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As men age, it’s not uncommon for the prostate to undergo changes that can impact urinary function. One such condition is Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. In this blog, we’ll explore the symptoms of BPH and various treatment options available to manage this common condition.
Symptoms of BPH
Frequent Urination: One of the hallmark symptoms of BPH is an increased frequency of urination, especially during the night. This occurs as the enlarged prostate puts pressure on the urethra, affecting the normal flow of urine.
Difficulty Initiating Urination: BPH can lead to a weak or hesitant urine stream. This is often the result of the prostate obstructing the urethra, making it more challenging for urine to pass through.
Incomplete Emptying of the Bladder: Men with BPH may experience a sensation that the bladder is not fully emptied after urination. This can contribute to the need for more frequent bathroom trips.
Urgency to Urinate: A sudden, compelling need to urinate, sometimes accompanied by a feeling of urgency, is another common symptom. This can disrupt daily activities and lead to anxiety about finding a restroom in time.
Straining During Urination: Due to the obstruction caused by an enlarged prostate, men with BPH may find themselves straining to push urine out, leading to increased effort during the urination process.
Treatment Options
While Benign Prostatic Hyperplasia can be a source of discomfort and inconvenience, numerous treatment options are available to manage its symptoms. Early detection and consultation with a healthcare professional are crucial for developing an individualized treatment plan that best suits the patient’s needs. Whether through lifestyle changes, medications, or surgical interventions, there are effective ways to address BPH and improve the quality of life for those affected by this common condition. See how we treat BPH at Fairbanks Urology.
Kidney stones are hard masses that form from crystals in the urine. Sometimes, they do not have recognizable symptoms, but often, kidney stones can be very painful. Either way, you will want to avoid them, or maybe you’ve had them and you’re in no rush for them to return. There are preventative actions you can take with changes to your diet plan that will help keep kidney stones from building.
Before we begin with diet recommendations, it’s important to note that all kidney stones are not the same. The most common type of kidney stone is a calcium stone, with uric acid stones following close after. Diet and medical treatment are different depending on the stone type.
Oxalate is naturally found in many foods, including fruits and vegetables, nuts and seeds, grains, legumes, and even chocolate and tea. Some examples of foods that have high levels of oxalate include peanuts, rhubarb, spinach, beets, Swiss chard, chocolate and sweet potatoes. Limiting intake of these foods may be beneficial for people who form calcium oxalate stones which is the leading type of kidney stone.
Eat and drink calcium foods such as milk, yogurt, and some cheese and oxalate-rich foods together during a meal. The oxalate and calcium from the foods are more likely to bind to one another in the stomach and intestines before entering the kidneys. This will make it less likely that kidney stones will form.
Calcium is not the enemy but it tends to get a bad rap! This is most likely due to its name and misunderstanding that calcium is the main cause in calcium-oxalate stones. A diet low in calcium actually increases your chances of developing kidney stones.
Don’t reduce the calcium in your diet. Work to cut back on the sodium in your diet and to pair calcium-rich foods with oxalate-rich foods. The recommended calcium intake to prevent calcium stones is 1000-1200 mg per day (you can eat 3 servings of dairy products with meals to meet the recommendation).
Extra sodium causes you to lose more calcium in your urine. Sodium and calcium share the same transport in the kidney so if you eat high sodium foods it will increase calcium leakage in the urine. Therefore, a high sodium diet can increase your chances for developing another stone. There are many sources of “hidden” sodium such as canned or commercially processed foods as well as restaurant-prepared and fast foods.
You can lower your sodium intake by choosing fresh low sodium foods which can help to lower calcium leakage in the urine and will also help with blood pressure control if you have high blood pressure.
2. Uric acid stones: another common stone
Red meat, organ meats, and shellfish have high amounts of a natural chemical compound known as purines. High purine intake leads to a higher production of uric acid and a larger acid load for the kidneys to excrete. Higher uric acid excretion leads to more acidic urine. The high acid concentration of the urine makes it easier for uric acid stones to form.
To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, beer/alcoholic beverages, meat-based gravies, sardines, anchovies and shellfish. Follow a healthy diet plan that has mostly vegetables and fruits, whole grains, and low-fat dairy products. Limit sugar-sweetened foods and drinks, especially those that have high fructose corn syrup. Limit alcohol because it can increase uric acid levels in the blood and avoid short term diets for the same reason. Decreasing animal-based protein and eating more fruits and vegetables will help decrease urine acidity and this may help reduce the chance for uric acid stone formation.
General Diet Recommendations for Kidney Stones:
Drink plenty of fluid: 2-3 quarts/day This includes any type of fluid such as water, coffee and lemonade which have been shown to have a beneficial effect with the exception of grapefruit juice and soda. This will help produce less concentrated urine and ensure a good urine volume of at least 2.5L/day.
Limit foods with high oxalate content Spinach, many berries, chocolate, wheat bran, nuts, beets, tea and rhubarb should be eliminated from your diet intake.
Eat enough dietary calcium Three servings of dairy per day will help lower the risk of calcium stone formation. Eat with meals.
Avoid extra calcium supplements Calcium supplements should be individualized by your physician and registered kidney dietitian.
Eat a moderate amount of protein High protein intakes will cause the kidneys to excrete more calcium therefore this may cause more stones to form in the kidney.
Avoid high salt intake High sodium intake increases calcium in the urine which increases the chances of developing stones. Low salt diet is also important to control blood pressure.
Avoid high doses of vitamin C supplements It is recommend to take 60mg/day of vitamin C based on the US Dietary Reference Intake Excess. Amounts of 1000mg/day or more may produce more oxalate in the body.
Interstitial cystitis (IC), also known as bladder pain syndrome, is a chronic condition that affects the urinary bladder, causing discomfort and pain. If you or someone you know has been diagnosed with IC, you may have several questions about the condition and its management. Here are five frequently asked questions about interstitial cystitis to provide you with a better understanding.
Is there a cure for IC?
Unfortunately, there is currently no cure for IC. However, the condition is manageable with treatments and medications. It’s important to work closely with your healthcare provider to develop an individualized treatment plan that suits your specific needs.
What are the symptoms of IC?
The symptoms of IC vary from person to person, but the most common ones include frequent urination, urgency to urinate, pelvic pain, and discomfort during sexual intercourse. Some individuals may also experience low back pain, blood in the urine, and swelling in the stomach or pelvic area. It’s crucial to consult with a healthcare provider to receive an accurate diagnosis and appropriate treatment.
How is IC diagnosed?
Diagnosing IC can be challenging as there is no definitive test for it. Healthcare providers typically consider a combination of symptoms, medical history, physical examination, and ruling out other possible conditions. Additional tests such as urine analysis, cystoscopy, and bladder biopsy may be conducted to confirm the diagnosis.
What treatments are available for IC?
The treatment options for IC aim to alleviate symptoms and improve the quality of life. They may include lifestyle changes, physical therapy, bladder training, medications, and in some cases, surgical interventions. Each treatment plan is tailored to the individual’s specific needs and may require a trial-and-error approach to find the most effective combination.
How often should I follow up with my healthcare provider?
The frequency of follow-up appointments depends on your specific treatment plan and how you feel. It’s important to maintain open communication with your healthcare provider and report any changes or new symptoms promptly. Regular check-ups allow for adjustments to the treatment plan and ensure that your condition is adequately managed.
Remember, while living with IC can be challenging, there are ways to manage the symptoms and improve your quality of life. By working closely with your healthcare provider, following the recommended treatment plan, and making necessary lifestyle adjustments, you can find relief and regain control over your well-being.
If you have further questions or concerns about interstitial cystitis, don’t hesitate to reach out to your healthcare provider. They are your best resource for accurate information and guidance on managing IC.
The pelvic floor plays a crucial role in supporting the bladder, bowel, and uterus in women. Pelvic floor stretches are a valuable tool for maintaining and improving pelvic floor health, particularly for women who may be experiencing issues such as Stress Urinary Incontinence (SUI). Understanding the benefits of pelvic floor stretches and incorporating them into your routine can have a positive impact on bladder control and overall well-being.
Incorporating pelvic floor stretches into your daily routine can be a proactive step towards maintaining pelvic health and addressing SUI. Here are some gentle stretches to consider:
Pelvic Floor Stretches
Incorporating stretching exercises can effectively relax the pelvic floor muscles. Here are some common stretches:
Happy Baby Pose – Lying on your back, open your knees wide and pull them toward your head. Hold your legs with your arms on/behind your knees or at your ankles. You can also gently roll from side to side.
Child’s Pose – On your hands and knees, spread your knees wide, keep your toes touching, and lean forward gently, placing your upper body between your legs. Stretch your arms out in front of you.
Adductor Stretch (Lying Butterfly Pose) – Relax on your back with the bottoms of your feet together and let your knees relax out to the sides. You can place pillows under your knees for support if needed.
Seeking Professional Guidance
While pelvic floor stretches can be beneficial, it’s important to approach them mindfully, especially if you are dealing with pelvic floor issues or SUI. Consulting with a healthcare professional, such as a pelvic health physiotherapist, can provide personalized guidance and exercises tailored to your specific needs.
Stress urinary incontinence (SUI) is a prevalent condition that affects one in three adults. It is characterized by the involuntary leakage of urine due to increased pressure on the abdomen, which can be triggered by activities such as coughing, sneezing, laughing, and lifting heavy objects. Factors such as childbirth, age, excess body weight, previous pelvic surgery, chronic coughing, and high-impact activities can weaken the muscles supporting the urethra, leading to SUI.
Symptoms of SUI may include urine leakage during physical activities, a sudden urge to urinate, and the inability to reach the toilet in time. Many women may also experience a combination of both stress and urge incontinence, known as mixed urinary incontinence.
It is essential for individuals experiencing symptoms of SUI to seek prompt medical attention for proper diagnosis and treatment. Treatment options for SUI include lifestyle changes such as bladder training and weight management, as well as nonsurgical treatments like pelvic floor therapy and pessaries. These interventions can help manage SUI and improve the quality of life for affected women.
Understanding the causes, symptoms, and treatment options for stress urinary incontinence is crucial for individuals experiencing this condition. By seeking medical assistance and exploring appropriate treatment options, individuals can effectively manage SUI and enhance their overall well-being.
As family travels from near and far to be together during the holiday season, it’s an opportune time for you to not only cherish the time with your loved ones, but also gain a deeper understanding of your family’s health history. Take the time to have important conversations about family health history. Discussing your family’s health background doesn’t have to overshadow the festive atmosphere, however, it can be a valuable way to understand potential health issues that may be hereditary, allowing you to proactively address them with your healthcare provider.
Understanding your family’s health history is crucial for everyone. It empowers you to develop a strategy for managing any potential health concerns. For instance, a family history of breast cancer can be associated with an increased risk of prostate cancer. Certain genetic mutations that elevate the risk of breast cancer also raise the likelihood of prostate cancer in men. Therefore, if you discover a family member has had breast cancer, it’s important to discuss your own cancer risk with your doctor.
This holiday season, take a moment to engage in discussions with your family about the significance of understanding your health history. The more you comprehend potential health impacts, the better equipped you and your doctor are to address them early on, allowing you to continue relishing those special holiday moments.
At Fairbanks Urology we offer many tests to help accurately diagnose urinary and sexual conditions for both men and women. Please click below to learn more:
FAIRBANKS UROLOGY IS NOW OFFERING SpaceOAR™ HYDROGEL
Fairbanks Urology to Offer Innovative SpaceOAR™ Hydrogel for Prostate Cancer Patients Undergoing Radiation Treatment. SpaceOAR Hydrogel Provides Barrier to Help Reduce Risk of Side Effects During Prostate Cancer Treatment
Fairbanks, AK, September 14th, 2020 – Fairbanks Urology announced this summer that it will now utilize an innovative technology shown in a clinical study to help prostate cancer patients avoid some of the negative effects of radiation therapy.
“The introduction of SpaceOAR Hydrogel as a pre-treatment option at Fairbanks Urology demonstrates our commitment to providing the best possible care to our patients by offering the latest innovation in treatments,” said Dr. Tony Nimeh, Urologist and Prostate Cancer Expert. “Men diagnosed with prostate cancer have some difficult decisions to make, but knowing that an option like SpaceOAR Hydrogel can potentially limit the risk of damage to other organs during radiation treatment will hopefully make a few of those decisions easier.”
Because of the proximity of the rectum and prostate, prostate radiation therapy can cause unintended damage to the rectum, which can lead to fecal incontinence issues or other long-lasting side effects. Placed through a needle, SpaceOAR Hydrogel is administered as a liquid between the prostate and the rectum, but quickly solidifies into a soft gel that expands the space and pushes the rectal wall away from the high-dose radiation area. The hydrogel stays in place for about three months. After about six months, the hydrogel is naturally absorbed into the body and removed through urine.
According to the American Cancer Society, prostate cancer is the most common cancer in American men, with more than 183,000 new cases diagnosed each year. More than 60,000 American men opt to treat their prostate cancer with radiation every year.
FDA clearance was granted for SpaceOAR Hydrogel following completion of a prospective, multicenter, randomized clinical trial. SpaceOAR patients experienced a significant reduction in rectal radiation dose and severity of late rectal toxicity when compared to control patients who did not receive SpaceOAR Hydrogel. The full pivotal clinical trial results have been published in the peer-reviewed Red Journal.
*Mariados N, Sylvester J, Shah D, et al. Hydrogel spacer prospective multicenter randomized controlled pivotal trial: Dosimetric and clinical effects of perirectal spacer application in men undergoing prostate image guided intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2015 Aug 1;92(5):971-7.
FAIRBANKS UROLOGY IS HERE TO HELP UROLOGY PATIENTS LIVE HAPPY AND HEALTHY LIVES THROUGH HEALING, EDUCATION, AND QUALITY CARE.
Urology has been making great advances in treatment options for symptoms that plague men’s lives as they age. One of the most common conditions we see in our office is Benign Prostatic Hyperplasia, or BPH. BPH is a noncancerous enlargement of the prostate gland. The enlarged prostate often compresses the urinary tube (urethra), which courses through the center of the prostate, this intrusion can impede the flow of urine from the bladder through the urethra to the outside. While this may not sound concerning, the inconveniences of living with this condition can include loss of sleep, inability to travel comfortably and difficulty with completely emptying the bladder. With this situation being so prevalent, there has become a solution as simple as the problem itself. Leading the state in the most non-invasive treatment option, Dr. Tony Nimeh has been designated with a Certificate of Excellence as a result of his experience and training with the Urolift Procedure. The Urolift offers patients improved quality of life without side effects of medications and avoids more invasive surgical approaches done in a hospital. The Urolift is the frontier of urological health; reducing recovery times and improving results. For more information about the Urolift or the many other urological aspects of care that Fairbanks Urology provides, call us at 907-328-0989.
Aaron Marks is a clinical care coordinator for Fairbanks Urology. Dr. Tony Nimeh is a urologist and men’s health expert at Fairbanks Urology. Aaron sat down with Dr. Nimeh to discuss Prostate Cancer Awareness Month.
HERE’S WHAT YOU NEED TO KNOW
Aaron: We’re here with Dr. Tony Nimeh, and we’re discussing Prostate Cancer Awareness Month. Dr. Nimeh, we hear a lot about the PSA blood test for testing for prostate cancer. Is this a reliable test?
Dr. Nimeh: The PSA is a very important test in prostate cancer detection. It is very reliable for some things, but it’s not very reliable for other things. Prostate-specific antigen, or PSA, is a protein produced by normal cells, as well as cancer cells, of the prostate gland. The PSA test measures the level of PSA in a man’s blood.
The analogy for this test that I like to use with my patients is that the PSA is like oil for your car engine. The oil is supposed to be there. But if you park your car in front of the house and in the morning you find there’s oil all over the ground, that’s a problem and you need to figure out why there is a leak.
Same thing with a prostate and the PSA. The PSA is inside the prostate. If we do a blood test and we find the PSA is elevated, that means there’s a leak. The PSA is leaking out of the prostate into the bloodstream, and we can measure an elevation in the PSA in your blood. We’re testing to see if there’s a leak in the prostate.
Now with that being said, prostate cancer is not the only thing that can cause a leak. That’s why when you go see your doctor and they see an elevation in the PSA, they say, well, we need to investigate this further. So what else can cause the PSA to leak? Well, there’s a few different things. Sexual activity before the test can cause it. Also, any procedure on the urinary tract, or urinary tract infections. Plus any physical activity like horseback riding or snowmachining can make an impact.
Aaron: So when should a man get a PSA test done?
Dr. Nimeh: The PSA is a screening test for prostate cancer that is done at the age of 50. And it’s done annually from 50 until the age of 70.
The reason why we call it a screening test is that we are trying to find the cancer before it becomes symptomatic. If we find the cancer before it becomes symptomatic, then we have a chance of catching the cancer early on and if we do that, then the chance of a cure is very high.
If we wait until it starts to give off symptoms, such as affecting the organs or leave the prostate and goes to the bone which can create fractures, then that means the prostate cancer has become quite advanced and it’s a lot more difficult to cure.
We can still treat it, but we want to catch it before it becomes advanced.
Aaron: If the PSA is elevated, how do we make sure it’s not from prostate cancer?
Dr. Nimeh: Once we have an elevated PSA, we do a prostate biopsy. It takes about 15 minutes, and we send the biopsy off to a pathologist. If there is a cancer, it all depends on what type of cancer.
Aaron: What happens if the prostate biopsy is positive?
Dr. Nimeh: The American Urological Association has categorized prostate cancer into four categories: very low risk, low risk, medium risk, and high risk.
Depending on where the patient is, we will recommend different courses of action. For example, for the very low risk category, we actually do not recommend any treatment at all. Of course, for the high risk category we do recommend treatment.
Aaron: We hear a lot about chemotherapy. Is this used in the treatment of prostate cancer?
Dr. Nimeh: Chemotherapy is rarely used in prostate cancer. It is effective with other types of cancer but not for prostate cancer. The different options for prostate cancer are active surveillance, hormone therapy, surgery, and radiation therapy.
Chemotherapy is used only for very advanced cases. If we are talking about active surveillance for low risk cancer, then all that means is that we are actively monitoring this cancer because we believe if we keep an eye on it, then the second it becomes more aggressive we still have a chance to completely cure it. If we diagnose a low risk cancer and we keep an eye on it for let’s say five years, and then five years later it becomes more aggressive and we intervene at that point, then we still have a chance of curing it.
Aaron: But what have we gained by waiting for five years while the man is on active surveillance?
Dr. Nimeh: Well, we gained that for five years that patient did not have to have therapy and did not have to suffer the side effects. Unfortunately, every therapy that we use in prostate cancer will have some sort of side effect. There’s always a downside. So by saying we’re going to implement active surveillance, then there was a five-year period where that man didn’t suffer any form of erectile dysfunction, incontinence, or any of the side effects that can come with it.
If we fast forward and it’s five years later and this cancer is now moderate or high risk, there are two treatments: One is surgery. The second is radiation. Radiation usually comes with some sort of hormone therapy. The surgery involves removing the entire prostate.
Aaron: What in your opinion is the best treatment?
Dr. Nimeh: Again, that depends on the type of cancer and the age of the patient.
For younger patients, we tend to recommend surgery. Older patients tend to go for radiation. Mostly because the surgery has a higher risk when the patient is older. Also if a younger patient has surgery and they have a recurrence, they can have radiation done later.
Doing surgery on tissue that has been through radiation is more difficult because the tissue doesn’t heal as well as tissue that has not been through radiation.
Concerning radiation, there is a new technique to decrease the side effects of the radiation on the surrounding organs such as the bladder and the rectum. The radiation is focused on the prostate, and the rectum is at risk for receiving part of that radiation and will suffer from side effects.
A new technique we’ve been doing is putting a gel called SpaceOAR gel, which is a spacer that creates a space between the prostate and the rectum. So now when the radiation is going to the prostate, there is less impact on the rectum. This is an advanced technique that we’re doing here in Fairbanks that will allow patients to have less side effects from the radiation.
