Sex and prostate health

Benign prostatic hyperplasia (BPH), also often called an enlarged prostate, affects about half of men aged 51 to 60, and the speed continues to extend with age.

As the prostate enlarges, it narrows the urethra, the tube that carries urine out of the body. For about half of men with BPH, it causes urination problems, equivalent to hesitancy, obstruction, or weak urine flow; Dribbling A sense that the bladder is just not completely empty. and more frequent urination, especially at night.

Medications are the first-line treatment for BPH, but surgery could also be needed if medications should not effective.

Although any medical treatment with BPH is prone to have unintended effects, men are sometimes concerned about how the treatment may affect their sex life. Depending on the treatment, sexual unintended effects may include erectile dysfunction (ED), low libido, low volume of ejaculate, or retrograde ejaculation (during which semen travels backwards into the bladder as an alternative of exiting through the penis). can.

Treatment

Three kinds of drugs are approved for the treatment of BPH: alpha-blockers, 5-alpha-reductase inhibitors, and the ED drug tadalafil (Cialis)—a phosphodiesterase-5 (PDE5) inhibitor. Your doctor may prescribe a number of of those medications, because they work well together. If sexual unintended effects occur, check with your doctor about changing the dose or taking one other medication.

Alpha blockers. Alpha blockers help chill out the prostate's grip on the urethra, allowing urine to flow more freely. Five alpha blockers used for BPH are alfozosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), tamsulosin (Flomax), and terazosin.

Adverse effects: Many men experience a decrease in the quantity of ejaculate. The predominant reason for that is retrograde ejaculation. One study found that tamsulosin reduced the quantity of ejaculation in about 90 percent of men, and a few third experienced no ejaculation. Some men have found this effect to be lower than that of other alpha blockers. “While men may find both of these issues bothersome at first, they don't necessarily interfere with the ability to achieve an erection or orgasm,” says Dr. Catherines.

5-alpha-reductase inhibitors. The two FDA-approved medications for BPH are dutasteride (Avodart) and finasteride (Proscar). These medications shrink the enlarged prostate to scale back pressure on the urethra and bladder, making it easier to pass urine and reducing symptoms.

Adverse effects: Reported sexual unintended effects include low libido, ED, and decreased ejaculation volume (although lower than with alpha-blockers). “Yet, studies show that less than 10% of men report these problems,” says Dr. Catherines. These drugs can even lower sperm count, which is simply a priority for men who still need to have children.

Tadalafil (Cialis). This PDE5 inhibitor is the one drug in its class approved to treat each ED and BPH. When taken in low doses (5 mg day by day), the drug relaxes the connection between the bladder and urethra, which improves urine flow and helps empty the bladder.

Adverse effects: Although tadalafil is just not related to the sexual unintended effects of other BPH medications, there may be a small risk that it might interfere with sex drive as a consequence of headaches, flushing, or stomach upset.

Minimally invasive surgical options Many minimally invasive options at the moment are available to treat BPH. They carry a lower risk of sexual unintended effects, especially retrograde ejaculation and erectile dysfunction. Two popular decisions are the prostatic urethral lift and water vapor thermal therapy (rhizm, pronounced “rezum”). During a prostatic urethral lift, the surgeon inserts an instrument called the UroLift through the urethra into the prostate. It pushes aside the obstructing tissue and provides small implants that lift the tissue and hold it in place in order that urine can flow more easily. Rezum uses a skinny hole tube that's inserted through the penis into the prostate. A nine-second burst of steam hits the prostate cells, killing them and slowly shrinking the enlarged tissue. “These are potential options for men who have relatively small prostates,” says Dr. Martin Kathryn, a urologist at Brigham and Women's Hospital.

Surgery

Two procedures are commonly used to treat BPH: transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP). These procedures may cause everlasting sexual unintended effects.

TURP With TURP, a skinny tube is passed from the urethra to the prostate. An electrical loop at the tip of the tube pulls away the prostate tissue to remove the urinary obstruction.

Adverse effects: More than half of men who've TURP experience retrograde ejaculation. ED can even occur, but only affects 12% of men.

PVP. With PVP, a skinny fiber optic tube is passed through the urethra to the prostate. Laser energy then vaporizes the surplus prostate tissue, which is excreted through urine. Various lasers are used, however the potassium-titanyl-phosphate laser, called green light, is the preferred.

Adverse effects: The risk of retrograde ejaculation is lower than with TURP but continues to be considered high. According to Dr. Catherines, ED can affect in regards to the same percentage of men as with TURP.

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