symptoms of BPH can mirror late-stage prostate cancer because the enlarging inner portion of the prostate puts pressure on the urethra, which can potentially cause urinary problems. Why doctors label this condition “benign” is diﬃcult to understand. If the BPH is not properly cared for, it can lead to extremely serious consequences, including kidney damage and failure. It is important to know that the prostate grows in two diﬀerent ways. In one kind of growth, cells multiply around the urinary passageway within the prostate and squeeze the urethra. The second type of growth is much worse; this is a middle growth in which cells grow into the urine tube and even up and into the bladder. It is suggested by doctors that this type of growth can be cleared up only through surgery.
The most eﬀective surgical procedures, transurethral resection of the prostate (TURP) and open prostatectomy, are also the most invasive. They carry the highest risks for signiﬁcant complications, including impotence and incontinence. Because of the invasiveness of surgery, it is imperative that when a man is considering treatment he should be sure his surgeon performs at least ﬁfty of these procedures each year. It is suggested that the complication rates of the surgeon should be no higher than 1 percent for incontinence and 4 percent for impotence.
THE MEDICAL PROFESSIONALS BELIEVE THAT THERE IS NO CURE FOR PROSTATE GROWTH.
Cell growth into the urine tube and the bladder suggest that prostate enlargement is not simply a case of too many prostate cells. This growth involves hormones; it involves diﬀerent kinds of prostate cells; and it aﬀects each man diﬀerently. As a result of these diﬀerences, the medical professionals believe that nothing answers growth problems for every man. “Nothing” refers to the well-known “Roto Rooter” operation, to drugs, to heat treatments, and to drug-free substances. The medical professionals believe that there is no cure for prostate growth; they believe that once it starts it never stops.
People sometimes ask if an enlargement of the prostate increases the risk of prostate cancer. The medical community suggests that there is no connection. A man can have prostate growth with no cancer. He can have prostate growth with cancer, and he can have prostate cancer without enlargement. Conventional medicine treatment options have increased: They are (1) surgery; (2) procedures similar to surgery but considered “noninvasive” or minimally invasive; (3) prescription medicines; and (4) two other available treatments, which are used as “last resort.” One is dilation of the urine passageway. The second is cryoablation, or cryotherapy, which freezes the prostate. Because this procedure was associated with signiﬁcant side eﬀects, it was abandoned until the early 1990s. With the introduction of transrectal ultrasound (TRUS), monitoring of probe placement and freezing was achieved.
Surgery: Many years ago, surgery included the cleaning out of the prostate through the bladder by retropubic operation, which was not appropriate for all men. Timing is vital when considering surgery for BPH; therefore it’s imperative that men discuss their symptoms and the eﬀect those symptoms have on their lives and the lives of their families. Retropubic procedure means the removal of either part or all of the prostate gland. Most doctors recommended early operations, because the risk of kidney damage was much increased if the symptoms were gradually getting worse. However, these procedures have been almost entirely replaced by more advanced techniques introduced by the medical community.
TUIP (Trans-Urethral Incision of the Prostate): The physician inserts a cutting instrument through the prostate to reach the neck of the bladder. He makes two large lengthwise cuts to tissue from the neck of the bladder and through the length of the prostate. This procedure is similar to TURP except that rather than removing the tissue, one or two small incisions are made in the prostate, causing the bladder neck and the prostate to open and relieve pressure on the urethra. It is suggested that men who are interested in having children should consider it because it does not aﬀect ejaculation or fertility provided the prostate is one ounce or smaller.
TURP (Trans-Urethral Resection of the Prostate): It is suggested that in the 1980s TURP accounted for about 95 percent of all prostate surgery, but it has declined as alternatives procedures have become more widely available. Some urologists still think of it as “the Gold Standard” in treating prostate enlargement. While in general this procedure is recognized by doctors to be safe, patients require spinal, epidural, or general anesthesia and also need days of hospitalization and weeks of recovery. The potential for morbidity and mortality limits the use of TURP in patients with high surgical risk. Potential complication include bleeding, infection, and prolonged catheterization as well as the frequent need for a repeat operation. If the ﬂuids used during TURP build up, water intoxication can develop, which can be serious. Symptoms including abdominal cramps, nausea, vomiting, lethargy, and dizziness and are referred to as TURP syndrome. In this procedure, after the patient is anaesthetized, the urologist inserts a resectoscope into the penis and passes it along the urethra until it reaches the bladder neck. The urologist then uses an electric cutting loop on the end of the resectoscope to cut away the enlarged tissue of the inner portion of the prostate.
Transurethral Needle Ablation of the Prostate (TUNA): TUNA is referred as a simple, safe, and relatively inexpensive procedure. The doctors uses needles to deliver high-frequency radio waves (microwaves) that heat and create lesions within the prostate to destroy excess prostate tissue. The procedure only requires topical urethral anesthesia. It is believed to be less eﬀective than TURP. The technique is similar to indigo laser and other noninvasive techniques and works best on the moderately enlarged prostate, though it is not very eﬀective on very large ones.
A study found that symptoms improved after six months. Complications include urinary retention, blood in the urine, retrograde ejaculation, and painful urination. However, it appears to pose very low to no risk of incontinence and impotence.
Laser Surgery: Various transurethral laser techniques have been developed and are being used in removing excess prostate tissue or vaporizing it. This approach uses laser energy direct with a ﬁber via a cyst scope into the prostate and uses heat to shrink the gland. This procedure is faster than TURP and causes no bleeding. There are two disadvantages of laser techniques: There is prolonged cauterization during the postoperative phase and no tissue is obtained during the procedure. In roller-ball laser surgery, direct contact with prostate tissue vaporizes it. In this procedure, the “laser-induced” and “laser- assisted” surgery, high-energy instruments heat prostate tissue to as high as 140 to 212 degrees. It is suggested by researchers that this heat kills the tissue and the body throws it oﬀ.
Indigo-Laser: The physician inserts a needle-shaped probe into the prostate and then ﬁres energy in the shape of a ball from the probe’s tip. The blast of the heat destroys prostate tissue. This is relatively recent therapy. The manufacturer sells its results favourable to “Gold- Standard” TURP. However, it is suggested that this procedure is too new for one to be sure of its long-term value.
Transurethral Microwave Thermotherapy (TUMT): This procedure, which was approved by the FDA in May 1996, is referred to as the “Granddaddy” of heat therapy for prostate enlargement. It includes a device that uses microwaves to heat and destroy excess prostate tissue. In this procedure, a prostatron-regulated microwave antenna is inserted through the urethra with ultrasound used to position it accurately. The antenna is enclosed in a cooling tube to protect the lining of the urethra. Computer-generated microwaves pulse through the antenna to heat selected portions of the prostate to about 111 degrees Fahrenheit. A cooling system protects the urinary tract during the procedure.
Transurethral Electrovaporization (TUEVP): This procedure uses high voltage to combine vaporization of prostate tissue and coagulation, which seals the blood and lymph vessels around the area. The excess tissue, deprived of blood, dies and is sloughed oﬀ over time. A study suggested that patients who had TUEVP were able to have their catheter removed fourteen to sixteen hours after the procedure compared to normal removal time of three to ﬁve days after TURP. The average hospital stay was only nineteen to thirty-six hours.
Hot-Water Therapy: The device known as thermoﬂex, which circulates heated water through a catheter to destroy prostatic tissue, has been approved for treating BPH. There is also another technique that uses a balloon ﬁlled with water to destroy tissue around the urethra. The procedure does not require anesthesia and can be completed during an outpatient visit.
Open Prostatectomy: In open prostatectomy the enlarged prostate is removed through an open incision in the abdomen using standard surgical techniques. This is said to be a major surgery and requires a hospital stay of several days. This procedure is only used for severe cases, in about 2 percent to 3 percent of patients, when the prostate is severely enlarged, and the bladder could be damaged; other potential serious problems exist. It is suggested that up to 14 percent of patients require a second operation because of scarring. In making a decision about open prostatectomy and discussing the consequences, it is imperative that BPH men be assertive. Physicians have the responsibility to advise patients of the side eﬀects of a diminished sexual capacity, which can often occur after this procedure. Prostatectomy should be considered as a last resort.
Prostatic Stent: Prostatic stent is a procedure where urolume, a mesh- like ﬂexible tube made of a special alloy, is inserted into the urethra, where it expands and eases urine ﬂow. The tube does not cause reaction in the body. The procedure takes only ﬁfteen minutes and requires only regional anesthetic and mild sedation. Patients require minimal recuperation and no overnight hospital stay.
ProstatronTreatment: Thissystemusescooledthermotherapy, otherwise known an transurethral microwave thermotherapy (TUMT) to deliver precisely targeted microwave energy to heat and destroy hyperplastic prostate tissue. At the same time, a unique cooling mechanism protects the surrounding healthy tissue, creating coagulative necrosis. Cooling water is circulated through outer channels of the catheter for protection of the urethra edema, for faster patient recovery. Prostatron was approved by the FDA in 1996 as an alternative treatment for enlarged prostate.
Tragis System: Approved by the FDA in September 1997, similar to the prostatron this procedure delivers microwaves to destroy selected portions of the prostate and a cooling system to protect the urethra. A heat-sensing device inserted in the rectum helps monitor the therapy. Both procedures take about one hour and can be performed at an outpatient basis without general anesthesia. It is suggested that neither procedure has been reported as the cause of impotence or incontinence. Microwave therapy does not cure BPH; it reduces urinary frequency, urgency, straining, and intermittent ﬂow. It does not correct the problem of incomplete emptying of the bladder.
ORAL ALTERNATIVES TO SURGERY
Hytrin, Gardura, Flomax: These prescription drugs were originally developed to relax heart muscles. Experiments by doctors found that
they also relax prostate muscles, which relieves the pressure on the urine channel through the prostate. Research claims that they help about 70 percent of men who try them. Side eﬀects include lowering blood pressure and dizziness. Flomax, the newest of the three, is suggested by doctors to have fewer side eﬀects.
Proscar: This drug shrinks the tissue around the prostate’s urine channel and the prostate itself. It is controversial. Information gathered by the American Prostate Society suggests that it helps about one in three men, and it takes about ten months for any beneﬁts to appear.
Men today have many options in seeking relief from the symptoms of prostate growth. It is up to every man to consider all options based on his personal needs. Men should not rely on their doctor to do this for them. If your doctor specializes in TUMT, you will not get TUNA as an option. If he is partial to TURP and “Roto-Rooter,” he may choose surgery. In treating prostate growth you are not likely to receive a prescription for an oral drug, not to mention anything for relief in alternative or natural treatment, from most standard physicians.
Bible verses for today’s meditation and inspiration: Matthew E. McLaren
“Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8
“Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24
“Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25
“Who of you by worrying can add a single hour to your life?” – Luke 12:25
“For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11
“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11
“A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22
“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.” – Philippians 4:6
“Above all else, guard your heart, for everything you do flows from it.” – Proverbs 4:23
“For God has not given us a spirit of fear, but of power and of love and of a sound mind.” – 2 Timothy 1:7
“Consider it pure joy, my brothers and sisters,[a] whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance.” – James 1:2-3
“In all your ways acknowledge him, and he will make straight your paths.” – Proverbs 3:6
“Commit your actions to the LORD, and your plans will succeed.”- Proverbs 16:3
“Consider the ravens: They do not sow or reap, they have no storeroom or barn; yet God feeds them. And how much more valuable you are than birds!” Luke 12:24 – Luke 12:24
“It’s not what goes into your mouth that defiles you; you are defiled by the words that come out of your mouth.” – Matthew 15:11
“Make a tree good and its fruit will be good, or make a tree bad and its fruit will be bad, for a tree is recognized by its fruit.” – Matthew 12:33
“I can do all things through him who strengthens me.” – Philippians 4:13
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