Prostate Information

ON THIS PAGE:

PSA Info

Blood in Fluid ...

Surgery

Nerve Sparing Surgery

Laser & Microwave

Retrograde Ejaculation

Diabetes, Dysfunction, Devices...

Natural Treatments & Devices

Nutrients

Prostate Massage

Kegel Exercises


[www.drlera.com/prostate_enlargement.htm ]

CHANGES TO MAKE FOR AN ENLARGED PROSTATE:

- drink 6-8 glasses (1 gallon) of steam distilled water a day- diet and nutrition are important for both healing and prevention

- eat lots of raw fruits and vegetables - juice is good (make your own with a juice machine)- whole grains are good to eat, raw nuts, and brown rice

- do not drink coffee, soda pop, other junk food drinks- do not eat processed foods white sugar, white flour, etc...

- eat less dairy products like milk and related products- use stress relief like going for walks with someone you like -or- listen to calming music

- control anger ... it can be a BIG problem and maybe even a root cause of cancer - do not smoke and avoid second hand smoke- onions and garlic are great anti-oxidants

- the lycopenes in tomatoes are good to eat - fasting a few days a month can be helpful
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[www.pathlights.com/nr_encyclopedia/05gast06.htm ]
Make sure you obtain foods high in potassium. This includes rice, bananas, blackstrap molasses, wheat bran, almonds, seeds, kelp and dulse, brewer's yeast, prunes, and raisins.

Drink lots of water; and, if at all possible, drink only pure water. Drink a little every hour.
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BPH

BPH is considered to be physiologically normal in men over 40 in the West. One theory is that it is due to constant sexual arousal without coming to a satisfactory resolution.

[http://www.lef.org/protocols/prtcls-txt/t-prtcl-095.html]

Impact of Dihydrotestosterone (DHT) on Prostate Growth

One cause of prostate enlargement is overproduction of a hormone metabolite called DHT, which is considered a prime culprit in the development of BPH and possibly prostate cancer. The stimulating nature of DHT in the development of prostate disease is well documented because castration before age 40 prevents prostate enlargement and prostate cancer. Additionally, castration is a proven therapy to reverse both benign and malignant prostate disease. These findings suggest that strategies to reduce DHT levels would prevent many forms of prostate disease.

Evidence that DHT is a cause of prostate disease comes from observations as early as 1979: Men with low blood levels of DHT maintained a small prostate compared with men with average DHT levels who experienced enlarged prostates (Bartsch et al. 1979).

Testosterone is converted into DHT by the enzyme 5-alpha reductase, which increases as men grow older, causing elevated DHT production, decreased serum testosterone, and the enlargement of the prostate gland. When the action of 5-alpha reductase is blocked, dramatic reductions in DHT levels occur. The reduction in DHT production via the inhibition of 5-alpha reductase produces a normalization of prostate volume and improvements in urinary and sexual function in some men suffering from benign prostatic hypertrophy.

[http://www.umm.edu/prostate/bph.htm ]

A higher risk for BPH has been found in association with a diet high in zinc, butter, and margarine, while individuals who eat lots of fruits are thought to have a lower risk for BPH.

Residual urine: BPH prevents the bladder from emptying fully. Normally, about 50 mL or less of urine is left; more than 200 mL is a definite sign of abnormalities.

[Urine retention: Causes] Damage to the tiny blood vessels in the kidney often happens if the bladder becomes too full and urine backs up into the kidneys, causing extra pressure.

Back Pain -- Pain in the lower region of the back is a frequent symptom of BPH & Prostatitis. Pain in this area is a consequence of the fact that blood vessels from the prostate drain into the lower back region.

Treatments may include:

  • Insertion of a catheter or hollow tube ( a "stent") to empty the bladder at regular intervals. A stent may be put into the area in your urethra that has been squeezed tight by the prostate. A stent is a short, screen-like tube that is put into the urethra to hold it open.

  • Prophylactic (preventive) antibiotic therapy (to reduce the incidence of infection)

  • placement of an artificial sphincter - a procedure that involves placing an artificial cuff around the neck of the bladder that can be inflated to prevent urinary incontinence and deflated when it is time to empty the bladder. You will still require intermittent catheterization to completely empty the bladder.

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Prostatitis:

There is a low-grade ache rectally. Inflammation of the prostate without infection, leading to enlargement, difficulty starting and finishing urination, chills and fever. Exacerbated by stress, nicotine, alcohol, lack of exercise, excessive sex, tooth abscesses and sometimes secondary to STDs and other infections.


[PSA Test Info]

[PSA Affected By:]
http://my.webmd.com/content/article/65/72746.htm?z=1738_00000_0000_ep_04
ejaculation within two days of having a PSA test may result in artificially high levels suggesting a "false positive."

A new study suggests another course of action: Another PSA test done more than a month later. That's because PSA levels can fluctuate up and down -- so a man with a high PSA level may not actually have any prostate problems at all. In fact, after studying nearly 1,000 men, researchers found that about half of those whose PSA levels were initially high had a normal result in a subsequent test.
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Prostate psa, etc.

[http://www.furl.net/forward.jsp?id=940538 ]

When you are getting ready to take a PSA let me recommend that you avoid any caffeine , alcohol or spicy foods for a couple days prior to taking the PSA. Take the PSA the first thing in the morning before you eat.

It seems that anything that one does that is involved in this area may increase the PSA. Things such as ejaculation, bike riding, weight lifting, prostate massage, urinary retention, race, certain medications, certain herbal supplements, may have an effect.

Daily Changes: It seems that the PSA when taken on a daily basis may change as much as 30% from one day to another (from 4 to 5.2 for example or 2.8). I also believe it may change within a day by the same amount. For example we had one man who decided to run a test for 30 days. He tried to make everything equal, test at the same time at the same lab, etc. He found: He had a high of 6.0 and a low of 4.5 (and actually over just 3 days). That would be an increase over the low of 33%.

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Estrogen can artificially lower PSA levels, making PSA tests unreliable in those who are taking hormones.

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[www.press.bayer.com/news/news.nsf/id/A2E584FA935BFF11C1256E440057A806 (Germany) ]

Bicycling can lead to elevated PSA expression in blood, falsifying the test results and unnecessarily disconcerting both patient and physician. It can also be caused by mechanical stress such cycling, sexual intercourse or digital rectal examination by the urologist.

Two-thirds of men with an elevated PSA level do not have prostate cancer

[http://www.afud.org/conditions/psa.asp ]
What Causes PSA to Rise? The level of PSA in the bloodstream may be elevated by an process that leads to an increase in the number of cells making PSA or to a breakdown of the normal barriers in the prostate that prevent much PSA from getting into the bloodstream. The most common condition leading to a high PSA is benign (noncancerous) enlargement of the prostate, called benign prostatic hyperplasia (BPH). BPH is very common in men over the age of 50 and may lead to difficulty with urination. Infection or inflammation in the prostate, called prostatitis, may also cause elevation of PSA by damaging the PSA barrier in the prostate. In addition, some diagnostic tests, such as a needle biopsy of the prostate, may increase PSA levels for several weeks. It does not appear that a routine digital rectal examination (DRE) of the prostate by the doctor's finger causes an elevation of the PSA.

Both BPH and prostate cancer are common in men over the age of 50. In addition, there is a lot of overlap in blood PSA levels between men with BPH and those with early prostate cancer. These factors limit the usefulness of PSA as a tool for detecting curable prostate cancer. Many patients who have a PSA level higher than 4 ng/ml will eventually be found not to have prostate cancer. These men have a "false-positive" test. If PSA is tested on men with BPH but no prostate cancer, as many as one-third to one-half of such men will have an elevated PSA. Their PSA results, however, are generally in the 4 to 10 ng/ml range.

PSA and DRE help to find men at higher risk for prostate cancer -- men on whom a biopsy may be indicated. Only with a biopsy can the diagnosis be made.
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So if you got an elevated PSA test result how would you then determine why it was elevated?

We then look at factors such as how the prostate feels, the age of the person, and whether there are any symptoms. Ultimately, we confirm our findings with a biopsy of the prostate, which is done using ultrasound imaging. Using a probe, we target certain areas in the prostate and press a button and a needle comes alongside the ultrasound probe directly into the prostate. It's spring loaded so it goes in and out and we retrieve a small piece of the prostate. We repeat that several times in several areas to ensure we have good representation of the prostate.
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"Gleason (3+3)" , PSA 4.6... I have wavered back and forth between radiation and surgery...permanent seed implant, that being the less invasive... brachytherapy (SI)... [Brachytherapy is an advanced cancer treatment. Radioactive seeds or sources are placed in or near the tumor itself, giving a high radiation dose to the tumor while reducing the radiation exposure in the surrounding healthy tissues. The term "brachy" is Greek for short distance, and brachytherapy is radiation therapy given at a short distance: localized, precise, and high-tech.]
implanted 83 palladium seeds into my prostate. ...
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[ http://www.healthscout.com/news/197/515823/main.html ]

A cellular protein called PCa-24 has been identified as a unique marker for prostate cancer. By Dr. Brian Liu, at Brigham and Women's Hospital . He and his colleagues used proteomics -- the study of all proteins produced by a cell -- to identify PCa-24 , which is unique to prostate cancer cells and is a smaller protein than prostate specific antigen (PSA).

[ http://battellemedia.com/tonic/archives/2003_11.html ]

I recently heard a doctor on NPR say that the biopsy process is akin to "looking for an olive in a grapefruit, blind" - in other words, ouch. This new discovery promises to ease the minds of those with raised PSA levels, but who in fact do not have cancer [Refers to above paragraph on PCa-24].
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[Androgen & PSA - Segments]

After androgen deprivation: When androgen deprivation is commenced PSA declines significantly and often to undetectable levels. This is because the vast majority of PSA producing cells are hormone sensitive . The minority of androgen insensitive cells continue to proliferate and eventually PSA is detectable again. At the first sign of an increase it tells the urologist that a change in hormonal therapy may be needed or that other adjuvant therapies might now be used. The rate of progression of PSA may also be an indicator of life expectancy and risk of distant disease.
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...Finasteride therapy (an enzyme inhibitor) that lowers androgen levels, thus reducing size of the prostate ;...

[ http://www.drmirkin.com/men/M155.htm ] Any manipulation of the prostate raises blood PSA levels (1). PSA levels can be raised for several hours just by having your prostate checked by a physician (2,3), so PSA blood tests should be drawn before the doctor examines the prostate (4). Having a climax raises PSA for up to 48 hours (5,6,7,8,9,10,11,12). Infections raise PSA and there is no way to tell the difference between a PSA raised by cancer or by infection (13).

PSA levels can be raised abnormally high by prostate infections, a benign enlarged prostate, making love and having a doctor check the prostate.

Prostate Specific Antigen is made by prostate cells and is released into the bloodstream. Large prostates have more PSA, so a rise in PSA means that the gland is enlarging rapidly, which can be a sign of cancer or is irritated by infection.

Exciting new research shows that PSA can be classified into two different fractions called free and bound PSA. Free PSA is made by a normal prostate, while bound PSA is made primarily by prostate cancer cells.

The usual rule is that if a man's PSA is above 4 (normal 0-4), the free PSA should be at least 18% of the total PSA. This rule usually holds for every situation except infection. The ratio of free PSA to bound PSA is the same for prostate cancer and infections. Exercise has no effect on PSA (15). If you have an elevated PSA blood test, your doctor will check your prostate and order a sonogram to see if you have a nodule that may be a sign of cancer. Most urologists recommend a biopsy done in their offices. If your PSA is low, you may have difficulty ejaculating and fathering a child. A normal ejaculate clots and traps sperm. PSA liquifies the clot and allows the sperm to swim toward the egg (16). PSA also causes the muscles of ejaculation to contract(17).
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Blood in Fluid

• Hematospermia (or hemospermia) is due to a tear in one of the fragile veins of the prostate gland.

[Spots][http://www.medhelp.org/forums/urology/archive/3179.html ]

It is most commonly caused by nonspecific inflammation of the urethra, prostate, and/or seminal vesicles. Most cases of hematospermia almost always resolve on their own, usually within several weeks. Hematospermia may be associated with infection, but is rarely secondary to malignancy.

Patients that have persistent hematospermia more than three weeks should undergo further urologic evaluation. The physical exam should include a genital rectal exam, PSA, urine cytology and a blood pressure. Also, cystoscopy and transrectal ultrasound to look for stones and cysts.

Hypertension can be associated with hematospermia.

[www.menshealth.co.uk/talk/thread.phtml/thread110349/?PHPSESSID=37a207b012e62b5961b2efb169 2aab62]

Brown spots in semen • by Brian, Mon 2 Sep 2002 at 11:09am
OK, I have had samples of semen taken and also blood tested for prostate problems. Im now told that it is nothing to worry about as this is normal. The blood sample showed that my prostate is fine. After asking why this blood appears in my semen, the doctor said it was possible that I might have strained myself whilst lifting heavy objects and this was just the end result. As of now I have noticed that there is hardly any staining in my semen.

My Dr. said to masturbate once or twice weekly, which really isn't a cure. I've had tests (blood and culture) and they both came back negative.

One final question: If what I have had is "Normal" how many other people have experienced this??
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• It could have been small blood vessels bursting in the seminal vesicles and the blood then exits anytime the person ejaculates.

We almost never discover the cause of blood in the semen. I think it is most probably due to irritation from concretions (stones) in the ejaculatory duct or seminal vesicle.

• If symptoms persist after adequate treatment, then attempts should be made to rule out prostate cancer.
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[www.prostatitis.org/blood.html ]

FOLLOWING PROSTATE DRAINAGE:

Blood in semen also occurs after beginning a series of prostate drainages. The pressure of the drainages, and the "popping" of clogged acini, can result in some temporary bleeding as tiny blood vessels are ruptured. This is worth noting, but not cause for alarm.

[Response to above;] By the way, have you felt an almost relief of pressure or pain or freer urination after the drainage of a tablespoonful of EPS? [EPS=fluid emitted from prostate massage]
I would not worry about it unless the blood does not clear up in a few days.

I have had 2 Cystoscopys, each followed by a Biopsy. These tests, along with Ultrasound tests have not found any sign of cancer. My PSA remains constant at about 5.7, I assume because of the infection.

(Comment by a urologist on the newsgroup sci.med.prostate.prostatitis on 1/3/98): What this sounds like is not necessarily prostatitis, but is hemospermia-- defined as the presence of blood in the ejaculate. Hemospermia is an almost always benign self-limiting condition that differs from prostatitis in that it has usually no lower urinary tract symptoms, sexual disturbances, or pain. It usually goes away, but if it persists should be worked up to rule out prostate cancer (DRE and PSA) and possibly a TRUS to r/o a cystic abnormality or the like. Drug use should be examined to rule out something that may cause a bleeding phenomenon, and bleeding/clotting parameters should be examined. Again, if blood in the ejaculate is the only symptom, I don't think that you can be said to have prostatitis--I hope this helps.
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SURGERY


Names: Prostatectomy / Surgery / Radical Prostatectomy

Radical prostatectomy is the surgical removal of the entire prostate gland along with the seminal vesicles (the vessels that carry semen) and surrounding tissue. The incision can be made in one of the following regions:

  • Retropubicly (through the abdomen and under the pubic bone, exposing the entire surface of the prostate).

  • Through the perineum (the skin between the scrotum and the anus).

The gland and other structures are then removed. The operation lasts two to four hours. Advanced surgical techniques called minilaparotomy and laparoscopy are being developed for radical prostatectomy. These techniques use smaller incisions, are less invasive, and may cause fewer complications.

Nerve-Sparing Techniques

Surgical procedures have been refined over the years, and many operations for localized low-grade prostate cancer now spare the nerves that control erection.
  • A bilateral nerve-sparing procedure saves the nerves on both sides of the sex organs.

  • A unilateral procedure saves nerves on only one side.

Nerve-sparing techniques can improve quality of life. The ability for sexual intercourse recovers in about a third of patients at three years and nearly 60% at five years after surgery. (Rates vary depending on certain factors, such as the patients age -- the younger the better.) In cases where the tumor is bulky and undifferentiated, nerve-sparing techniques may not be appropriate.

Complications from Radical Prostatectomy:
Complications include the usual risks of any surgery, such as blood clots, heart problems, infection, and bleeding. Complications specific to radical prostatectomy, incontinence, impotence, and contracture of the bladder neck, are discussed below. The mortality rate is very low, about 0.4%.

Urinary incontinence is a common complication and a more distressing side effect of surgery for most men than sexual dysfunction. When the urinary catheter is first removed following surgery, nearly all patients lack control of urinary function and will leak urine for at least a few days and sometimes for months. Major medical centers report that continence returns within about 18 months for nearly all men younger than 70 and in the great majority of men older than 70.

Nerve-sparing techniques can help prevent incontinence, although even in experienced centers, 8% of patients will have some postoperative incontinence, and this rate is much higher (up to 50%) in many community medical centers.

A procedure called endopelvic anterior urethral stitch (EAUS) used with prostatectomy appears to reduce urinary incontinence. The procedure requires a simple stitch at the front of the urethra.

[From: adam.about.com/reports/000033_10.htm ]

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[TURP & TUIP - Surgery]
[www.cornellurology.com/uro/cornell/bph/treatments/surgical.shtml ]

Standard surgical options include: transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and open prostatectomy.

TURP, the gold standard of effective treatment for BPH, involves removal of the core of the prostate using an instrument passed through the urethra. High frequency current flowing through a wire loop allows removal of "chips" of prostatic tissue and coagulation of blood vessels. The prostate tissue is removed through the cystoscope used to visually guide and monitor this process. Patients require a urethral catheter for 2 days and usually stay in the hospital for 2 days. Most patients (80% to 90%) experience dramatic improvement in their symptoms and urinary flow rates after TURP. Possible side effects include bleeding requiring transfusion, salt imbalances from fluid absorption, impotence (less than 5%) and incontinence (1% to 2%).

TUIP similar to TURP . Instead of removing prostatic tissue, an electrical knife is used to make small cuts in the prostate. This relieves pressure on the urethra and generally results in decreased symptoms and increased flow rates. TUIP is generally used in smaller prostates.

Open prostatectomy is performed for those patients with very large prostates (greater than 80 grams) in whom transurethral surgery would be difficult to perform safely. In this procedure, an incision is made from the navel to the pubic bone. The bladder is opened; and prostatic tissue is removed through the bladder. A urethral catheter remains for approximately 7 days and patients stay in the hospital 5-7 days. It is a more invasive procedure and complications include bleeding and infection.
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[http://www.prostate-research.org.uk/faqs/faqbph.htm ]

Both microwave and laser treatment appear to be safe and they probably have less effect on ejaculation than TURP. In terms of how well they work, results with these techniques are improving as the technology develops, but heat-based treatments such as these still do not produce the rapid and reliable results achieved with TURP.

What can go wrong if I opt for a TURP? Although this procedure is largely safe and effective, complications can occasionally occur. The main problem is bleeding, either at the time of the surgery or afterwards. It can usually be dealt with by washing out the area with relatively large volumes of liquid. In the longer term, incontinence after a TURP does affect a proportion of men, as does scarring (stricture) of the urethra, which may need further surgery to remedy.

What are the chances that I'll need a second operation? Because the prostate continues to grow after a TURP, a proportion of men will need a second operation eventually. One man in ten undergoing TURP will need a second operation sometime during the following 5 years.
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Nerve Sparing Surgery -


About half of all men in the United States who have prostatectomies opt for a relatively new technique called nerve-sparing surgery, which saves the nerves that control a man's ability to have an erection.

If you want to have this surgery, make sure that your surgeon is skilled and experienced in the procedure. Ask him how many times he has done this operation (the answer should be at least 150), and ask him for his patients' statistics on incontinence and impotence.

Talk to your doctor to determine if you are a good candidate for this surgery. Without it, the risk of becoming impotent after a standard prostatectomy is very high.

A nerve-sparing prostatectomy saves the bundles of nerves, one on each side of the prostate gland, that allow you to get and keep an erection. If your surgeon is able to save the nerve bundles on both sides, your chances of regaining sexual potency are between 40 and 85 percent. If only one side of the nerve bundles can be saved, then the likelihood of regaining sexual potency is 25 to 45 percent.

If you are not a good candidate for this procedure, talk to your doctor about the possibility of doing a nerve-graft procedure. In this procedure, the surgeon will take a nerve from the ankle area and graft it in place of the nerve bundles. It must be done at the same time as the prostatectomy, and, if the procedure works, men usually see an improvement in potency within a year or two. Our surgeons are leaders in the Northwest in this procedure.

From: www.seattlecca.org/patientsandfamilies/adultCare/clinicalProgs/prostate/TreatmentOptions/Nervespa ring.htm

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Alternatives To Surgery

Green Laser (PVP)

MASS GENERAL Page On Green Laser PVP (& Appt. Info: 617-726-3574 )

GREEN LASER Company FAQ Page - www.laserscope.com

PRACTITIONERS OF GREEN LASER


MGH Urology Dept.list of Urologists & Appointment Info (Different from list below).

1. Shahin Tabatabaei, M.D. Massachussetts General Hospital 15 Parkman Street Boston, MA 02114 US Phone: (617) 726-3574 Distance: 6.12 miles from the center

2. Gennaro A. Carpinito, M.D. 860 Washington Street, South Bldg, Mezz. Level Boston, MA 02111 US Phone: (617) 636-7956 Distance: 6.33 miles from the center

3. Paul S. Freedberg, M.D. Urology Associates of Essex North, Inc. 288 Groveland Street Haverhill, MA 01830 US Phone: (978) 372-7751 Website: http://www.haverhillurology.com Distance: 29.42 miles from the center

4. Kalpesh R. Patel, M.D. Urology Associates of Essex North, Inc. 288 Groveland Street Haverhill, MA 01830 US Phone: (978) 372-7751 Website: http://www.haverhillurology.com Distance: 29.42 miles from the center

5. Ralph P. Orlando, M.D. Urology Associates of Essex North, Inc. 288 Groveland Street Haverhill, MA 01830 US Phone: (978) 372-7751 Website: http://www.haverhillurology.com Distance: 29.42 miles from the center

6. Edward A. Chibaro, M.D. Urological Surgical Professional Association 44 Birch Street, Suite 303 Derry, NH 03038 US Phone: (603) 434-6380 Distance: 36.66 miles from the center

7. J. Keith Bleiler, M.D. Cape and Island Urology 19 Bramblebush Park Falmouth, MA 02540 US Phone: (508) 540-7555 Distance: 61.74 miles from the center


Trans Urethral Microwave Therapy (TUMT)
(Less Effective, see below)
MetroWest Urology
Photoselective vaporization of the prostate (PVP) is GreenLight PVP Laser to vaporize excess prostate tissue and seal the treated area. The procedure is performed on an outpatient basis and may be performed under local, spinal, or general anesthesia. PVP takes between 10 and 30 minutes to perform.

The type of laser used in PVP is delivered to the prostate through an endoscope (an optical tube) that is inserted into the urethra. The procedure prevents damage to surrounding tissue and minimizes side effects such as pain, blood in the urine (hematuria), and swelling.

Many patients do not require a catheter after PVP. Patients are advised to avoid strenuous exercise for 2 weeks and can usually resume regular activities the next day. PVP provides immediate and long-lasting results comparable with other minimally invasive procedures.



Indigo Laser


Interstitial laser coagulation is often performed under local anesthesia on an outpatient basis. The Indigo LaserOptic Treatment System uses a cystoscope through which a fiberoptic probe is directly introduced into the prostate. Heat energy is conducted through the probe for 3 minutes and quickly coagulates the obstructing prostate tissue. The process can be repeated to treat another area in the prostate , as determined by the physician. The procedure lasts approximately 30 to 60 minutes. Symptoms resolve over 6 to 12 weeks, as tissue is absorbed.

After the device is removed, a Foley catheter is inserted to drain urine for several days, until bladder function returns. Blood in the urine is a common side effect of the procedure and resolves within a week or so. Erectile dysfunction (impotence), retrograde ejaculation, and incontinence are rare complications.

Comparing "GREEN" With "INDIGO:"

Descriptions of different laser methods: www.seniorlivingstrategies.com/seniorResources/MensCorner.asp

COMMENTS:


Men receiving GreenLight PVP laser surgery usually see an immediate improvement in their symptoms and urine flow, whereas those treated by the Indigo laser coagulation method find the response is delayed.

A DISADVANTAGE: GreenLight PVP's laser frequency is optimized for blood and coagulation, which limits bleeding. However, this advantage may be the laser's disadvantage. The laser's coagulation effect may extend deeply in the prostate, increasing the chances for charring, sloughing and bleeding of the urethra in the weeks following the procedure.

[MESSAGEBOARD COMMENTS: groups-beta.google.com/group/sci.med.prostate.bph ]

My understanding of the difference between the PVP (Green Light ), and the Indigo Laser is that they use a different frequency. The PVP (green Light) vaporizes the tissue, and creates a channel for the urine to flow, the Indigo laser "coagulates" the tissue... My choice would be the PVP (green light) procedure.

... [I think] Green light is the one that does the best job because it only destroys red blood cells (which are in prostate) and does not destroy muscle or sphincter tissue so the chance of incontinance and impotence is basically zero

...If you register your concern over retrograde ejaculation with the surgeon before the operation , as I did, he can avoid the muscles you refer to at the bladder neck.

...The Urologist specialized in microwave and indigo laser. He said when it "came time for him" he would have the microwave. Shortly after that I found this group. After lurking plus doing Google searches I became convinced PVP using green light laser seemed the best approach. The results were immediate and rewarding...

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Microwave


TherMatrx [One of SEVERAL microwave methods] is a minimally invasive procedure performed in a urologist's office that uses heat delivered through a microwave antenna. This requires local anesthesia. A mild sedative or pain reliever may be given.

A urethral catheter containing the microwave antenna is passed through the urethra and prostate gland and is secured by a balloon at the tip of the catheter that passes through the uretheral sphincter. Localized microwave energy is delivered at a temperature high enough to relieve BPH symptoms, including difficult, frequent, or urgent urination. The procedure lasts approximately 1 hour.

Following the procedure, a catheter is inserted to drain urine from the bladder for a few days. Once the catheter is removed, the patient can resume normal activity. Symptoms improve in 4 to 6 weeks. Healing takes 6 weeks to 3 months.

Possible complications include incontinence, pain during urination, and urinary retention. Most complications resolve during the healing period without intervention.

[ More from: www.urologychannel.com/prostate/bph/treatment_therm.shtml ]

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[Prostate: DOT Microwave thermotherapy]
[http://www.fda.gov/cdrh/safety/bph.html ]

FDA Public Health Notification: Serious Injuries from Microwave Thermotherapy for Benign Prostatic Hyperplasia

Since 1996, we have received reports of 16 thermal injuries related to microwave thermotherapy systems. Of these, 10 resulted in fistula* formation and 6 resulted in clinically significant tissue damage to the penis or urethra. These injuries may not be apparent at the time of treatment, and may take hours or days to develop.

When considering a patient for microwave thermotherapy for BPH, ensure that he meets the device's indications, including the criteria for eligible prostate size indicated for the specific system being used. Additionally, it is important to verify that the patient has not had prior radiation therapy to the pelvic area, as these patients are at increased risk of rectal fistula* formation . Furthermore, the labeling of each device lists specific patient populations for which safety and effectiveness of this therapy are unknown (e.g., those with prostate cancer).

*[A fistula is an abnormal tunnel connecting two body cavities (such as the rectum and the vagina) or a body cavity to the skin (like the rectum to the outside of the body.)

We have identified several factors that may have contributed to the injuries noted:

Failure to pause treatment when the patient is communicating serious pain; Oversedation of the patient, which compromises his ability to communicate pain; Treatment of patients who have undergone prior radiation therapy to the pelvic area; Treatment of patients whose prostate sizes are outside the ranges specified in the labeling; and Leakage from the balloons used to retain either the urethral catheter or the rectal temperature sensor in the correct anatomical position.

When discussing the procedure with the patient, it is important to ensure that he understands the risks and benefits listed in the labeling of the specific device. He should also understand the duration of the procedure, the level of pain or discomfort that should be considered normal, the importance of telling the physician of any unusual pain during treatment, how to operate any emergency stop button, and the need to remain as still as possible during treatment.

Either patient movement or component breakage may cause migration of a properly placed urethral catheter or rectal temperature sensor.

Manually pause treatment if the patient complains of excessive pain or anything unusual occurs.


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[http://bphforpcp.com/treatment/microwave.shtml ]

TherMatrx DOT™ (Dose-optimized Thermotherapy) TherMatrx DOT™ delivers microwave energy through a flexible catheter that contains a patented microwave antenna. This treatment targets periurethral [periurethral: Surrounding the urethra. (That took 10 minutes... - rj)] prostate tissue, without affecting tissues of the ejaculatory ducts or the rectum. TherMatrx DOT™ uses a series of multiple feedback loops to constantly monitor the procedure and identify and utilize the optimal dose of microwave energy to treat BPH. It delivers the correct dose to precisely the right tissue, maximizing safety, minimizing discomfort, and providing durable results.

Patients who undergo TherMatrx DOT™ may receive mild oral medication before the procedure. Treatment takes 90 minutes to 2 hours to perform. Patients may experience slight discomfort, a warm feeling in the groin, and the urge to urinate during treatment.

Side effects are mild, self-resolving, and occur at a lower incidence than with other microwave devices. Patients are able to go home right after treatment and require a catheter for 2–5 days. Normal activity can be resumed after 24 hours.

Relief of symptoms occurs gradually over 4–6 weeks and continues for about 6 months as prostatic tissue heals. One year after treatment, most patients are satisfied with the results of therapy.

[TherMatrx Info, from another source:]

[www.urologychannel.com/prostate/bph/treatment_therm.shtml]

Following the procedure, a catheter is inserted to drain urine from the bladder for a few days. Once the catheter is removed, the patient can resume normal activity. Symptoms improve in 4 to 6 weeks. Healing takes 6 weeks to 3 months.

Possible complications include incontinence, pain during urination, and urinary retention. Most complications resolve during the healing period without intervention.


------------------------------

TUMT - Trans Urethral Microwave Therapy


  • Several weeks may pass before improvement is noticed

  • Re-treatment is likely due to limited effectiveness of treatment

The Prostatron® [A Different Type, not the "TherMatrx DOT" type - may have some general info:] cooled thermotherapy system is available in three treatment protocols: Prostasoft 2.0, Prostasoft 2.5, and 30 Minute TUMT for obstructive BPH. Prostasoft 2.0 often is indicated for patients when drug therapy is ineffective. Prostasoft 2.5 and 30 Minute TUMT produce results similar to transurethral resection of the prostate (TURP), without the serious risks.

Before treatment, patients are given an enema to improve the accuracy of the RTU (rectal thermosensing unit). During treatment, the MDS (microwave delivery system )is inserted into the prostate through the urethra and the RTU is inserted into the rectum. Microwave energy is then calibrated and cooled water is circulated through the MDS. When the MDS temperature is 35° C (95 F), microwave energy is delivered to the prostate.

Treatment lasts from 30–60 minutes, during which time, a urethral temperature of 40° C (104 F) is maintained. When the targeted prostatic tissue is sufficiently heated, treatment is ended and coolant is circulated for 5 minutes to reduce the risk for damage to the prostatic urethra.

Following treatment, most patients require catheterization for 2–4 days due to urethral swelling. Anti-inflammatory medication and antibiotics may be prescribed.

After treatment, destroyed prostatic tissue is discharged in the urine or reabsorbed by the body. Catheterization usually is necessary to prevent urinary retention.

Complications include mild-to-moderate frequency, urgency, and straining. These usually resolve without intervention within a few weeks. Most patients can resume normal activity immediately after treatment.

[Prostate Enlargement & Prolonged Sexual Phenomena]

[http://www.naturalways.com/prostacare.htm ]

A sedentary lifestyle and a diet rich in red meat, coffee and alcohol are known to precipitate BPH. Prolonged sexual activity without climax and nutritional deficiencies in zinc, essential fatty acids, fruit and vegetables may also contribute.

[http://www.morganstern.com/prostateintro.html ]

Prostate congestion occurs when excess prostate fluid builds up within the gland. One job of the prostate is to constantly produce prostate fluid. Unless its buildup is relieved by sexual intercourse, nocturnal emission, or masturbation, pressure continues to increase within the gland. Prostate irritation, a logical consequence, can be quite painful.

Prostate congestion can occur anytime after puberty and is related to your pattern of sexual activity. Men who experience long periods of sexual abstinence or who indulge in prolonged sexual foreplay without consummation are most likely to have this problem. Paradoxically, occasional bouts of intense sex with repeated ejaculations can also trigger painful prostate irritation.

Prostate congestion can be relieved by appropriate life-style changes. Prostate massage by a urologist can also help relieve the condition.
-------------
[http://www.actionlove.com/cases/case11810.htm]

I am masturbating since I'm 14, and for the last about 5 years I do it every day, or sometimes more than that (in the beginning it was 2-3 times a week). About 5-6 years ago I started feeling that I cannot control my ejaculation (I didn't have a girlfriend that time), and I started having pains in my prostate. Also, sometimes after ejaculation I'm getting a feeling that my prostate is "bigger" than normal for a couple of hours (this is happening during the last 2-3 years). I had problems with erection, I was ashamed and scared. I went to a doctor and told him about this, and my pains. He said I had chronic prostatis, and I went throught a prostate massage course. My erection became much better, but still I was having problems with premature ejaculation.

[ANSWER:] Dr. Lin: 11/30/2003 Yes! Over-masturbation has depleted your cerebrospinal fluid, exhausted your testicular function and seminal production and alternated your seminal chemistry. As a result, your semen is very alkaline and contains a high-level of the harmful prostaglandin E-2 (PGE-2) but a low level of the relaxin and elastin PGE-1 (the cellular repair and healing hormone), and your prostate tissue also produces a lot of harmful PGE-2 but no PGE-1. As a result, your prostate has been chronically blasted the poor-quality ejaculation jet to induce more production of PGE-2 in the prostate tissue. PGE-2 causes inflammation, bleeding, pains and cramps and of course, gives premature ejaculation when your abraded prostate duct and nerve have been damaged even without having a chance to repair! PGE-1 in the prostate and penile tissue are responsible for damage repair/healing and for erecting your penis bigger and lasting longer. Don't blast your prostate by the direct prostate massage either.

You need ViaPal-hGH-J (3-015) and 5-HTP (2-001) to help you out. You must reduce your ejaculation frequency to no more than twice a week for healing.

If you want to heal faster, add Fish Oil 3000 mg and Borage Oil 3000 mg daily.
------------------------------
[General Info]
The prostate gland is surrounded by a thin layer of muscle that squeezes the secretion out during ejaculation. It is generally believed that regular "exercise" of the prostate is vital for health in that area of the body.
----------
[http://www.prostatitis.org/doityourself.html]

Couldn't I just ejaculate normally instead of having my prostate drained (by massage)?

No. Once the acini clog up, a normal ejaculation does not drain them. If it did we wouldn't all be suffering from prostatitis.
------------------------

Retrograde Ejaculation

[Note: Strengthening the "PC" muscles using Kegel exercises may have a direct effect on strengthening the muscles ability to deliver ejaculate and remit retrograde ejaculation.]
[http://www.healthandage.com/Home/gid6=6704 ]

Retrograde ejaculation occurs when the muscles of the urethra do not pump properly during orgasm and sperm are forced backward into the bladder instead of forward out of the urethra. Sperm quality is often impaired. The internal sphincter muscle surrounds the opening of the bladder. It closes tightly during ejaculation to stop sperm passing 'backwards' into the bladder. It also stops urine and semen leaving the body through the urethra at the same time. If this muscle doesn't contract, the ejaculate can pass back into the bladder, causing retrograde ejaculation.

Retrograde ejaculation can be the consequence of a number of conditions: Surgery to the bladder neck (the lower part of the bladder) or prostate is the most common cause of retrograde ejaculation. Diabetes. Multiple sclerosis. Back surgery. Spinal cord injury. A temporary side effect of certain drugs, such as tranquilizers, certain antipsychotics, or hypertension medications.
---------
[http://www.medhelp.org/forums/urology/messages/30274a.html]

How is Retrograde Ejaculation treated?

When Retrograde Ejaculation is caused by a condition such as diabetes or multiple sclerosis, a medication like Sudafed can cause the urethral sphincter to contract, forcing-out the ejaculate. Success rates as high as 40% have been achieved in clinical studies using drugs such as:

  • Sudafed
  • Phenylpropanolamine
  • or the antidepressant Imipramine
to treat retrograde ejaculation associated with diabetes...
----------
[Difference Between BPH and Prostatitis]
An Abstract from the May 1998 meeting of AUA reporting a study of men's visits to the doctor for prostatitis problems which shows that PAIN is the major complaint that differs from BPH.

Pain was slightly more common than voiding complaints, but much more common than sexual dysfunction among chronic prostatitis visits. Since 2 missing symptoms reflected sexual dysfunction and 1 voiding dysfunction, these categories may have been under-represented. Nevertheless, the most common reason for chronic prostatitis visits was painful urination, which was uncommon among BPH.
---------------

Diabetes & Sex

[Diabetes & retrograde]

Retrograde ejaculation also occurs in men with diabetes who have certain forms of neuropathy.

Sexual and urologic complications of diabetes are related to the nerve damage diabetes can cause.
More from www.webcare.md/Index538.aspx

Ejaculatory dysfunction is another problem men may experience. The most common abnormality is a decreased amount of semen, called retrograde ejaculation. This is caused by nerve dysfunction and occurs when the semen goes backward into the bladder instead of going forward. Retrograde ejaculation can cause fertility and sterility problems, so it's important to be diagnosed and treated as soon as possible. Retrograde ejaculation can sometimes be overcome by the use of appropriate medications.
--------------------
Normally, the muscle around the exit hole of the bladder closes tightly at orgasm to prevent this happening. If the muscle or its nerves are damaged, retrograde ejaculation may occur.
---------
[www.goaskalice.columbia.edu/2259.html ]

During ejaculation, the internal sphincter, a muscle located between the prostate and the bladder, closes tightly, preventing a man from ejaculating and urinating at the same time. If this muscle relaxes, it can force some of the ejaculate backwards into the bladder, rather than out of the urethral tip. This is called retrograde ejaculation. The next time a man with this condition urinates, the urine is noticeably cloudy because it has been mixed with ejaculate. Health care providers or urologists can confirm the diagnosis of retrograde ejaculation by testing a man's urine for the presence of sperm.

Retrograde ejaculation has many causes. Certain medications that treat hypertension and prostate conditions; genital surgery; or, diseases, such as diabetes, which can cause nerve impairment in and around the bladder, cause ejaculate to flow backward. Often, retrograde ejaculation is a first sexual side effect for men with diabetes, who are the most commonly affected group. It's important to get an accurate diagnosis by a health care provider or urologist. Depending upon the cause of retrograde ejaculation, treatments and outcomes vary. Medications are usually used first, often pseudoephedrine initially, or imipramine.

Men with retrograde ejaculation still produce sperm. Sperm can be medically retrieved from the first urine sample after ejaculation. This sperm can be used for artificial insemination.

Men feel no pain, and usually no sensation at all, from having retrograde ejaculation. Strange and unfamiliar, however, may come to mind when they notice their orgasm is not accompanied by a "burst" of semen. Since orgasm and ejaculation are two separate physiological processes, a man with retrograde ejaculation can still feel intense pleasure and contractions during orgasm.

Alice
==================================
[http://www.accu-chek.com/understanding/basics_sexuality.jsp]

Sexual Dysfunction And Neuropathy: Diabetes can lead to sexual problems for both men and women. These problems are often created by a complication known as neuropathy. Diabetic neuropathy is a nerve disorder caused by diabetes. Symptoms include numbness and sometimes pain in the hands, feet or legs. Neuropathy can also affect the nerves that control internal organs, genitals, small blood vessels and sweat glands of the skin, bladder muscles, and the gastrointestinal tract. These nerves are called autonomic nerves because they control parts of your body that you don't move voluntarily. Autonomic neuropathy is the type of nerve disorder that causes sexual dysfunction in men and women with diabetes.

Men, Sexual Disorders and Diabetes
Types of sexual problems: As you probably know, impotence is the main sexual problem experienced by men with diabetes. In fact, as many as 50-60% of men with diabetes experience impotence at some point. Impotence, also called male erectile dysfunction, is the inability to have and maintain an erection rigid enough for sexual intercourse.

Ejaculatory dysfunction is another problem men may experience. The most common abnormality is a decreased amount of semen, called retrograde ejaculation. This is caused by nerve dysfunction and occurs when the semen goes backward into the bladder instead of going forward. Retrograde ejaculation can cause fertility and sterility problems, so it's important to be diagnosed and treated as soon as possible. Retrograde ejaculation can sometimes be overcome by the use of appropriate [?] medications.

Diminished interest in sex and failure to reach orgasm are additional sexual problems men may experience. These problems are frequently caused by psychological factors such as depression.

Causes: What causes men to experience diabetes-related sexual dysfunction? The following factors, working alone or together, can cause these problems:

Nerve damage caused by poor blood sugar control over a long period of time (neuropathy).

Circulation problems such as heart disease and high cholesterol, and others that relate to circulation.

Some medications such as blood pressure drugs, antidepressants, and stomach ulcer medications may have side effects that cause sexual dysfunction. Be sure to check with your doctor to see if any medications you're taking could cause ejaculation or erection problems.

Emotional or psychological factors such as depression, anger, stress and low self-esteem. These often contribute to sexual disinterest even if they're not the main cause.

Low testosterone levels.

Treatments


Treatments: Several types of treatment are available for * dysfunction. The type of treatment will depend on the physical and psychological factors specific to your condition.

Yohimbine is another oral drug. It comes from the bark of the pausinystalin yohimbe tree and has been used for decades as an aphrodisiac.

Saw Palmetto: "A dose of 160 milligrams twice daily or 320 milligrams daily (containing 80 percent to 90 percent liposterolic content) for up to 11 months has been taken by mouth." Saw palmetto extract may improve symptoms of benign prostatic hypertrophy, such as urine flow and burning with urination, and may reduce the number of times per night that a man with this problem has to urinate. It may be as effective as the drug finasteride (Proscar), with fewer side effects.

Possible side effects of saw palmetto: erectile dysfunction, mild headache, dizziness, insomnia, fatigue, depression, stomach upset, breathlessness, fast heart rate, dry mouth, bad breath, nausea, constipation, vomiting, diarrhea, ulcer, liver inflammation, yellowing of the skin (jaundice), loss of libido, urinary tract infection and muscle pain.

Physical devices: "Penile" ring: This is an elastic band that is placed at the base of the erect penis to keep blood in it, maintaining the erection during intercourse. Rings may be used alone or combined with the vacuum device, injections, or MUSE system.

Vacuum device: This device consists of a long clear plastic tube, a pump, and a constriction band, which is applied to the base of the penis after erection is achieved. The vacuum chamber is attached to a vacuum pump on one end and is open on the other. This open end is placed over the penis, and a seal is obtained at the base with lubricant jelly. The pump creates a vacuum, pulling blood into the penis and creating an erection. Once erection is complete, an elastic ring is moved from the tube around the base of the penis to prevent blood from flowing back out of the penis. Side effects may include feeling cold and numb during erection, with difficulty ejaculating because of the ring. Some may have difficulty reaching orgasm. Frequent use may result in changes in the curvature or skin of the penis.

Penile prostheses and surgical implants: These implants are not popular now, since drug therapies are widely available. Implants are generally chosen by men who aren't satisfied with other methods and are available in either semirigid or inflatable types. The main side effect is infection.

Counseling. You can probably benefit from counseling no matter what the cause of your sexual dysfunction. If your impotence is the result of emotional causes, then a sex counselor or other appropriate mental health professional may be all you need to get back on track.

Prevention: Here's what you can do to avoid or minimize the effects of sexual dysfunction: avoid poor circulation and nerve damage by maintaining good blood sugar control, good blood pressure control, and good cholesterol levels. Stop smoking.

Exercise. Don't drink alcohol. And if you notice any erectile dysfunction whatsoever, talk with your doctor right away. Many men wait until their problems are too far along. The sooner you address the problem, the better the chance of finding effective treatment.
--------------

Nutrients

VITAMIN E - There is growing evidence that certain micronutrients - antioxidants - may help. Selenium, for example, has been found highly effective in preventing prostate cancer. The Johns Hopkins School of Public Health now reports that gamma-tocopherol, the form of vitamin-E found in most foods, is also effective in preventing prostate cancer. Vitamin E retards cellular aging and free radicals formed due to oxidation and the environment. It increases cell oxygenation. Several studies indicate that Vitamin E reduces the risk of prostate cancer. Vitamin E also reduces androgen signaling in the prostate gland without affecting androgen metabolism. ["Signaling" is the term for a communication between one gland and another through hormones.]

TOMATOES - [Lycopene ] Several studies show that tomatoes, tomato products, especially tomato sauce, have a protective effect against prostate cancer. The University of Illinois now reports that tomato sauce is also effective in slowing down and perhaps even reversing this.




Prostate Massage


THE BASICS

External Massage:
One kind of prostate massage is the "external massage." Massage the prostate by pressing against the middle of the perineum (between the scrotum & anus). It is a rounded lump about the size of a large marble.

Regular Prostate Massage:
This is more effective. Insert your finger, or a massage wand, into the anus. Reach back and up toward the navel until you feel the prostate gland. It is important to use a lubricant, because there is no natural secretion in the rectum to protect against tearing the tissue. Gently rub back and forth on the prostate, applying pressure without causing pain.

Spend one minute angled toward the right, then alternate toward the left for one minute. Repeat back and forth for the duration of the massage.

Five minutes will do a great deal to heal this long-neglected area. Urologists often suggest massaging 2 or 3 times a week at 10 to 20 minutes per session, but you don't want to exceed your patience. It's better to do a little 3 or 4 times a week than to do 20 minutes once and then give up out of boredom.

Bacterial transmission isn't a problem as long as the hands are clean. Use of a therapeutic massage wand can make it easier. (An inexpensive alternative would be a cyndrilical plactic-handled paintbrush of the appropriate size at an art supply store - save yourself ~50 bucks over the "orthopedically-engineered" stick of nearly the same proportions).

How can you tell if you're doing the massage right? You will feel the movement of fluid. With enough fluid movement you will see a few drops at the end of your penis; but don't feel that you are a failure if you don't. It's a long way from the acini to the tip of your penis. If the burning sensation increases after a drainage then that is also a good sign that you have managed to get some out. Repeated massages every one or two days will slowly dislodge the blockages.

It usually takes more than one massage to remove all the toxins. Specially designed massage inserts, or plugs, can be worn for the same period or longer as an alternative. People often report that this produces quantities of prostate fluid that keeps both the gland exercised and flushes the ducts.

Also, when unrelieved sexual tension takes place, the prostate should be massaged for release of EPS to prevent enlargement.


  • Prostate massage, if done properly, will drain the clogged pockets in the prostate (called acini). Once the acini clog up, a normal ejaculation does not drain them . If it did, we wouldn't have prostatitis!

  • The acini-pockets in the prostate seldom unclog on their own even if the trapped bacteria are defeated. The body attempts to fight the bacteria by coating them with calcium. These calcium coated bacteria can combine into a prostate stone.

  • Prostate Massage benefits PROSTATITUS (infected prostate), but it can also be useful for BPH. Most if not all BPH results from prostatitis, according to www.prostatitis.org . Inflammation has been found in most surgically resected BPH prostates.

  • Neuropathy can prevent you from noticing pain or pressure in your prostate. The symptoms of prostatitis may be hidden if one has neuropathy in that area, and the condition be inaccurately diagnosed as "BPH".

  • A theory, based on the discovery that only housebroken dogs have prostatitis, is that holding-in the urine damages the prostate. The belief is that pressure builds up and forces urine backwards into the acini where it combines with prostatic secretions, causing clogs to form.

  • Controlled studies indicate anxiety and depression occur more frequently in men with NBP [Chronic Nonbacterial Prostatitis] and PD [Prostadynia ].

  • Until recently, doctors would massage their patients' prostates as a common treatment for prostatitis. Though still prescribed by some practitioners, most doctors now only check the prostate, and if they find a problem, prefer to cut it out or prescribe medication. But a doctor is not required for prostate massage.

  • Prostate massage promotes circulation and drainage of infected areas. (Prostatic massage should be avoided in Acute Bacterial Prostatitis because it could spread the infection. Also avoid this therapy if there are prostatic stones, a condition common in elderly men in which small calcifications develop in the prostate.)



PROSTATE MASSAGE: MORE DETAILS

[ library.gnc.com/health_notes/healthnotes.aspx?KW=Enter+keyword+or+item+number%5c&CHANGE_SEARCH=gn clibrary&Pre=&Post=&ContentId=1252007&lang=en]
• [ www.holisticwisdom.com/article_sex_prostate_massage.htm]


The technique of prostate massage actually involves three organs of the male reproductive system:

  • the prostate gland
  • the seminal vesicles
  • the ampulla, which is the reservoir which actually holds the male sperm just prior to ejaculation.

The prostate gland when engorged can be felt by pressing a finger into the middle of the perineum (between the scrotum & the anus). It is a rounded lump about the size of a large marble. It can be massaged from this point as well. It can also be accessed via the rectum, where it can again be felt as a rounded lump toward the front of the body and just about an index finger's length inside the rectum.

A better way to find it is from the inside the rectum: insert the middle finger, and slide it from just inside the rectum (on the front side) up and in, until you feel it move over a lump. That will be the prostate.

Just in back of (up from) the prostate is a smaller and roughly triangular wedge shaped nodule that is the bottom portion of the somewhat larger seminal vesicles, which is where most of the fluid of the ejaculate is produced and accumulated. Underneath the seminal vesicles are the ampulla.

During sexual arousal, sperm and ejaculatory fluid accumulate in these glands backing up behind valves in the ejaculatory ducts. When fluid pressure reaches a high enough threshold, the valves open and the urethral bulb fills, triggering the ejaculatory reflex and muscular contractions of orgasm, which empties the glands.



Lifestyle changes:

Urination and ejaculation may defend against prostate infection by flushing the urethra. The prostate also secretes an antibacterial substance known as "prostatic antibacterial factor" into the semen, which helps to fight infection. In one study, unmarried men with NBP [Non-Bacterial Prostatitis] who avoided sexual activity for personal or religious reasons and who had not responded to medication, were encouraged to masturbate at least twice a week for six months. Out of 18 men, 78% experienced moderate to complete relief of symptoms. In healthy men, prostatic secretions are high in zinc, which is antibacterial and is part of the natural resistance of the male urinary tract infection.

Self Examination

The prostate is analogous to the G spot in women, shown above.

It is important that men examine themselves often by checking the condition of their prostates. You can determine the condition of the prostate by feeling for changes in size and resilience.

Check this as often as possible, at least every few months, and you will be able to establish a standard for yourself. By doing so, you will be able to detect any changes in the size and flexibility of your prostate. A very hard, enlarged, or painful prostate is an indication of a disorder that could lead to cancer or some other major problem.

Prostate disorders do not develop overnight, and regular massage can prevent and reverse problems. Medical science accepts that it is normal for men over the age of fifty to experience problems with their prostates. Although prostate problems may be common, they are not normal: they're abnormal. There is no need for any man to have prostate problems.

[ http://www.highisland.com/pm_overview.php ]

The object is to free the gland of congestion that may lead to prostate problems such as blockage which can lead to prostatitis, cancer and other problems including sexual dysfunction.

In traditional Japanese families, wives often perform prostate massage to promote their partners' health. In general, Asian men tend to have lower rates of prostate enlargement and cancer than their American (counterparts)." (PS 2 Massage Device - $48)

-------------------------------

[ www.prostate.com.ph/prostate_massage_3.htm#Technique ]

The standard procedure of prostate examination is performed by first noting shape, size, consistency, mobility, and masses. Palpation [examination by touch] of the prostate starts on the superior portion of the lateral margin towards the median groove, finally finishing down into the inferior section. Both lobes are compared and the volume of the prostate is estimated. A more rounded prostate, with a mildly sensitive and generally distinct median groove, is indicative of chronic prostatitis.

The drainage is initiated after the patient relaxes. It is started from the lateral margin of the superior portion of the selected lobe. Slow, gentle pressure is exerted followed by increasing intensity up to the patients' pain threshold. Pressure is maintained by moving from the lateral margin towards the groove. Pressure is decreased by lifting the finger as it reaches for the next lower lateral margin. The procedure is applied consistently covering the entire lobe up to the inferior section. The same maneuver is performed on the other lobe.
------------------
The patient is reassured that the sensation of urine passing, and the urgency to defecate, is due to the pressure of the finger inside the rectal canal and the passage of the prostatic fluid into the urethra. Less than 10% of patients may experience dizziness or fainting during the first drainage. This experience does not recur in succeeding drainages, and is presumably prompted by anxiety.
----------------
[http://www.chronicprostatitis.com/massage.html]

Prostate massage may help by releasing the tension around nerve endings near the prostate in a manner similar to Thiele Massage which helps women with IC [Interstitial Cystitis - inflammation of the bladder wall]. This represents a form of "myofascial [muscle-to-connective-tissue] release".

But vigorous prostatic massage may be dangerous. If you have acute bacterial prostatitis it can result in blood poisoning. If you have the beginnings of a carcinoma in your prostate, it could conceivably result in it being disturbed, broken up and spreading.

As regards technique: do not push in one place; rather move from lateral to the center line of gland. Pushing at one place only can damage that area, especially if you are pushing very hard.

"Sometimes no drops of prostatic secretions are produced at the tip of the penis Not all prostates yield fluid following all massages. There is an interesting concept put forward by Dr. Krieger in 1996 according to which the inflamed ducts empty following the massage, rather than during it. If you keep that in mind, massage can be beneficial even when no fluid comes out."

"Remember that for some men, massage can be beneficial even when it is a massage of the muscles surrounding the prostate, rather than the gland itself."

The arrows on prostate illustration above show direction of drainage: from lateral to median. Patient position as shown. Ideally 2 to 4 drops of free-flowing prostatic fluid should be extracted.
"Lastly, an aggressive massage can theoretically cause an autoimmune response by releasing 'forbidden antigens,' and this may explain why some men have a lot of pain after prostate manipulation."

----------------

[ Editied from: www.prostatitis.org/selfdrainage.html ]

SELF DRAINAGE: A swollen clogged duct in the prostate feels better when only 4-5 drops are drained from it. I do not believe that drainage alone will cure the infection but it sure does relieve the dull pressure feeling and aching pain.

I now do massage myself and get EPS (expressed prostatic secretion) every time with immediate relief of local prostate pain/pressure. I lay on my side with my legs bent in the fetal position and legs propped apart with a large pillow. I use K-Y Gel and cut one finger off a vinyl surgical glove and slip that over my thumb. I can't use the index finger ... can't bend my wrist that way! The thumb is positioned perfectly and, can exert a good amount of pressure. The biggest factors in my success are:

1. When the massage is done correctly and EPS (expressed prostatic secretion) is being forced out of the prostate there is a feeling like you are going to pass urine. Well my primary care doc (who is good ... listens to the patient) told me I would feel this... BUT what he did NOT say was, don't try and fight it. What I do now is actually try to pee and the EPS will come out. If I fight it then I will not get any. Other 2 uros never said anything about what I was supposed to do. Except relax, which is hard to do with a stranger sticking his finger up your butt.

2. The technique I use is initially a constant firm pressure on the top area of the prostate. I do not move my thumb. To get all the way to the back of the prostate I actually push like I would during a bowel movement and the prostate gets pushed lower and I can get my thumb way to the back. After the constant pressure for 2-3 seconds I slowly press the thumb down towards the openings and I can feel the EPS starting to come out. This is where a slight pushing, like you are trying to urinate, comes in. If I don't do this the EPS will actually stop. However when I stand up there is usually a small drop after 5-10 seconds.

I have good drainages (8-12 drops) and not so good (maybe just a drop) but the normal is 4-5 drops. If I don't get much out and the pressure is bad I do it again the next day and usually get more EPS and relief of pain PS: I bet most urologists squeeze their toothpaste from the middle of the tube

-------------
[http://www.goaskalice.columbia.edu/2246.html ]

Prostate Massage Points:
GoAskAlice.com

It can be helpful to urinate and/or have a bowel movement before you begin. Relaxation is also important, minimizing or preventing the possibility of tearing the thin lining of the rectum. Begin massaging the prostate externally. Using your index and middle fingertips, you can touch, rub, stroke, or press the perineum (the area of skin from under the testicles to the anus). Gradually insert the massaging finger into the anus. Insert your finger about an inch or so, and when you're comfortable, move your finger in an upward motion along the wall of the rectal lining that faces the front of your body. Try to locate a round bulb of tissue — this is the prostate.

Once you locate this area, move your finger(s) in a "come here" motion, as if you were asking someone to move closer to you so that you could whisper a secret. Use your finger pad(s) on the tip(s) of your finger(s) to massage the prostate, and be mindful of not using your nail(s). Notice what feels good and what is the best touch. While you are touching in this way, sense if you want more or less pressure, or slower or faster strokes. Be aware that receiving anal stimulation may cause feelings of having to go to the bathroom. More often than not, this is just a "feeling" that the stimulation causes and may take some getting used to. If you indeed find pleasure from this experience, it might set one over the edge if you rhythmically or irregularly press on the prostate gland before or during ejaculation. It is even possible for men to orgasm through prostate stimulation alone.

----------

GENERAL INFO

[http://www.chastity-uk.co.uk/prostate.htm ]

You need a healthy prostate gland to urinate efficiently and also to have an erection. One of it's main functions is to create the seminal fluid which mixes with, and carries, the sperm out of the penis during ejaculation. The prostate gland also serves as a pump to transport the semen and sperm with sufficient power out of the penis on it's way to fertilising a woman's egg. Therefore the prostate acts as a gland and a pumping muscle.

In Tantric terms [a yogic term roughly meaning "center"], the prostate is also considered to be the nerve and emotional centre of a man's sex life and his sexuality. It's thought to be the feeling centre for sexual pleasures, and disappointments.

When the prostate gland swells it puts pressure on the urethra (the largest pipe), and makes the passage of urine more difficult . The swollen prostate, also puts pressure on the nerves responsible for an erection (the erection nerves pass over and are attached to the outside of the prostate gland) and makes them less sensitive, and therefore, an erection difficult, or even impossible.

--------------

Filippino Prostate Massage

[http://www.prostate.com.ph/apatientsstory.htm]

Dr. Feliciano has explained to me that pushing hard on the prostate is no more damaging then pushing hard with your finger on your arm. And the over 4,000 patients successfully treated by prostate drainage in the Philippines would seem to prove his point. I can tell you that after 20 such drainages I do not feel my prostate has been damaged in any way and neither does the other American patient who was cured right before me.

Sometimes doctors will recommend surgery or any of several high tech methods of heating or destroying prostate tissue to treat prostatitis. The track record of these methods in prostatitis is poor, because pain often persists. Collected from the newsgroup archives, the prostatron page contains a number of comments on the "Prostatron" device which cooks the prostate gland with microwaves. T.U.N.A. comes under this general heading. (T.U.N.A. stands for T rans U rethral N eedle A blation. VidaMed's TUNA System delivers low-level radiofrequency energy directly into hyperplasic prostate tissue... )


MASSAGE DEVICES

[Messageboard on "PS 2" Prostate Massage device, exercises, etc.
http://www.highisland.com/forum/viewtopic.php?f=1&t=1003 ]

I think the Kegel exercises are probably every bit as beneficial as the job the device does on the prostate. Getting the strength of those muscle up sure has improved my performance.

I agree with you. Before the massager came I was doing Kegels and boy I could tell that my erections were alot harder than without them. When I do them I do 100 reps of contractions to the count of twelve holding my sphinter and PC muscles as tight as I can then relax on the exhale and breathe in while contracting again. After that I do thirty to fifty repetitions while slowly breathing in through my mouth and rapidly contracting and relaxing the sphincter and PC muscles to the count of twelve as tightly as I can.

After that, I do thirty reputations of inhaling while contracting the Sphincter and PC muscles. On the exhale I push as if I am trying to take a number 2. This has helped tremendously with blood flow and strength of erection. I also maintain an erection longer with the Kegels. It does take some time to do these exercises, but they are well worth the effort. I have done them with the massager in place also. In my opinion I think the results are enhanced by doing them with the massager in place. The prescribed exercises on the site are very similar.Kegel exercises aren't just for women after giving birth. They can be adopted to the male physique as well.

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Home Made Prostate Massage Device

[More from: http://dom.alt.com/magazine/articles/advice/20303.html?action= ]

Look in any toy department for a small plastic baseball game, the kind that are carded to be given as favors for parties. The small plastic bats make excellent prostrate massagers. Also, most craft stores have small plastic dowels. Also, cylindrical plastic paint brush handles work well. You can find some very usable devices in the pet section of the supermarket.



Kegel Exercises


[http://www.the-confident-penis.com/kegel-exercises.html ]

The pubococcygeus ("PC" for short) muscle is the most important muscle group that a man can develop to improve his sexuality. The PC muscle is located in between your testicles and the anus. It's the muscle that you use to stop the flow of urine and it's also the muscle that contracts during ejaculation...yep! Those are the ones! In fact, when you get a chance, place your hand in between your testicles and your anus and pretend like you want to stop the flow of urine...Did you feel the muscle that contracted? That's the PC muscle!

So how will kegel exercises help you improve your virility? When properly performing kegel exercises, you will force more blood into your penis and genital area, giving your penis a "shot" of life-enriching nutrients. This helps to strengthen and tone your entire genital system- keeping it in optimum condition (along with a healthy lifestyle). In the same way, kegel exercises can increase the firmness and angle of your erections.

Exercising your pc muscle requires that you contract it over and over again- beyond the time you normally use it throughout the day (ejaculating, squeezing the last few drops of urine out). And the best way to do this is by doing Kegel exercises. When properly performing kegel exercises, you can actually indirectly massage the prostate. And you already know the health benefits of massage. Also, since kegel exercises force more blood into the genital area, including the prostate, kegel exercises health to keep the prostate in optimum shape (along with a healthy lifestyle).

During each contraction, squeeze your pc muscle until you begin to feel your anus contract. Keep contracting until you feel that a second group of anal muscles kick in just inside the first group. This second group of anal muscles are much more powerful than what you feel at first- and this is the key sign that your Kegel exercise contraction was a good one. You should almost feel like your anus is drawing in as if you could "suck" air with it. I know this sounds weird but this is what it feels like when you're doing them with force and intensity.

If you find the above kegel exercise method difficult( i.e. you're not feeling the strong contraction of that second anal muscle), then you'll have to more Kegel exercise repetitions- like lifting lighter weights but doing more repetitions.

Daily Kegel exercise routine: Intense Kegel Exercise Method: 10-30 once each day .

Less-Intense Kegel Exercise Method: 20-40 twice each day

OTHER KEGEL & P.C. IDEAS

[ http://www.bettydodson.com/barbellinfo.htm ]

There are many ideas about how to best do PC muscle exercises like squeezing the muscle 10 times and resting. Or holding the muscle tight for a count of 5 followed by several rapid contractions. Most professionals agree that having a resistance device inside the anus gives better results.

However there's nothing wrong with exercising the PC muscle without the Barbell (a massage device) while watching television, talking on the phone, or browsing the Internet. A healthy PC muscle will lower the high percentage of older men who no longer have erections and/or end up with urinary incontinence.



LINKS:

Prostate Massage FAQs - www.prostatitis.org

Prostate Massage Forum - www.highisland.com/forum

Prostate: Part 2 - Hormones, Castration, Sexual Frequency, Things That Effect PSA Levels, Functions of the Prostate, much more...

B17, Laetrile, & Apricot Seeds - The Benefits of Vitamin B17 - examining the facts.



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