Bigger isn’t always better!! At least when it relates to your prostate
People with enlarged prostates from B.P.H. (benign prostate hyperplasia) are twice as likely to be diagnosed with prostate cancer as the general population. The guys with the larger “benign” prostates are also twice as likely to die of prostate cancer than the little ones. According to a study published at the 2011 European Multidisciplinary Cancer Congress, men with enlarged prostate have twice the risk of prostate cancer and prostate cancer death. This report is from the largest registry study looking at over 2.8 million men in the general population of Denmark from 1980 to 2006.
So what does this mean for us Americans? First and foremost, screening may help diagnose prostate problems or cancer and save lives. Second, that an enlarged BPH (or benign) prostate does not protect us from prostate cancer; it actually puts us at a greater risk.
Sex and Erections: The little pill just got faster and easier to use
What’s new in sexual dysfuntion?
There is a new pill for treating faulty erections. ED, erectile dysfunction or impotence can be treated with oral pills like Viagra, Cialis, or Levitra. The problems with these medications are that it often takes hours for them to work after you ingest it and they don’t allow for sexual spontaneity. Now there is a new pill that may be helpful for those suffering from ED. Staxyn is a new oral tablet that contains the same ingredients as Levitra but is used as a tablet that dissolves on the tongue. It works faster than the pills you have to swallow, as it doesn’t not require absorption in the stomach.
Staxyn helps increase blood flow to the penis, so it may help men with ED get and keep an erection that lasts long enough for sexual activity. Once a man has stopped sexual activity, blood flow to his penis decreases, and his erection goes away.
It is suggested that you take Staxyn about an hour before sexual activity. The tablet is placed on the tongue where it will dissolve rapidly. The tablet should be taken whole and not crushed or split. The tablet should not be taken with liquid. The tablet may be taken with or without food. It is not recommend to take more than one Staxyn a day.
Forget the Rumors:
1. Staxyn will not give you an instant erection
2. You’ll need to be sexually stimulated for it to work.
3. The medication not leave you erect for hours. (If , however, you have an erection lasts more than 4 hours, get medical help right away to prevent lasting damage that may make future erections difficult or impossible.)
4. No the drug will not make you have a stiff tongue. It’s mechanism of action is on the blood supply to the penis and not the tongue!
5. No, no, with nitrates
Do not take Staxyn if you take any medications called ”nitrates” (often used to control chest pain, also known as angina). Nitrates may cause abnormally low blood pressure and Staxyn may increase that risk.
The Bottom Line: Erectile dysfunction is a common problem affecting millions of American men. Help is available. You don’t have to suffer the “tragedy of the bedroom”.
Adapted from Dr. Neil Baum
Prostate cancer: Pee to find out if you have it!
There is an investigational urine test that can rate a man’s risk for prostate cancer and identify men with two of the genes responsible for prostate cancer. The urine tests detects these genes if a man has prostate cancer. As a note, only 50% of men with prostate cancer have this gene, but it is a good way to start the evaluation and perhaps prevent repeat prostate biopsies.
All of the men in this study had elevated PSA levels and had undergone either biopsy or prostatectomy. The men were tested for the genes and then stratified into low, intermediate and high risk. The risk level was compared to their biopsy results and found that 69% of men with a high risk level on the urine test had prostate cancer. Only 21% of men with low risk on the urine test had prostate cancer.
“Testing for TMPRSS2:ERG and PCA3 significantly improves the ability to predict whether a man has prostate cancer,” said Dr. Tomlins in a press statement. “We think this is going to be a tool to help men with elevated PSA decide if they need a biopsy, or if they can delay having a biopsy and follow their PSA and urineTMPRSS2:ERG and PCA3.”
The test has not yet made it to clinics, but there is hope that we can avoid lots of unnecessary biopsies with these new genetic urine tests.
“Many more men have elevated PSA than actually have cancer, but it can be difficult to determine this without biopsy. This test will help in this regard. The hope is that this test will be an intermediate step before getting a biopsy,” said senior study author Dr. Arul Chinnaiyan.
Scores Correlate with Aggressiveness
In addition to helping predict the likelihood of prostate cancer, the urine test scores correlated with aggressiveness, as indicated by Gleason score. Only 7% of men in the low-score group had an aggressive tumor (Gleason score above 6), compared with 20% in the intermediate-score group and 40% in the high-score group. The difference between the low- and high-score groups was significant (P < .001).
This article was adapted from medscape.com
http://www.medscape.com/viewarticle/747705?src=top10
Sci Transl Med. 2011;3:94ra72. Abstract
Botox: For a youthful bladder that doesn’t leak
The FDA announced approval this week for the use of Botox, Allergan Inc, to treat urinary incontinence resulting from an over active bladder (OAB). While this use is limited to patients with spinal cord injury and multiple sclerosis (MS), the future of other indications of Botox for overactive bladder is like coming soon after. Botox offers another treatment option for hard to treat patients with OAB who have inadequate response to traditional therapy using anticholinergics.
Injection of the drug is given directly into the bladder and results in relaxation of the bladder to increase it’s storage capacity and therefore decrease urinary incontinence. Injection is performed using cystoscopy, which may require general anesthesia. The duration of effect of treatment is about 9 months.
The most common adverse reactions seen following injection were urinary tract infection and urinary retention (the inability to empty one’s bladder). “Those who develop urinary retention after Botox treatment may require self-catheterization to empty the bladder,” the FDA statement adds.
While this isn’t the cure-all for every patient with incontinence and overactive bladder symptoms, it’s one tool to help manage tough to treat symptoms.
OnabotulinumtoxinA is already approved for other indications, including chronic migraine, upper limb spasticity, strabismus, and blepharospasm.
From September 2011 Medscape Urology.