By H. A. Guess (auth.), Nicholas A. Romas M.D., E. Darracott Vaughan M.D. (eds.)
For decades, sufferers who complained of prostatism had just a couple of remedy offerings. The sufferer used to be both a candidate for an optionally available prostatectomy, or the operation used to be deferred till the sufferer turned extra symptomatic. the current textual content summarizes the a number of recommendations that have turn into on hand to the practising urologist. Minimally invasive thoughts corresponding to transurethral incision of the prostate, balloon dilatation, hyperthermia, laser treatment, and prostatic stents are defined. clinical therapy with alpha-blockers, five alpha-reductase inhibitors, and flutamide are addressed by means of authors who've had wide scientific event with using those agents.
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Extra info for Alternate Methods in the Treatment of Benign Prostatic Hyperplasia
The epidemiologic aspects of BPH are well covered elsewhere in this volume. It is agreed that between 400 000 and 450 000 prostatectomies are done yearly in the United States for what is originally diagnosed as benign prostatic disease. The total costs of prostatectomy for benign disease include not only surgical fees and hospitalization costs, but the costs of preoperative evaluation, lost productivity time, the treatment of complications, and similar considerations for reoperations. These costs account for a significant percentage of the American health care dollar.
Local exposure of the prostate to this testicular factor could play a critical role in the initiation and/or promotion of BPH. The proposed testicular nonandrogenic accessory sex gland stimulating factor offers a reasonable explanation for the regional (periurethral) and localized (nodular) growth and the variegated histology that characterizes human BPH. Additionally the cited observations with regard to SHBG binding to and interacting with prostatic epithelial cells (Rosner 1991) provides support for another potential source of a prostate stimulating protein.
1989) The natural history of untreated prostatism. Br J Urol 53:613 Ball AJ, Smith PJB (1982) The long-term effects of prostatectomy: a uroflowmetric analysis. J Urol 128(3):538-540 Barry MJ et aI. (1992) The American Urological Association's symptom index for benign prostatic hyperplasia. J Urol (to be published) Barry MJ et aI. (1988) Watchful waiting versus immediate transurethral resection for symptomatic prostatism: the importance of patients preferences. JAMA 259:3010-3017 Birkhoff JD et aI.