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Doctors' Answers to "Frequently Asked Questions" - Prostate
Answer: This would depend on your age, previous values and size of your prostate. For example, 5.04 at 50 is significantly higher than at 75. If your previous value(hopefully about a year ago) was 1.0 and this was 5.04 this would be a significant change and would usually require an ultrasound. Younger age, smaller glands, jumps in the PSA all indicate further evaluation-usually an ultrasound and biopsy. If the numbers are slowly rising, you are older etc. then you can repeat the PSA in 3-4 months and see if it is still rising.
Answer: Low grade infections are often asymptomatic. Very common in men, like bladder infections in women. This is not usually transmissable from men to women, depending on the organism causing the infection. Most of these are due to gram negatives from the colon(presumably), they could be due to other organisms-I assume he did a culture?
Answer: Saw palmetto available in any pharmacy is useful in BPH and usually cheaper. It will take about a month to be effective. As to the lorazepam, use the generic-but no other options here. Any of the benzodiazepines will work in its place but they're all about the same cost.
Answer: First, you must determine that there is neurologic control of your bladder. Some diabetics will lose nerve control of their bladder as a manifestation of neuropathy. Once this has been done, you should try a couple of months of saw palmetto, failing this cardura or hytrin to help this problem.
Answer: I assume you have tried saw palmetto? Also, occasionally Kegel exercises-normally used for women's pelvic relaxation will be helpful. Occasional patients have success with high doses of zinc supplements with this problem. Lastly, there is a condition called prostadynia. Pain and discomfort in the prostate-cause unknown. Diet is the mainstay for this condition, avoid pizza sauce, ketchup, beer, highly spiced items. All worth a try. Lastly, before I would have a complete prostatectomy I would try Lupron shots every month for six months or so and see if "shrinking" the prostate will give you some relief. This is like a "medical" prostatectomy, so you can experience the "benefits" prior to the complete loss of your prostate.
Enlarged Prostate Treatment [posted
Answer: Flomax is generally better tolerated by most of my patients, although some prefer cardura. They are completely different classes of drugs. If the flomax is working, why not stay with it? Cardura will lower his blood pressure that Flomax will not. Maybe that is his doctor's goal.
Prostate Cancer & Barrett's
Syndrome Concerns [posted 11/24/98]
Is Prostitis Related to Sexual
Activity [posted 11/11/98]
Answer: Prostate problems have no correlation with sexual activity. If anything, increased activity decreases infections by increasing flow through the prostate.
Saw Palmetto: The Better Herbal
Remedy ? [posted 10/13/98]
Answer: Yeah, but a better herbal treatment is Saw Palmetto, very effective.
Saw Palmetto Herbal Remedy for
Answer: Saw Palmetto doesn't usually reduce the size ;but, often allows better urine flow after being taken for several months. I have seen no contraindications to taking the two together;but, this is a question I've posed to the makers of Cardura myself. To date, I have no information back from them. I would probably try it if it were me.
Prostate Infection Treatment
Answer: I haven't heard of this drug. Drugs that sometimes work are zinc tablets and/or saw palmetto (Assuming traditional antibiotics aren't helpful).
Answer: Prostitis is unusual in a young man, but does occur. The first step in refractory infections is to identify the organism. This will take massage of your prostate and culture of the exudate. This is essential for elimination of the organism. If nothing cultures, go on a good broad spectrum antibiotic for at least 4-6 weeks. There are those who think that zinc orally (found in any pharmacy) will help. This is unclear, but it won't hurt. There are advocates of saw palmetto as well, which is also untested, but fairly risk free. Regular prostatic discharge is thought to help. This means regular masturbation or sex (you are not infectious sexually). Good luck.
Answer: Prostate infections are notoriously hard to cure. Often antibiotics are needed for 3-5 weeks. Also, the organism must be isolated to ensure proper antibiotic coverage. This will need a prostatic massage and subsequent culture of the penile discharge. Occasionally, surgery will be needed if long term antibiotics are not curative.
Answer: Hytrin is drug given to decrease the symptoms of Benign Prostatic Hypertrophy. This is a condition where the prostate continues to grow and slowly blocks the ability to urinate. A biopsy of the prostate is done to detect cancer of the prostate. Occasionally, the inflammation produced by the biopsy needle will cause additional swelling or a flare of an underlying infection. Increasing the dosage of Hytrin is occasionally of help. The antibiotics are what I would prescribe.
Answer: The prostate is the most common problem in mens urinary tract. As the prostate ages, it continues to grow. It is anatomically positioned between the bladder and the penis with the urethra (tube which the urine exits the body) going through the center of the gland. Consequently, as the gland enlarges it tends to block off the ability to urinate. This is seen with decreased force or urination and more frequent urination. There are several treatments ranging from drugs to affect the control muscles of the bladder to surgical treatment of the obstruction. Occasionally, this will he simply a low grade infection in the prostate and not permanent enlargement. In any case, you will need to consult your physician.
Answer: Several of my patients have reported improvement with this medication. I have seen no controlled studies and do not know the dose or side effects. Another treatment might be low dose Hytrin. This is a blood pressure pill that helps prostate blockage about 75 % of the time and is available through your physician.
Answer: Proscar got a great deal of play when it came out since it looked effective and should work if you believe the theory behind the drug. Most physicians have concluded that it has minnal effectiveness and most patients have decreased or stopped taking the drug. I would stop taking it.
Answer: Six months. One year is longer than most urologists recommend. Usually 3 is the average. Although the nerve sparing surgery preserves a higher frequency of potency, it is not 100%. Usually patients will have at least nocturnal erections if the function is adequate. Also, there is often delayed healing. When there is pressure there are minor amounts of swelling and damage, in spite of the "nerve sparing". This takes a while to heal, sometimes a year.
Prostate - Fluid Retention
Answer: Tylenol will have no effect on the prostate, but the PM part will. The PM part is an antihistamine to promote sleepiness. However, it has the effect of interfering with the outlet muscle of the bladder (bladder sphincter). Any antihistamine will have this effect and it should clear within 1-2 days of stopping the medication.
BPH - Saw Palmetto
Answer: Several of my patients have tried this and swear by it. I can't find any research done comparing the effectiveness of this with any prescription medication. However, I also can't find any particular toxicity. My current feeling is to try it, and if it works, keep with it. It's not like medicine has particularly good alternatives.
Answer: Prostate infections in men are very common and somewhat difficult to clear up. The bacteria which causes the infection usually comes from the colon and is a "gram negative". The prostate is very cavernous with many places for bacteria to "hide". This usually takes antihiotics-sometimes for a protracted course. Some people have recommended oral zinc replacement for recurrent infections. Controlled studies have not shown this to be very helpful; but, I do have some patients who think it helps recurrent infections.
Answer: These are really it. Cardura is about due to go generic. I have had some patients who have had improvement with saw palmetto or zinc replacement in minimizing prostatis. This is anecdotal and not proven.
Answer: This is probably a prostate infection although could be a condition called prostadynia. Prostate cancer (in the prostate) is painless-it is painful after it spreads to bones etc. If it were painful in the prostate, deaths from prostate cancer would be rare. You need to have your prostate checked for infection. If none is present you could be having prostadynia a painful condition of the prostate which is triggered by certain foods beer, tomato sauce etc.
Answer:There are several antibiotics available for prostate infections. I'd personally take at least a little food until the antibiotics are used up and tell him/her the next time to try a different medication. There is a similar drug called Levoquin which is only the active ingredient in Floxin and seems to have less GI toxicity.
Answer: If you are having difficulty urinating, it can be from several problems. These can range from prostatic enlargement(treated by Cardura) to a mild infection to different drugs(like antihistamines) causing the problem. Usually, I treat my patients for 2 weeks or so with antibiotics to see if there is a mild infection(hard to diagnose). If this doesn't work Cardura, Hytrin, or occasionally Saw Palmetto are used to treat the obstruction. Occasionally, previous gonorrhea infections etc. could cause a problem.
Answer: Depends a little on the patients age. Use of Hytrin or Cardura is
sometimes helpful by changing the tone of the outlet muscle. There is a drug called
Proscar;but, I don't think it is very helpful. Some patients tell me that saw
palmetto(available in health stores) is helpful. If none of these works, surgery is the
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