Urology Center Of Idaho

Urology Center of Idaho
208.233.3355
500 S 11th Ave # 301

Pocatello, ID 83201

         
 

When men hit about 50, they frequently run into problems urinating. First symptoms include ‘urgency’ – as soon as you hear a running faucet, you got to go. And you better get there fast, because otherwise it feels like you’re going to have an accident. The stream is getting slower also. And then there is ‘slow stream’: Little by little, you may find yourself standing there still going, while others have come and left.

Then there is ‘nocturia’, which means nighttime voiding. You find yourself waking up with the bladder calling more and more often during the night. Then, when you get to the place, it becomes hard to get started. This is called ‘hesitancy’ in medical jargon. .

When things get worse, trips to the bathroom get more and more frequent even during the daytime. You may find yourself only going to places where you have scouted out where the bathrooms are. Sometimes it happens that just after you thought you got it all done, you got to go all over again. This usually means the bladder does not empty all the way.

Prostate Enlargement

Why does this happen? It turns out that about half of men above 50 will develop an enlarged prostate. Half of those will actually run into trouble with this, and will experience the above problems. Sometimes enlargement may be caused by prostate cancer. For further explanation please click here.

The Prostate’s Job
To explain what prostate trouble is, it is important to understand what the prostate is supposed to do in the first place. The prostate is a ‘genital ‘gland. Which means, that without it, we could not be fathers. Did you ever wonder how the same tube is used for urinating and also to father children? Somewhere there needs to be a 3-way switch! This switch is the prostate. Located just below the bladder, its first inflow is from it. In the middle of it, the semen stream comes in. Its outflow is the tube running through the penis called the urethra.

During ejaculation, the prostate shuts off the urinary stream, since otherwise the semen would take the easier route into the bladder, and no one would get pregnant. So, without the prostate, we could not have any children. 

Prostate Hyperplasia

When the prostate enlarges, which often happens with age, the urine flow through it becomes obstructed. This means that the bladder has to work harder to get the urine through the prostate. It turns out that the bladder has it’s own control center. When it becomes harder to push the urine out, the bladder reacts by regulating how much urine it will hold. The more volume that is in the bladder, the harder it would be to empty completely. This is a self-preserving strategy, otherwise the bladder would not empty, and back up urine to the kidneys. Should this happen, the kidneys would fail with fatal consequences. Going often and urgently is the body’s response to prostate obstruction. There are several ways to address this condition.

Conservative Management

Sometimes Urological surgeons forget that ‘doing nothing’ is an option! Initially when symptoms are not severe, they may be addressed with simply making changes such as reducing fluid intake in the evening or making sure to go to the bathroom just before bedtime.

Prescription Medicine Can Help

Half of the prostate is made up of muscle tissue. Prescriptions are available to relax this muscle which leads to easier voiding. This will take effect very rapidly (within a few days) and can relieve nighttime voiding and frequency. Medicines in this class are Doxazosin, Terazosin, Tamsulosin, Alfuzosin, or Silodosin.

However, prostate enlargement does not stop with these pills. They may delay symptoms, but do not prevent further problems as the gland continues to grow.

There are medications (Finasteride and Dutasteride) which keep further prostate enlargement. These reduce the testosterone effect on the gland. This works because the prostate needs testosterone to exist; without it, the gland will actually shrink. This process takes time and benefits take about 6 months to emerge.

These two types of medications are frequently used together. Many men are completely fine with this, and require no other measures to overcome their symptoms.

Prostate Procedures  

Sometimes the medications used to control prostate symptoms are not enough, or they are not tolerated. In that case, it is necessary to perform a procedure in order to open the urine stream. The technology to achieve this involves removal of obstructing prostate tissue with a special tool or with laser treatment. Rarely, in very large glands, open surgery is necessary. 

Surgery is very effective in controlling prostate symptoms. Most patients express remorse for prolonging their surgery option.

Treatment Decision

Whatever your case may be, the decision of how to deal with prostate symptoms lies with you. Dr. Sauerwein sees his function not so much as a surgeon, but as a teacher and partner. He is there to explain which options are available, so you are empowered to make the choice that is right for you. 

 

Prostate Screening

 

 



 
 

Urology Center of Idaho
500 S 11th Ave # 301
Pocatello, ID 83201
208.233.3355

 
 
         

Urology Center of Idaho
500 S 11th Ave Ste. 301,
Pocatello, ID 83201
208.233.3355

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98 Poplar St.
Blackfoot, ID 838221
208.785-3800

 

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