Category Archives: Prostate
REZUM therapy is a minimally invasive, in-office, and non-surgical procedure to shrink an enlarged prostate due to benign prostatic hyperplasia or BPH. Heat generated by radiofrequency waves is delivered to the prostate through a needle that emits water droplets that generate steam. This allows for a rapid treatment that has the ability to expand but will not go beyond the anatomical boundary of the prostate itself. The REZUM starts with a transrectal ultrasound which will be used to take a picture of the prostate, determine its dimensions, and inject lidocaine as local anesthesia. This is a very well-tolerated step akin to numbing before a dental procedure and is very quick. The patient will then be repositioned with legs in stirrups and the REZUM can commence.
Benign Prostatic Hyperplasia (BPH) or enlarged prostate is a concern that most men will experience as they age. On average, about 50% of men over 50 and 80% of men over 80 will experience the lower urinary tract symptoms associated with prostatic enlargement. Because of the nature of this condition, many novel procedures have tried to address the limitations of their predecessors. Some have succeeded, while others have fallen out of favor. In the absence of more serious medical complications, Dr. Engel always focuses on medical therapy as a first line of treatment for most cases of an enlarged prostate. However, if initial medical therapy does not offer the relief the patient expects, if there are side effects, or if the patient simply does not want to be on chronic medication, we often move on to offering minimally invasive BPH therapies that can be quick, effective, and have minimal side effects. However, some patients will need surgical intervention such as robotic simple prostatectomy or HoLEP (Holmium laser enucleation of the prostate) as the procedure of choice when the prostatic enlargement is extreme. The prostate is measured in grams; we consider a large prostate to be anything over 80g, and Dr. Engel has treated prostates of up to 400g.
Transurethral Needle Ablation or TUNA is a safe and effective in-office therapy to treat benign prostatic hyperplasia / BPH. Dr. Engel is one of the leading users of this technology across the entire United States. One of the great benefits of using TUNA is its versatility. A TUNA can be likened to a free swing – where downtime is minimal, and the procedure does not preclude the use of other treatment options after that. But what about the other way around? For example, can a TUNA be performed after a TURP or transurethral resection of the prostate?
Exercise is one of the most important predictors of long-term health. Without exercise, i.e. living a sedentary lifestyle, we increase our risk for a number of problems not least of which is are certain forms of cancer. Beyond the tangible improvements in health that we see from exercise, regular cardio and strength training can even improve some mental health issues including anxiety, depression, and mood problems.
Benign prostatic hyperplasia or BPH is a non-cancerous enlargement of the prostate gland. It is extremely common with about 50% of men over 50, and 80% of men over 80, suffering from its symptoms. While BPH is very common, there is a lot of confusing information that can delay patients from receiving the most effective treatment. Many men live with the lower urinary tract symptoms associated with BPH for years before they pursue a treatment option. Many are then bombarded by advertisements telling them that herbs may shrink the prostate. Having read this website you know that these claims are questionable.
Coffee has historically had an up and down relationship in researchers’ eyes. What was once considered incredibly healthy, was later vilified as carcinogenic. Today, many studies have shown that coffee confers more antioxidant benefits than it does risks in the average person when consumed in moderation. But what did recent studies say about coffee as it relates to prostate cancer risk?
As a leader in the evolution of diagnosis and classification of prostate cancer over the past few decades, Dr. Engel has seen and participated in changes regarding how we view prostate cancer and how it is ultimately treated. Elsewhere on this website and in his webinars, Dr. Engel has discussed PSA or Prostate Specific Antigen and how it revolutionized the diagnosis of prostate cancer…however, early on it was poorly understood, used improperly and ultimately led to over-treatment in many men.
Prostate cancer can become a trigger for panic when we hear that 13 out of every 100 men in the United States will have it at some point in their lives. Although you cannot change your age or genetics, which certainly factor when calculating your risk of prostate cancer, you can take active, preventative measures to decrease your chances.
Many men suffer from Benign Prostatic Hyperplasia or enlarged prostate. It becomes more common as a man ages with approximately 50% of all men experiencing it by the age of 50 and 80% by the age of 80. And while the condition is not life-threatening and only in rare cases medically problematic, it can be very limiting. Those who suffer from BPH may have difficulty urinating or may experience urinary incontinence. They may limit activities because of the psychological impact that such problems have on one’s psyche. BPH can also cause frequent urination, especially at night and many patients report going to the bathroom up to a dozen times, which not only is terribly disruptive, but also causes fatigue and tiredness throughout the rest of the next day. Many patients visit their urologist in a panic believing that they may have prostate cancer and for the vast majority, this is not the case. It is worth remembering that early stages of prostate cancer do not present with urinary symptoms similar to BPH. However, this reassurance does not address the underlying cause of the enlargement and the resultant symptoms.
Many men come to our office with lower urinary tract symptoms or LUTS and very concerned about the prospect of prostate cancer. While there is always a chance of prostate cancer, the likelihood of other prostate conditions is far higher. In fact, prostate cancer is most often asymptomatic except in the very worst stages of the disease. So, right off the bat, it is important to understand the “symptoms of prostate cancer” are, more likely than not, related to the common, non-cancerous condition known as Benign Prostatic Hyperplasia or BPH.