By David Blyweiss, M.D., Advanced Natural Wellness
April 29, 2022
Nearly all men will experience an enlarged prostate (benign prostatic hyperplasia, or BPH) in their lives. At some point, they will find themselves making constant trips to the bathroom, especially at night. And it may seem that urgency is required… but when you stand over the toilet you may only be able to dribble.
You see, a normal sized prostate is about the size of a golf ball. But over the years, it can become as large as a tennis ball. When this happens, it presses down on your urethra like a vice. This can cause all sorts of troubles when it comes to passing fluids from your bladder through to the toilet bowl.
As a result, up to 50% of men over the age of 50 – and up to 80% of men over the age of 80 – will experience urinary tract symptoms cause by BPH.
There are drugs for it. You’ve got your alpha blockers. They don’t do anything to reduce the volume of your prostate. All they do is relax the prostate and bladder neck muscles, and they come with a ton of side effects including impotence, dry ejaculation and fainting.
Then you’ve got your 5-alpha reductase inhibitors. They inhibit the production of dihydrotestosterone (DHT) in the prostate gland which helps reduce prostate volume. But I don’t like these drugs, either.
They decrease your sex drive and make it tough to get and maintain an erection. They increase your risk of growing male breasts and make your testes hurt. They’re basically a form of chemical castration, and that’s the last thing you want!
So what is a man with an enlarged prostate to do? Spend their entire lives in the bathroom?
The Ups and Downs of BPH Procedures
Well, there’s always surgery.
The so-called gold standard surgery for BPH is called a transurethral resection of the prostate (TURP). It’s awful. We often referred to as the “roto-rooter” because they go in through your penis and just start rotating this device around, destroying prostate tissue and pulling it out.
So you urinate blood for a couple of weeks and everything hurts. You don’t want to pee but you have to. Then you lose your ability for an erection and you no longer get to have sex.
Yikes! A lot of men would rather wear Depends or resort to self-catheterize before going this route.
But there are other treatments that are somewhat less invasive.
We have the prostatic artery embolization, or PAE. Tiny beads are injected into the artery that supplies blood to the prostate, partially blocking the blood flow. The reduced blood flow kills off some of the tissue in the prostate, which helps reduce the size.
The downside? The procedure can be affected by how far the median lobe of the prostate protrudes into the base of the bladder. Depending on how severe the protrusion is, this procedure could actually increase urinary retention and urinary tract symptoms.
Then we’ve got the UroLift system. It permanently inserts tiny implants that lift and hold prostate tissue out of the way so it doesn’t block the urethra.
Nobody seems to know why, but this procedure appears to result in a higher rate of emergency room visits afterwards than you would expect for a minimally invasive treatment. Plus, some men still remain catheter dependent at 30 days, and many have to be re-catheterized after 30 days.
You also have photoselective vaporization of the prostate (PVP, or Greenlight). It’s a laser surgery that involves inserting a tube into the penis and zapping excess tissue that blocks the urine flow.
This actually sounds like a pretty good option. But oddly enough, a two-year follow-up study found that most men who chose PVP had a significant decrease in erectile function afterwards. Another follow-up discovered that 65% of men lost the ability to ejaculate after PVP. That’s pretty alarming to any man.
Give Your Prostate a Steam Bath
One on the newest treatments for BPH is called Rezūm water vapor therapy. And so far, I don’t see any downside to it. Well, except for the fact that the basic concept is pretty frightening.
It involves injecting steam into your prostate gland through the urethra to destroy the tissue that’s causing the blockage.
And here’s the thing. They tell you it’s only going to hurt a little bit. But according to the few patients I know who have had the procedure, don’t believe it. They’re lying!
It’s more of a screaming, burning, they’re pulling my tongue out with a pair of pliers kind of pain. So if you decide you want this procedure and they don’t offer you anesthesia or sedation, make sure to ask for it. The most painful part will happen while you’re under.
But it works. And you’re not actually ripping anything out of your body, putting anything into it or changing the way it works. You’re just killing unwanted prostate tissue and your body will naturally carry it away. Most men see an improvement within just a few weeks, and the improvements continue for the next three to six months.
Better yet, these improvements come without the erectile dysfunction and ejaculation issues associated with other procedures. The treatment is also one of the few that works to reduce the size of the median lobe. Plus it has a very short catheterization period. On average just about four days, and sometimes less.
So if you haven’t been interested in taking BPH medications or undergoing BPH procedures in the past, this might be something you might want to check into. You can find a local urologist who specializes in Rezūm treatment here.
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