DEAR DR. DONOHUE: About three years ago, I had a procedure to reduce the size of my prostate. It was Greenlight PVP laser procedure. My doctor did it on an outpatient basis. Since then, I have a normal flow for someone who is 79 years old. I sleep through the night without having to get up to go to the bathroom. Perhaps you could comment on this treatment. — L.M.
ANSWER: Prostate gland enlargement — benign (noncancerous) prostate hyperplasia or hypertrophy — is something that happens to just about all men. Fifty percent of men between the ages of 51 and 60 have some gland enlargement, and by age 80, more than 80 percent have it. Not all these men have to deal with its exasperating consequences — frequent urination, nighttime urination, difficulty starting the stream — but enough do that it is a quite common problem.
Sometimes medicines can relax the chokehold that the big prostate has on the urethra, the tube draining the bladder, and there also are medicines that shrink the gland.
When medicines strike out, a large number of invasive procedures are readily available. The standard operation, TURP — transurethral resection of the prostate — is done with a scope and instrument passed into the urethra and advanced upward to the gland. The doctor shaves away portions of the gland. TUNA — transurethral needle ablation; TUMT — transurethral microwave therapy; and TUIP — transurethral incision of the prostate are procedures done very much like a TURP, but they employ different techniques for reducing the gland’s size. Some are done in the doctor’s office.
Greenlight Laser Photovaporization is a technique in which the prostate gland is downsized by vaporizing the excess with a laser that emits a green light. One big advantage this offers is a reduction of bleeding. The green-light laser seals blood vessels in the process. I am sure many men readers will appreciate your bringing up the topic.
The booklet on the prostate gland, both enlargement and cancer of, summarizes treatments for these conditions. Readers can order a copy by writing: Dr. Donohue — No. 1001W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I found myself in my car, stopped at a stop sign, just blocks from my home. I wasn’t quite sure where I was or how I got there, and did not remember where I was headed. Things did return to normal. Since then, my short-term memory has been questionable. Is it too early (age 48) for Alzheimer’s disease? — D.K.
ANSWER: Forty-eight is too young for the more common Alzheimer’s variety. Your story suggests transient global amnesia, a temporary loss of memory with disorientation. An affected person is befuddled by the locale, why he’s there and what he’s doing. Such an episode isn’t a warning of future problems.
Others things can cause a similar reaction — a tiny stroke, a migraine or even a seizure originating in the temporal lobe of the brain. Play it safe by consulting a neurologist.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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