Diagnosing Benign Prostate Enlargement
To find out whether your prostate gland is enlarged, youll need to have a few tests.
Some tests will be carried out by your GP and others will be carried out by a urologist .
First, your GP will ask about your symptoms. If it seems that you have symptoms of benign prostate enlargement, the next stage is to calculate your International Prostate Symptom Score .
Popular Drugs Used For Treating Enlarged Prostates Associated With High
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
If a man has an enlarged prostate, theres a good chance hell be treated with a type of drug called a 5-alpha reductase inhibitor . These drugs shrink the gland to improve urinary flow, and the approved forms used for treating enlarged prostates come in two varieties: Proscar and Avodart .
However, a side effect of 5-ARI inhibitor treatment is that it suppresses blood levels of prostate-specific antigen by about 50%. Doctors measure PSA during prostate cancer screening, and if a man on 5-ARI therapy winds up with results that are artificially low, then he might be falsely reassured that he doesnt need any additional prostate cancer testing.
A new study with just over 80,000 prostate cancer patients highlights this risk. Men in the study who developed prostate cancer while taking a 5-ARI inhibitor had significant delays in diagnosis compared to nonusers. And because those cancers were discovered at more advanced stages, the mens outcomes were also comparatively worse. The study was led by Dr. Brent S. Rose, assistant professor in the department of radiation medicine and applied sciences at the University of California, San Diego School of Medicine.
How Effective Is Combining Drugs
Alpha blockers and 5-alpha reductase inhibitors are sometimes combined to try to relieve the symptoms as quickly as possible and at the same time prevent the prostate from growing further. This combination is considered for men who have severe symptoms and a very enlarged prostate gland. Their prostate gland is more likely to grow even larger.
Combining these drugs can lower the risk of the symptoms getting worse or complications arising. But these advantages only became apparent after one to two years of treatment, and only in men with very large prostate glands.
The disadvantage: Ejaculation problems and erection problems are more likely in people who use this combination than in people who only use alpha blockers.
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Current Therapies For Bph
At present, the primary goals of BPH treatment are to ameliorate LUTS, improve QOL, inhibit disease progression, and reduce complications. The treatment of BPH involves three different stages: watchful waiting, drug therapy, and surgical treatment . Watchful waiting is recommended by the AUA for patients in whom QOL has not been influenced by mild LUTS this strategy includes the implementation of dietary changes, exercise, education, and regular review . However, for patients with severe LUTS, watchful waiting is often ineffective and may delay optimal treatment such patients need to be administered appropriate medication. A range of drugs are currently available for the treatment of BPH, including 1-blockers, 5-ARIs, MRAs, PDE5Is, 3-adrenoceptor agonists, and plant extracts. Of these, the most commonly used drugs are 1-blockers, 5-ARIs, and a combination treatment featuring both 1-blockers and 5-ARIs .
How To Take Tamsulosin
- Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about tamsulosin and will provide you with a full list of the side-effects which you may experience from taking it.
- Take tamsulosin exactly as your doctor or pharmacist tells you to. Swallow each dose with a drink of water – do not crush, break, or chew the tablets/capsules.
- Your first dose of tamsulosin may make you feel dizzy or faint, so it is important that you take it just before you go to bed. If you feel dizzy or weary, or if you start sweating, remain lying down until these symptoms have completely gone.
- Take one tablet/capsule every day. After the first dose, you can take your dose at a time of day that best suits you. Although you can take tamsulosin either before or after a meal, the usual advice is to take your doses after the same meal of the day each day.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses at the same time to make up for a missed dose.
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Supplements Vs Other Treatment
As we have mentioned here several times, BPH is becoming increasingly common.
Typical treatment would generally include the use of a1-adrenergic receptor antagonists and 5a-reductase inhibitors. Studies show these drugs are helpful for Benign Prostatic Hyperplasia.
However, the side effects associated with their use are leading patients and practitioners alike to turn elsewhere for solutions. Surgery is relatively common in the management of prostate health as well.
This is invasive, costly, and risky as well, and therefore, it should not be a routine treatment method.
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How Bph Is Treated
A number of medications can relieve symptoms of BPH. However, these medications may cause sexual side effects, such as ejaculation problems and erectile dysfunction.
Other nonsurgical therapies include transurethral microwave thermotherapy and water-induced thermotherapy. Both use heat to destroy prostate tissue and reduce or resolve urinary symptoms.
If medications and/or thermotherapies are unsuccessful, surgery may be recommended.
Excess prostate tissue often can be surgically removed using a transurethral approach, which does not require an outside incision.
A more traditional, open surgery, which does require an incision, may be necessary if the prostate gland is very large or when the bladder has been damaged and needs to be repaired.
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The Issue With Supplements
Dietary supplements go through fewer regulatory hurdles than drugs. Drugs must undergo clinical trials to demonstrate to the FDA that they are safe and effective.
The FDA can then approve the new drug, so it can be marketed and sold in the US. However, safety issues are detected with a third of medicines after market approval.
Dietary supplements are considered safe until proven otherwise. Manufacturers are not obligated to conduct clinical trials to prove the efficacy and safety before entering the market.
Brands are free to make a number of health claims related to addressing nutrient deficiencies, supporting general health or supporting a particular body function .
The manufacturers need to follow the claim with the following message: This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Popular Prostate Drug Linked To Serious Side Effects
- Boston University Medical Center
- Treatment of benign prostatic hyperplasia with the commonly prescribed Avodart may put men at an increased risk for diabetes, elevated cholesterol levels, non-alcoholic fatty liver disease and worsening erectile dysfunction, new research concludes.
Treatment of benign prostatic hyperplasia with the commonly prescribed Avodart may put men at an increased risk for diabetes, elevated cholesterol levels, non-alcoholic fatty liver disease and worsening erectile dysfunction.
Physicians should be fully aware of these new findings according to the researchers, and to discuss with their patients the potential adverse side effects of Avodart on metabolic and sexual function before prescribing it. The study appears in the journal Hormones Molecular Biology and Clinical Investigations.
As men age, their prostate enlarges. This condition often results in urinary retention or other lower urinary tract symptoms, such as reduced urinary flow which results in waking up several times at night to urinate. To help improve symptoms, men are often prescribed an alpha blocker, such as Tamsulosin which relaxes the prostate smooth muscle and improves urination or other drugs such as Proscar or Avodart which work by reducing prostate volume thus, improving urinary function.
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Tamsulosin Side Effects In Elderly People
In the last few years, there has been some controversy about whether tamsulosin increases the risk of dementia in the elderly.
A 2018 study published in the journal Pharmacoepidemiology and Drug Safety examined Medicare data about men taking tamsulosin over a period of six years . The researchers found those men had a significantly higher risk of developing dementia than men who didnt take the drug .
However, a 2019 study published in the Journal of Urology pointed out several limitations with the Duan, et al. study. Using records from the National Health Insurance Database, South Korean researchers looked for a connection between -blocker use and dementia in the adult Korean population with BPH between 2011 and 2017they didnt find one. The authors concluded that benign prostatic hyperplasia medication is not associated with a risk of dementia . It does not seem that tamsulosin definitively increases the risk of dementia in the elderly, but more research is needed.
What Are The Side Effects
The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .
Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.
Also Check: What Causes Your Prostate To Enlarge
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What Is Flomax What Is Viagra
Flomax is an oral drug prescribed to treat men who are having difficulty urinating because of an enlarged prostate gland due to benign prostatic hyperplasia . Difficulty urinating is caused only in part by the enlarged prostate. The other cause of the difficulty is the muscle cells tightening around the bladder outlet. Flomax helps the muscles relax, which results in a decrease in obstruction to the flow of urine.
Viagra is used for treating impotence . It is in a class of drugs called phosphodiesterase inhibitors that also includes tadalafil , vardenafil , and avanafil . It works by increasing blood flow to the penis, enabling a man to get and keep an erection.
Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesnt do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications arent developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
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Which Enlarged Prostate Treatment Is Best For You
Drugs for enlarged prostate can help manage BPH symptoms but also have several potential side effects as noted above. A minimally invasive procedure such as Rezm Water Vapor Therapy can be a potential treatment option for those who may be tired of medications, frustrated with side effects of medications and are looking for more durable relief. Rezm Therapy is an in-office procedure for men 50 years or older that treats the cause of BPH. It uses the natural energy stored in water vapor to remove the excess prostate tissue bearing down on the urethra. A recent five-year clinical study showed that Rezm Therapy successfully reduces prostate volume and significantly relieves BPH symptoms while preserving sexual function out to five years.13Hear more from Rezm Therapy patients.
Most patients report relatively minor discomfort during the procedure. *Potential risks associated with Rezm Water Vapor Therapy include but are not limited to painful or frequent urination, blood in the urine or semen, decrease in ejaculatory volume, urinary tract infection , inability to urinate or completely empty the bladder, and urgent need to urinate. A complete list of risk information can be found here. During healing, symptoms may continue or worsen. Most men require a catheter for several days post-procedure.13,14
Its important to speak with a doctor to understand all BPH treatment options available to you, including their benefits and side effects. Find a doctor near you.
Proscar Side Effects List For Healthcare Professionals
Clinical Trials Experience
Proscar is generally well tolerated adverse reactions usually have been mild and transient.
4-Year Placebo-Controlled Study
- In PLESS, 1524 patients treated with Proscar and 1516 patients treated with placebo were evaluated for safety over a period of 4 years.
- The most frequently reported adverse reactions were related to sexual function. 3.7% treated with Proscar and 2.1% treated with placebo discontinued therapy as a result of adverse reactions related to sexual function, which are the most frequently reported adverse reactions.
- Table 1 presents the only clinical adverse reactions considered possibly, probably or definitely drug related by the investigator, for which the incidence on Proscar was â¥1% and greater than placebo over the 4 years of the study.
- In years 2-4 of the study, there was no significant difference between treatment groups in the incidences of impotence, decreased libido and ejaculation disorder.
Table 1: Drug-Related Adverse Experiences
|N = 1524 and 1516, finasteride vs placebo, respectively*Combined Years 2-4
Phase III Studies And 5-Year Open Extensions
- The adverse experience profile in the 1-year, placebo-controlled, Phase III studies, the 5-year open extensions, and PLESS were similar.
Medical Therapy Of Prostatic Symptoms Study
High-Grade Prostate Cancer
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How To Cope With Side Effects
What to do about:
- feeling dizzy if tamsulosin makes you feel dizzy, stop what you’re doing, and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you’re feeling dizzy. Do not drink alcohol as it will make you feel worse. Talk to a doctor if these side effects last more than a few days.
- problems when men ejaculate if the amount you ejaculate is less than usual or you have no semen at all, you do not need to worry as this side effect is harmless. Talk to a doctor if it bothers you or does not get any better.
Table 3 Lifestyle Changes That May Relieve Mild Symptoms Of Prostate Enlargement
|These measures can be helpful:
Urinate when you first feel the urge dont wait.
Do not rush urination. Take your time and relax before, during, and after to give your bladder extra time to empty if the stream is slow or intermittent.
Practice double-voiding: Urinate as much as possible, relax for a moment, and then go again.
Urinate before car trips, meetings, or movies.
Spread fluid intake throughout the day and reduce it before bedtime, especially coffee, tea, or caffeinated beverages. Do not avoid fluid intake to reduce the need to urinate. That can cause dehydration.
Drink alcohol and caffeine in moderation.
Avoid antihistamines and decongestants when possible.
If you take a diuretic , ask your doctor if you can take a lower dose or a different drug.
If you have diabetes, controlling blood sugar can reduce frequent urination.
|Theres no clear evidence these work:
Herbal supplements such as saw palmetto, Pygeum africanum, rye-pollen grass, and beta-sitosterol.
If youre taking diuretic drugs, you should ask your doctor whether the dose can be reduced or if you can take a different medication, since doing either could potentially improve your symptoms. Men with diabetes should work with their doctor to make sure their blood sugar levels are kept in control because if they arent, it can lead to increased urination.
Surgery and other procedures
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A Canadian Study Of Alpha Blockers:
A study published in the BMJ analyzed data from older men living in Ontario, Canada who were prescribed tamsulosin, alfuzosin or silodosin between 2003 and 2013. Nearly 150,000 men received one of these drugs to ease symptoms of prostate enlargement and difficult urination . These men were matched with an equal number of guys who did not take such medications. The authors found that:
Prostate-specific alpha antagonists , which are commonly used to treat lower urinary tract symptoms among older men, are associated with a small but significant increase in the risk of hospitalization or emergency room assessment for a fall, and an increase in the risk of fracture by 16% and of head trauma by 15% during the first 90 days of use.
Needless to say, falls, fractures and head trauma are serious complications, even if they occur relatively rarely. The Canadian researchers point out that older people have a 50% mortality rate within one year if they experience a fall that leads to hospitalization. A head injury can lead to cognitive decline. Any drug that increases the risk of dizziness, falls and fractures needs to be monitored very closely.