What is an open prostatectomy

An open prostatectomy is the removal of the obstructing portion of a benign prostate through a surgical incision. Open prostatectomies are usually reserved for large prostates that weigh more than 100 grams. The open prostatectomy allows for the greatest amount of prostate tissue to be removed, but the morbidity is greater than less invasive options because it is an open surgical procedure. The most common approach to performing an open prostatectomy is through a lower abdominal incision that...

Do I need to be monitored while on testosterone therapy

All hypogonadal men receiving testosterone replacement therapy require monitoring. All men should have a baseline PSA, hemoglobin level, and digital rectal examination prior to the start of testosterone replacement therapy. Those males with an elevated PSA and or abnormal digital rectal examination should undergo further evaluation to rule out prostate cancer prior to starting testosterone replacement therapy. Once testosterone therapy has been started, patients return for an assessment of the...

What are the signs and symptoms of an enlarged prostate either cancer related or benign

The prostate gland in the adult male is normally about 20 to 25 cm3 in size. Over time, the prostate gland may grow as a result of benign enlargement of the prostate, known as benign prostatic hyperplasia (BPH), or as a result of prostate cancer. Enlargement of the prostate gland may cause changes in urinary symptoms however, the severity of urinary symptoms does not correlate with the size of the prostate. In fact, some men with mildly enlarged prostates (for example, 40 cm3) may be more...

Are there any other blood tests to check for prostate cancer

Early Prostate Cancer Antigen (EPCA) and EPCA-2 have been demonstrated to be plasma-based markers for prostate cancer. EPCA is found throughout the prostate and represents a field effect associated with prostate cancer, whereas, EPCA-2 is found only in the prostate cancer tissue. However, EPCA-2 is able to get into the plasma, the liquid part of the blood, allowing for it to be detected by a blood test. In preliminary studies, EPCA-2 has been able to identify men with prostate cancer who had...

What is prostate cancer

Prostate cancer is a malignant growth of the glandular cells of the prostate. Our body is composed of billions of cells they are the smallest unit in the body. Normally, each cell functions for a while, then dies and is replaced in an organized manner. This results in the appropriate number of cells being present to carry out necessary cell functions. Sometimes there can be an uncontrolled replacement of cells, leaving the cells unable to organize as they did before. Such abnormal growth of...

What are the riskfactors for prostate cancer and who is at riskIs there anything that decreases the risk of developing

Theoretically, all men are at risk for developing prostate cancer. The prevalence of prostate cancer increases with age, and the increase with age is greater for prostate cancer than for any other cancer. < 39 years of age 40-59 years of age 60-79 years of age Theoretically, all men are at risk for developing prostate cancer. Basically, every 10 years after the age of 40 years, the incidence of prostate cancer nearly doubles, with a risk of 10 for men in their 50s increasing to 70 for those...

What are the warning signs of prostate cancer

Prostate cancer gives no typical warning signs that it is present in your body. It often grows very slowly, and some of the symptoms related to enlargement of the prostate are typical of noncancerous enlargement of the prostate, known as benign prostatic hyperplasia (BPH). A chemical that helps prevent changes in cells and reduce damage to the cell that can cause it to become cancerous. With more advanced disease, you may have fatigue, weight loss, and generalized aches and pains. When the...

What causes prostate cancer What causes prostate cancer to grow

The exact causes of prostate cancer are not known. Prostate cancer may develop because of changes in genes. Alterations in androgen (male hormone) related genes have been associated with an increased risk of cancer. Alterations in genes may be caused by environmental factors, such as diet. The more abnormal the gene, the higher is the likelihood of developing prostate cancer. In rare cases, prostate cancer may be inherited. In such cases, 88 of the individuals will have prostate cancer by the...

Where does prostate cancer spread

Prostate Carcinoma Lymphatic Drainage

As the prostate cancer grows, it grows through the prostate, the prostate capsule, and the fat that surrounds the prostate capsule. Because the prostate gland lies below the bladder and attaches to it, the prostate cancer can also grow up into the base of the bladder. Prostate cancer can also grow into the seminal vesicles, which are located adjacent to the prostate. It may continue to grow locally in the pelvis into muscles within the pelvis into the rectum, which lies behind the prostate or...

What is prostate cancer screening

The goal of any screening is to evaluate populations of people in an effort to diagnose the disease early. Thus, the goal of prostate cancer screening is the early detection of prostate cancer, ideally at the curable stage. Prostate cancer screening includes both a digital rectal examination and a serum PSA. Each of these is important in the screening process, and an abnormality in either warrants further evaluation. Only about 25 of prostate cancers are revealed by rectal examination most are...

Are all prostate cancers the sameAre there different grades

Not all prostate cancers are the same. Prostate cancers may vary in the grade of the cancer and the stage of the cancer. The grade of a cancer is a term used to describe how the cancer cells look. That is, whether the cells look aggressive and not very similar to normal cells (high grade) or whether they look very similar to normal cells (low grade). The grade of the cancer is an important factor in predicting long-term results of treatment, response to treatment, and survival. With prostate...

What is prostate cancer staging

By staging your cancer, your doctor is trying to assess, based on your prostate biopsy results, your physical examination, your PSA, and other tests and X-rays (if obtained), whether your prostate cancer is confined to the prostate, and if it is not, to what extent it has spread. Studies of large numbers of men who have undergone radical prostatectomy and pelvic lymph node dissections have provided for the development of nomograms predicting the pathologic stage of CaP based on clinical stage...

What options do I have for treatment of my prostate cancer

After finally realizing that, despite feeling great, I did indeed have prostate cancer, I had to figure out what the best treatment for me was. When faced with the option of leaving my prostate in place or removing it, I knew that, even though I was petrified of surgery, it would be the best thing for me in the long run. I knew that I could not live with my prostate gland and the continuous question of whether there were any viable cancer cells remaining in my prostate after interstitial seeds...

What are the risks of surgery How are they treated

All surgical procedures have risks, and the common ones are infection, bleeding, pain, and anesthetic complications. Larger surgical procedures, which involve lengthier operative times and decreased postoperative mobility, have the risk of blood clots in the legs (deep venous thrombosis), pulmonary embolus, pneumonia, and stress-related stomach ulcers. Complications of radical prostatectomy include hernia, significant bleeding requiring blood transfusion, infection, anesthetic-related...

What is brachytherapyinterstitialseed therapy Who is a candidate What are the risks

Greek Word Prostate

Brachytherapy derives from the Greek word brachy, which means near to. Brachytherapy is a technique in which either permanent radioactive seeds (Figure 13) or temporary needles are placed directly into the prostate gland. Palladium 103 and iodine 125 are two radioactive agents that can be used for permanent seed placement and both are effective in the treatment of prostate cancer. Palladium gives a higher initial dose of radiation when it is placed, and some people think that it may be more...

What is Peyronies disease and what causes it

Peyronie's disease is a benign condition of the penis that tends to affect middle-aged males. The exact cause of Peyronie's disease is not known. The disease is characterized by the formation of plaques in the tunica albuginea of the penis. These plaques may be felt on penile examination and at times can feel as hard as bone. The plaques are like scar tissue and affect the function of the tunica in that area. Because the plaque is not elastic and stretchy like the rest of the tunica, it pulls...

How common is prostate cancer

There are more than 100 different types of cancer. In the United States, a man has a 50 chance of developing some type of cancer in his lifetime. In American men, (excluding skin cancer) prostate cancer is the most common cancer. Prostate cancer accounts for about 33 (234,460) of cases of cancer (Table 2). More than 75 of the cases of prostate cancer are diagnosed in men older than 65 years. Based on cases diagnosed between 1995 and 2001, it is estimated that 91 of the new cases of prostate...

What is a penile prosthesis

A penile prosthesis is an artificial device that, when placed in the penis, allows a man to have an erection. The development and use of penile prostheses began in the 1970s. Since then, numerous revisions and modifications in the prostheses have improved the satisfaction rate and mechanical durability of these devices. The most commonly used is the three-piece prosthesis, which is comprised of two cylinders, a scrotal pump, and a separate reservoir that is placed in the pelvis (Figure 36). The...

What happens if my sex drive libido is low What causes it can it be treated

Your interest in sex is governed by sex hormones, primarily testosterone, and by psychosocial factors. Low testosterone levels are associated with decreased libido. Stress, depression, or anxiety may also affect your libido. In men with erectile dysfunction, interest in sex may be diminished as a result of their inability to achieve an adequate erection. Any man with decreased libido should have his serum testosterone level checked. Normally, there is a feedback loop between the brain and the...

How is prostatitis diagnosed

The patient's clinical history, general appearance, and uri-nalysis are often suggestive of acute bacterial prostatitis. A urine culture is commonly positive for a urinary tract infection. A digital rectal examination will usually identify a very tender prostate. In rare cases, fluctuance may be palpable in the prostate, if there is a prostatic abscess. In men who appear toxic or who fail to improve with antibiotic therapy, a transrectal ultrasound may be obtained to rule out a prostatic...

What is electrovaporization of the prostate

Electrovaporization of the prostate (TUVP) is, similar to a TURP. Rather than a resecting loop, the urologist uses a roller ball to heat and desiccate the prostate instead of actually resecting tissue (Figure 24). Electrovaporization of the prostate has been used in patients with a history of bleeding disorders or in cases in which it is desired to minimize blood loss. Electrova-porization of the prostate tends to be used in patients with small- and medium-sized glands. Like TUIP, in properly...

What is microwave therapy of the prostate

Microwave energy has been used to treat BPH using both transrectal and transurethral approaches, but most modern machines use the transurethral route. Current machines deliver microwave energy to the prostate via a transurethral catheter, and a transrectal balloon monitors rectal temperature simultaneously. The treatment is delivered under local anesthesia on an outpatient basis and typically takes about one-half hour. The patient will go home with an indwelling urethral catheter for a period...

What is intraurethral alprostadil MUSE and how do I use it

Muse Alprostadil

Intraurethral alprostadil (Vivus's MUSE) is an intraurethral medication (i.e., a drug that is injected into the urethra) that was approved by the FDA in June 1998. Alprostadil is a synthetic form of a normal body chemical, prostaglandin E1, that causes increased blood flow into the penis. MUSE works differently than sildenafil (Viagra), the oral therapy for ED. That is, the prostaglandin in MUSE stimulates the production of a chemical called cAMP, which, like cGMP, can cause the relaxation of...

What are the side effects of surgical treatment TURP of BPH

The side effects associated with TURP can be divided into intraoperative and postoperative complications. A TURP is performed under either spinal or general anesthesia, Figure 24 Electovaporization of the prostate using a TURP VaporTrode . Courtesy of Gyrus ACMI, Southborough, MA Figure 24 Electovaporization of the prostate using a TURP VaporTrode . Courtesy of Gyrus ACMI, Southborough, MA and the usual complications that are associated with these forms of anesthesia can occur during a TURP....

What are externalbeam and conformal externalbeam radiation therapies What are the side effects of EBRT

Ams Artificial Urinary Sphincter

External-beam radiation therapy (EBRT) is the use of radiation therapy to kill or inactivate cancer cells. The total radiation dose is given in separate individual treatments, known as fractionation. Cancer cells are most sensitive to radiation at different phases in their growth. By giving the radiation on a daily basis, the radiation oncologist hopes to catch the cancer cells in the sensitive phases of growth and also to prevent the cells from having time to recover from the radiation damage....

What if my testosterone level is low What are the risks and benefits of testosterone therapy

Hypogonadism is a condition in which low levels of testosterone are found in association with specific signs and symptoms, including decreased desire (libido) and sense of vitality, erectile dysfunction, decreased muscle mass and bone density, depression, and anemia. When hypogonadism occurs in an older male, it is referred to as andropause, or androgen deficiency of the aging male. Hypogonadism is estimated to affect 2 to 4 million men in the United States, and its incidence increases with...

What are the risks ofa penile prosthesis

As with any surgical procedure, there are complications associated with the placement of a penile prosthesis. These risks may be subdivided into intraoperative complications (those occurring during surgery) and postoperative complications (those occurring after surgery). During dilation of the corpora cavernosa, the dilating instrument can perforate the urethra. If this occurs, the procedure must be terminated, the catheter must be left in place, and the urethra must be allowed to heal. If one...

What are the 5alpha reductase inhibitors

The 5-alpha reductase inhibitors are a class of medications that inhibit the enzyme 5-alpha reductase. The enzymes 5-alpha reductase are present in two isoforms type 1 and type 2. Type 1 is found predominantly in extrapr-ostatic tissues such as the skin and liver, although it is also found in the prostate. Type 2 is found predominantly in the prostate. The type 2 5-alpha reductase enzyme in the prostate is responsible for converting testosterone to its active form in the prostate,...

What are some of the side effects of hormonal therapy and how are they treated

LHRH analogues and antagonists have side effects that may affect your quality of life over the short and long term (Table 9). Some of the side effects related to these medications, such as hot flashes, erectile dysfunction, anemia, and osteoporosis, can be treated. Erectile dysfunction occurs in about 80 of men taking LHRH analogues and antagonists and is associated with decreased libido (sexual desire). The widely prescribed drug silde-nafil (Viagra) as well as the other oral therapies for...

Are there different types of hormone therapy Do I need to have my testicles removed

Hormone therapy is a form of prostate cancer treatment designed to eliminate the male hormones (androgens) from the body. The most common androgen is testosterone. Androgens are primarily produced by the testicles, under control of various parts of the brain. A small number of androgens are produced by the adrenal glands, which are small glands located above the kidneys and produce many important chemicals. Prostate cancer cells may be hormone sensitive, hormone insensitive, or hormone...

What happens when hormone therapy fails

If the PSA level increases while you are receiving total androgen blockade (LHRH agonist or antagonist plus androgen receptor blocker), first your doctor will stop the antiandrogen, which is called antiandrogen withdrawal (Figure 19). This causes the PSA to decrease in about 20 of patients, and the effect may last for several months to years. The LHRH analogue antagonist therapy is continued. It is not clear why this antiandrogen withdrawal works. When the PSA rises after antiandrogen...

What is the success rate of MUSE

In the initial studies of MUSE's effectiveness, the success rate was 64 . More recent studies have demonstrated its efficacy to be only 30 , however. Attempts to increase this success rate via the use of the ACTIS venous constrictor, a constricting band that is placed at the base of the penis, have helped some men. In some men, an erection rigid enough for penetration may occur in the standing position however, when these individuals change to a supine position, the erection may decrease. In...

Who is a candidate for penile injection

Because the injection requires manual dexterity, it is important that the man be able to perform self-injection. In some men for whom giving an injection may be difficult or who are anxious about pushing the needle into the side of their penis, an autoinjector is available that makes this task easier. Another option is to have the man's partner perform the injection. Similarly, if the man is obese and has trouble seeing his penis, self-injection may be difficult, so he would need to enlist the...

What is the success rate for PDE5 inhibitors

Overall, the PDE-5 inhibitors have a similar success rate. Success rates range from 48 to 81 with the various therapies, depending on the etiology of the ED. Individuals who have failed to respond to one of these medications may, however, respond to a different PDE-5 inhibitor. In one study, vardenafil was shown to be helpful in patients who had previously failed to respond to sildenafil therapy. However, studies have also demonstrated that patients who have failed an initial trial of...

Are there different types of problems with ejaculation What causes them and how are they treated

There are three different types of ejaculatory problems that can occur premature ejaculation, retrograde ejaculation, and anejaculation. What is premature ejaculation and what causes it Premature ejaculation is ejaculation that occurs sooner than desired, either before or shortly after penetration, that causes distress to one or both partners. This condition tends to occur more frequently in younger men. Premature ejaculation is the most common form of sexual dysfunction, occurring in 21 of men...

Prostate Cancer Support

Affiliation Southeast Alabama Medical Center Doctor's Building, SE Alabama Medical Center, 7th Floor, 1108 Ross Clark Circle, Dothan, AL 36301 334-794-3216 Meets the first Thursday of each month at 7 00 PM Gulf Shores, AL 36542, 334-968-1115 Meets the first Thursday of each month, except September Affiliation Fountain Valley Regional Hospital 11250 Warner Avenue, East Tower Cafeteria, Prostate Cancer Survivor's Support Group 200 Mowry Avenue at Civic Center Drive, Freemont, CA 510-657-0759...

Who is a candidate for oral therapy with a PDE5 inhibitor

Nevertheless, there are certain contraindications to the use of these therapies. If these limitations are ignored, serious or even life-threatening problems may occur. Specific contraindications to the use of PDE-5 inhibitors include the use of products containing organic nitrates, such as sublingual nitroglycerin, amyl nitrates, nitro-glycerin patches, and long-acting nitrates such as Imdur (Table 20). Nitrates (e.g., nitroglycerin), which are a form of...

What other disorders can mimic BPH

Other underlying disorders can mimic the symptoms of BPH. A neurogenic bladder, or bladder with impairment of its nerve supply, can cause a patient to void either frequently or infrequently depending on the nature of the neurologic problem. At times, a neurogenic bladder can cause the patient to be unable to urinate or go into urinary retention. Diabetes mellitus can cause frequent urination, as many patients with diabetes make a greater volume of urine per 24 hours. With long-standing...

What is the prostate gland and what does it do

The prostate gland is actually not a single gland. It is comprised of a collection of glands that are covered by a capsule. A gland is a structure or organ that produces a substance used in another part of the body. The prostate gland lies below the bladder, encircles the urethra, and lies in front of the rectum. Because it lies just in front of the rectum, the posterior aspect of the prostate can be assessed during a rectal examination. The normal size of the prostate gland is about the size...

What is a transurethral incision of the prostate TUIP

A transurethral incision of the prostate (TUIP) is exactly that an incision rather than a resection of the prostate. Using a special knife-like instrument, a Colling's knife that is placed through the same resectoscope sheath used for TURPs two incisions are made at 5 o'clock and 7 o'clock through the bladder neck and prostate to the verumontanum where the ejaculatory ducts exit. A TUIP is a quicker, easier procedure than a TURP. TUIPs tend to be used in younger men with smaller prostate...