Sunday, December 28, 2008

Goodbye to painful prostate

Goodbye to painful prostate

Treating prostatic-related lower urinary tract symptoms is no longer a pipe dream
by Joseph Masilamany

agony of a prostatic condition such as the pain of an enlarged prostate or benign prostatic hyperplasia (BPH), which is also known to cause hesitant urination or urination that comes in drips, is only understood by sufferers of BPH.

(from left) Roehrborn and Rohan say there’s
hope for sufferers of BPH.

Its symptoms vary from obstruction of the urethra to the gradual loss of bladder function, which results in incomplete emptying of the bladder.

The most common of these involve changes or problems with urination, such as a hesitant, interrupted, weak stream; urgency and leaking or dribbling; and more frequent urination, especially at night.

The hope for a more permanent and stable regulation of these urinary tract symptoms is no longer a pipe dream. A leading research-based pharmaceutical and healthcare company announced findings from a large study recently which offers new hope to men afflicted with BPH.

The study revealed that a combined treatment – with a 5-alpha-reductase inhibitor (5-ARI), which shrinks enlarged prostates, and another common oral medication (alpha-blocker), which relieves symptoms only – offers a significant improvement than treatment with just either one of these drugs.

The study has also established that combination management eases symptoms including acute urinary retention (AUR) to a large and positive extent.

The analyses from the study (CombAT) were presented to the local media recently by Dr Claus G. Roehrborn, professor and chairman of the Department of Urology, University of Texas Southwestern Medical Centre.

Roehrborn said in the post-study period, it was discovered that 5-ARI showed a pattern of "decreasing" enlarged prostate symptom over a 24-month period.

"The study included 4,800 men with moderate to severe BPH symptoms. All study participants received placebo for four weeks and then were randomised to receive a 5-ARI and alpha-blocker combination as well as single therapy with either one of the two drugs.

"The results suggested that physicians should consider combining both these medications in the early treatment stages of BPH to achieve improved symptom relief for men with enlarged prostate.

"This study also provides important new data to guide medical therapy for men with symptomatic BPH. The discomfort and anxiety suffered by men living with BPH should not be underestimated.

"The daily distress of coping with frequent and urgent urination, getting up throughout the night, as well as the underlying fear of potential future complications and possible need for surgery significantly undermine a patient’s quality of life," Roehrborn added.

He went on to explained that the study has shown we can now make a difference to the lives of men with moderate to severe BPH by bringing together the key benefits of each medicine so that they can experience rapid, effective and long-lasting improvement of urinary symptoms.

Roehrborn also said the findings are on-going and researchers will issue a final report at the end of four years regarding the efficacy of the combination-therapy in reducing symptoms, disease progression, the discomfort of AUR and even the possibility of eliminating prostate surgery (prostatectomy).

According to Selayang Hospital’s head of Urology Department Dr Rohan Malek, the incidence of BPH in the country is of concern especially when recent population studies in neighbouring countries have revealed that BPH cases are significantly on the rise.

He also said that despite the apparently low incidence of BPH complications in general, the absolute number of patients who present irksome symptoms of BPH especially in government hospitals is worrying.