Archive | August, 2010

Connection Between Night-Time Waking and Depression

If you, or anyone close to you, suffers from benign prostatic hyperplasia, then you are well aware of the symptoms enlarged prostate, urgent need to urinate, weak urine stream, and frequent night-time waking to use the bathroom.  Night-time waking to urinate is referred to as nocturia, and recently researchers have linked it with depression.  Although benign prostatic hyperplasia is often more bothersome than dangerous, depression can be a debilitating psychiatric disorder.  The National Comorbidity Survey Replication and the International Consortium of Psychiatric Epidemiology state that approximately ten percent of the worldwide population has reported symptoms of depression, yet the causes of depression are still not well known.  Some researchers point to genetics and personality types, while others focus on stress factors and a history of traumatic experiences.

In a recent publication of the journal Urology on July 2, 2010, urologists published a study that examined the relationship between the physical condition of nocturia and depression.  In the past, it has been established that those patients who have severe physical conditions like cancer or stroke often exhibit signs of depression as well, but it is a new finding that otherwise healthy individuals who are waking in the night are experiencing the psychiatric problem.

Dr. Johnson and his colleagues from the Department of Urology at Emory University conducted a survey of over 500 men asking specific questions concerning nocturia and depression.  Approximately one-fifth of the subjects exhibited signs of depression.  If the patients reported less than 2 episodes of waking in the night to urinate, then they often did not meet the criteria for depression; however, if the subjects reported more than two episodes of nocturia, they often did meet these requirements.  Further, if the subjects reported more than five episodes of nocturia per night they had a 700 percent higher incidence of depression.

The underlying causation of depression is still being studied, but given the results from the Department of Urology, it is safe to say that a connection has been established between night-time waking and depression.  BPH affects nearly 90% of men over the age of 70.  If these male patients are more at risk for depression, then it is imperative that they seek treatment in order to get a full night’s rest and lead healthy lives.

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Life-Style Changes May Reduce Symptoms of Nocturia

As an individual ages, the number of times he or she may be waking up in the middle of the night to urinate increases.  This is a common problem among older people and has actually been termed nocturia.  Nocturia is a urological condition that may be curbed by life-style changes alone.

According to senior researcher Dr. Koji Yoshimura of Kyoto University Graduate School of Medicine in Kyoto, Japan, “Lifestyle modifications such as fluid restrictions” may reduce the frequency of night-time urination.  “However,” he continues, “the efficacy of the lifestyle therapy has not been established so far.”

Yoshimura and his team of researchers studied 50 patients who have reported urological symptoms of nocturia.  These patients were about 75 years of age, on average.  The team of researchers tested the connection between making simple lifestyle changes and the number of times the patients woke up to urinate.  Lifestyle changes tested included fluid restriction, limiting any excess hours in bend, moderate daily exercise, and keeping warm while sleeping.  The amount of fluid intake recommended was about 2 percent of their body weight during the day while limiting the intake so as not to over-consume at night right before going to sleep.

After four weeks of the lifestyle changes, the patients were experiencing a decrease in the number of night-time trips to the bathroom.  More than half of the patients were making at least one less trip to the bathroom at night.

Dr. Serge Marinkovic of St. Francis Hospital in Indianapolis remarked that “the effectiveness of the lifestyle changes was comparable to that of drug interventions.”  Drug interventions come in the form of medications such as a synthetic version of a hormone that keeps the body from making urine at night or antidepressants that make it harder to urinate.  But, according to Dr. Marinkovic, “None of these medications are a great cure, and all have side effects, including dry mouth, constipation and heartburn.”

Instead, urologists and researchers are recommending the lifestyle changes or, at most, natural supplements, to reduce the urological symptoms of nocturia.  Natural supplements have an added benefit of increasing your intake of other healthy ingredients for either prostate or bladder health.  If you feel you are experiencing nocturia or other urological conditions such as benign prostatic hyperplasia, which is an enlarged prostate, then contact your urologist for more information concerning your treatment options.

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The Official Urology Week Begins September 13th Through 17th

Each year, the European Association of Urology (EAU), which is the center for urology in Europe, and the national urological societies in Europe organize Urology Week.  This year Europe will be recognizing urological problems such as prostate cancer and other diseases during the week of September 13th through September 17th.  The purpose of Urology Week is to create awareness of urological diseases, provide information concerning the symptoms of the diseases, and focus on treatments urologists across the world are practicing.

Millions of men suffer from urological disorders in Europe.  For example, 42.8 million men suffer from erectile dysfunction in Europe alone.  And in the United States, over 4 million visits to the doctor each year are for benign prostatic hyperplasia, or enlargement of the prostate gland.  Further, the mortality of prostate cancer ranks within the top three cancer death rates in the world.

Despite the number of men who have been diagnosed with a urological disease, many men still feel too ashamed to discuss the health of their prostate.  In fact, studies have shown that shame and undetected symptoms are the two major reasons why many people do not seek medical help when experiencing urological symptoms. But urological patients should not be afraid to discuss their issues with their physicians: the urologists can help, especially when the disease is diagnosed early.

In order to promote Urological Week, the EAU has updated its website www.urologyweek.org to include activities throughout the week, information concerning prostate conditions and erectile dysfunction, and treatments.  The platform also contains patient and expert interviews, film documentation, and many articles.  In addition to the information, promotional materials such as brochures and leaflets may be downloaded for anybody to read or distribute.  Finally, debates concerning the pros and cons of prostate screening are available through the website.

The message the European Association of Urology is sending to Europe and the rest of the world is important.  Men over the age of 50 who are experiencing urological problems should not be ashamed of their conditions.  Instead, a healthy, open relationship with your urologist leads to a healthy prostate.

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Relief for Painful Bladder Syndome/Interstitial Cystitis is on the Way

Urigen Pharmaceuticals, Inc., announced on Wednesday, August 18, 2010, that the company and the FDA will begin discussing its program URG101.  Urigen Pharmaceuticals is a pharmaceutical company that develops special programs, therapies, and machines to treat painful urological disorders, including Painful Bladder Syndrome and Interstitial Cystitis.

According to Lowell Parsons, MD, Urigen’s Chief Medical Officer, “We are pleased the FDA has agreed to meet to discuss our URG101 program.  Since Painful Bladder Syndrome/Interstitial Cystitis occurs in a discrete region of the body, there is a definite role for a regional therapy such as URG101, and it may also provide the safest approach.”  Dr. Parsons believes that this treatment is the most significant advancement in the treatment of such painful urological diseases, and will improve both the quality of the patients’ lives and the quality of care in the field of urology.

URG101 is a urological therapy designed specifically for Painful Bladder Syndrome/Interstitial Cystitis and is currently patented by Urigen Pharmaceuticals.  The URG101 treatment is instilled into the bladder and works with lidocaine and heparin.  Lidocaine recues the sensations of pain, urgency, and muscle spasms, while heparin coats the bladder wall and augments the natural heparinoids.  Clinical studies have been conducted on the therapy, and each study was a multi-center, double-blind, placebo-controlled, crossover trial.  The results were clear:  an improvement in average daytime pain.

In the field of urology, Painful Bladder Syndrome is sometimes referred to Interstitial Cystitis.  This painful condition is increasingly being diagnosed by urologists across the country.  It is characterized by pain the bladder, urgency to urinate, and disrupted sleep due to the urge to urinate at night.  Approximately 10.5 million women and men in the United States alone suffer from Interstitial Cystitis.  Unfortunately, few treatments exist for this condition, and no urological therapies have been approved yet, which makes URG101 such a cutting-edge program and why urologists such as Dr. Parsons are excited at the FDA’s agreement to meet.

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BPH Diagnosis and Treatment

As men age they are at a higher risk of benign prostatic hyperplasia, or BPH.  BPH is characterized by an enlarged prostate with symptoms including increased urinary frequency, urgency, hesitancy, reduced force of stream, dribbling, and frequent waking in the night to urinate.

In order to have BPH diagnosed, an examination by a physician must be conducted, in addition to the observation of these symptoms.  This examination may include a bedside bladder scanner which determines the amount of urine left in the bladder after urination.  The flow rate of the urine may also be measured electronically.  And, although an enlarged prostate does not necessarily mean prostate cancer, a prostate specific antigen, or PSA, may be ordered to check for cancer.  Finally, a cystoscopy may be conducted in order to determine the size and shape of the prostate and any bladder problems associated with the enlarged prostate.

If a patient is diagnosed with BPH, several modern methods are available for the treatment.  The first method is medication, namely proscar and avodart, to shrink the prostate.  The use of the medications leads to side effects such as decreased volume of semen and need for long term medication.  A smooth muscle relaxant may also be used, but potential effects include decrease in blood pressure, dizziness, sinus pressure, and retrograde ejaculation.  To avoid these side effects, patients may opt for natural supplements.

If the physician determines the symptoms to be severe enough, then surgical therapies may be advised.  These therapies include microwave therapy, trans urethral needle ablation, and laser/trans urethral resection of the prostate.  These surgeries are determined to be relatively safe, but in the case of the laser/trans urethral resection of the prostate, anesthesia is required and scarring is possible.

Overall, benign prostatic hyperplasia neither indicates cancer, nor does it increase the likelihood of prostate cancer.  But if you are concerned about an enlarged prostate, you should make an appointment with your physician as soon as possible.  The symptoms of BPH are simple to diagnose and relatively easy to alleviate as many treatment options are available to you.

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Advancements in Urology are Good, but What About the Bad?

Despite the numerous advancements in urology surgeries and medication therapies, many of these treatments still produce negative side-effects.  And frequently the researchers of these treatments are failing to include the potential harms.

Recent analysis on medical literature reveals that there is a considerable deficiency in what is being reported as harmful side-effects and what harms are actually associated with the treatment.  According to Dr. Rodney H. Breau of Ottawa University Hospital in Canada, “We found considerable deficiencies in harm reporting that do not seem to be improving with time.”  Clinical research reports on the urological treatments are often leaving out the information concerning adverse side-effects, even if that information was gathered during the trial.  In fact, Breau’s study is the first study to actually look into the field of urology to verify treatment research reports.

If this information is not being included, it is nearly impossible for urologists to make “strong recommendations for or against a treatment.”  It also prevents patients of urological problems such as benign hyperplasia, interstitial cystititis, or prostatitis to make an informed decision on the type of treatment to undertake.

With nearly 20 percent of all studies not meeting the harm reporting criteria, patients may, justifiably, begin to question the overall benefit of the new surgeries and medications.  Instead, many patients are beginning to turn toward natural supplements, which promise an all natural, safe, healthy, and effective treatment.  For example, one natural supplement company, Farr Laboratories, produces several products such as BP-Q Max, Prosta-Q, Prourol, Cysta-Q, and Citurol Plus for a healthy bladder, prostate, and/or many other organs associated with urology.  These products have all been researched, clinically tested, and physician recommended.  The field of urology is seeing a turn toward a more natural remedy.

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Are you Receiving the Correct Dosage of Saw Palmetto to Alleviate BPH?

According to a recent study conducted by Valensa International, one of the leading producers of saw palmetto, some consumers may not be receiving the correct dosage, or form, to maximize its benefits.  Saw palmetto has been proven through a series of clinical trials to reduce the symptoms of benign prostatic hyperplasia; however, these trials show that a daily dose of 320 milligrams of the oil extract mitigate the effects, not the powdered form.

Currently, two forms of saw palmetto are being advertised in capsules of natural supplements, which has subsequently led to some confusion surrounding the efficacy of the ingredient.  Dr. Rudi E. Moerk, President and CEO of Valensa, states, “There is a solid body of evidence based on a number of clinical trials that show the 320 mg per day dosage of pure saw palmetto oil extract offers support to men experiencing the common effects of BPH.  There have been no studies done on similar levels of the powder-form products.  Just because both product forms start with saw palmetto berries, it doesn’t mean they are equivalent when it comes to achieving the result we expect from saw palmetto oil extracts.”

And the differences between the two forms are clear.  In order to extract the powder from the saw palmetto berries, the berry must be dried, crushed, and ground.  Often, younger berries are used in this process and the majority of oil in the crushed berry is left as discard.  On the other hand, high-efficiency extraction methods, like supercritical CO2, are used to extract the oil from more mature berries.  Because mature berries are used for the oil extraction, a higher concentration of the saw palmetto is obtained, thus leading to a more potent form for the capsules.  While powdered forms only see 10 to 12 percent of the effective oil, the oil extract forms are near 100 percent.

Although Dr. Moerck’s objections to the powdered forms are not based on the safety of the product, he does criticize the recommendations made by marketers and retailers.  Manufacturers normally suggest taking 1 pill of the 320 milligram powdered extract form, which is the same dosage recommendation for the oil extract form.  But in order for consumers to retrieve the amount of saw palmetto needed to alleviate BPH, as conducted in the clinical trials, 7 to 10 pills a day are required.  “Saw palmetto has been used safely and effectively for decades.  The powder-form product is probably fine if you take eight to ten capsules or tablets a day,” he said.  “However, if men only use one 320 mg dose of powdered-form product, there is no proof that it will have any impact on the effects of BPH at all.  As people who work in the nutritional supplement market, we are doing a disservice to our customers when we make these casual recommendations that are not based on science—and perhaps more importantly, we aren’t helping give men the relief that they so desperately need.”

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