The Tribune

By DR GREGGORY PINTO

Prostate Cancer affects one in six men in their lifetime.

Almost half of men 50 years or older are afflicted with Benign Prostate Hyperplasia BPH, a non-cancerous enlargement of a man's prostate. Almost all men by the age of 70 years old suffer from BPH.

Nearly 40 million men suffer from BPH.

Bahamian men cannot escape BPH.

The prostate is a walnut sized organ underneath the bladder, found only in men. The role of the prostate is only for male fertility.

Benign, non-cancerous enlargement of the prostate causes an obstruction of the opening of the bladder and squeezes the urethra, which is the tube that delivers the urine from the bladder and out through the penis.

Benign enlargement of the prostate can lead to bothersome urinary symptoms such as a weak urinary stream, hesitancy in initiating urination, stop and start urine stream, increased urinary urgency and frequency, incomplete bladder emptying and urinary incontinence/leak.

Chronic obstruction of the bladder outlet by BPH can lead to devastating health issues such as the development of an atonic bladder whereby the bladder loses its ability to contract and empty effectively and chronic kidney failure secondary to prolonged back pressure on kidneys or it may lead to severe sleep deprivation from severe nocturia - frequent nighttime urination, recurrent urinary tract infections and possible bladder stone formation with chronic bladder obstruction.

Waking up to urinate due to BPH, often results in your spouse also being frequently awoken and could lead to sleep deprivation for women and often marital conflict and resentment.

The first line of treatment for BPH are medications. Tamsulosin, Alfuzosin, Avodart, Finasteride, Saw Palmetto are commonly prescribed drugs; with erectile dysfunction drugs such as Viagra and Cialis also showing the additional benefit of reducing BPH urinary symptoms.

The drugs Finasteride and Dutasteride are five alpha reductase inhibitor drugs and they artificially halve the Prostate Specific Antigen PSA blood values when a man takes these drugs for more than five to six months; so the PSA values must be doubled to get an accurate screening of PSA values in such cases. This fact is fundamentally important in prostate cancer PSA screening.

Medical therapy usually works well initially but the prostate gland continues to grow with age and once effective medications for BPH often eventually become less efficacious over time.

Multiple minimally invasive endoscopic procedures are readily available to surgically manage the urinary symptoms of Benign Prostate Hyperplasia.

Bipolar and Monopolar TURP Transurethral Resection of Prostate, TUNA Transurethral Needle Ablation, Thulium and Holmium Laser Enucleation and Vaporization of Prostate, Greenlight Laser Prostate Resection, Steam Vaporization Therapy, Prostatic Artery Embolization, the Urolift System amongst many other treatment modalities.

Benign prostate hyperplasia will affect us all as men if we are blessed with advancing age.

Urinary symptoms can reduce the quality of life and could potentially lead to devastating health consequences such as irreversible kidney damage.

Minimally invasive prostate resection requires minimal recovery and can be done as an outpatient in many cases with pain killers rarely required post procedure. It does not affect erection function and can provide a man the ability to once again control his bladder instead of having his bladder and often severe urinary symptoms devastate his social life, professional life and negativity affect his happiness.

The minimally invasive procedure can turn your life from darkness to life immediately, in turns of urinary issues and you return immediately to the normal routine of your life but with a now strong urine stream and no further struggles to empty your bladder or the need to urinate frequently and with great urgency.

Regain your urine control and regain your happiness and confidence.

Stop waking up six times in the night to struggle to pee and wake up your poor wife/partner in the process.

State of the art minimally invasive prostate resection treatments are readily available locally with world class expertise and experience.

There is no need Bahamian men to plan your daily routine based on the location of the next bathroom.

Seek confidential compassionate advanced urological treatment for your urinary complaints.

• Board Certified Dr Greggory Pinto - Bahamian Urologist and Laparoscopic Surgeon - trained in Germany, South Africa and France. Member of the European Association of Urology.

The Surgical Suite, Centreville Medical Centre 68 Collins Avenue/Sixth Terrace, Nassau, Bahamas, telephone 326 - 1929