What did old timers use for BPH before Flomax?

[janeslogin]

What did persons use for BPH (benign prostatic hyperplasia) before Flomax (antagonist of alpha1A adrenoceptors in the prostate)?

I remember hearing of prostate problems when I was a kid about the end of WWII or so. What was the treatment back then?

[DrFidelius]

Prostatectomy?

[janeslogin]

Prostatectomy? At the end of WWII and earlier surgery was quite serious. Perhaps some did have prostatectomy but wouldn't that have been rare and dangerous?

What did they do in 1300 or 1700 or even 1900 perhaps?

[Gary T]

Saw palmetto is sometimes efficacious in relieving symptoms of an enlarged prostrate. Surgery offered a sure cure, though with the typical risks of surgery.

[barbitu8]

Saw palmetto is sometimes efficacious in relieving symptoms of an enlarged prostrate. Surgery offered a sure cure, though with the typical risks of surgery.

Saw palmetto's benefits, if any, were not known then. In any event, as you noted, it doesn't work for everybody. I relied on it and was unable to urinate at all for a while, after Achilles' tendon surgery. I went to my tp who said that in "the old days" I'd be dead.

[panache45]

I don't know how far back people have been using saw palmetto . . . but I take it, and it works.

[panache45]

I relied on it and was unable to urinate at all for a while, after Achilles' tendon surgery.

Uh . . . you seem to have an atypical anatomy. :confused:

[KneadToKnow]

What was the treatment back then?

I honestly believe it largely consisted of the doctor telling the patient, "Well, you're getting older, you're going to have to expect some stuff like this."

[barbitu8]

Uh . . . you seem to have an atypical anatomy. :confused:

An anesthesiologoist told me afterwards, that this is common after some surgeries due to the pain drugs you are given with the anesthesia. The real problem was that I was discharged from the hospital, unable to urinate, and when I complained about this to the nurse, she said it was just sensitive. The problem was not adequately addressed and I should not have been discharged in that condition.

[LouisB]

I honestly believe it largely consisted of the doctor telling the patient, "Well, you're getting older, you're going to have to expect some stuff like this."Hell, I was told that very thing last Tuesday.

When my father had prostrate problems back in the 1950s, his doctor told him that every man would have prostate cancer if the just lived long enough. The surgeon's cure for my father was to remove the whole damn thing. He lived to be 93 and had to give up sex in his mid-40s. I suspect that surgery was the method of choice for quite a while.

[panache45]

BTW, men who have had their prostates removed do not have to stop having sex.

And also BTW, if you have an enlarged "prostRate," it probably means that you take up too much space when you're lying down.

[Fear Itself]

BTW, men who have had their prostates removed do not have to stop having sex.The ones whose cancer requires a bilateral nerve resection will find it difficult with a limp dick, however.

[panache45]

The ones whose cancer requires a bilateral nerve resection will find it difficult with a limp dick, however.

Does that mean there's no longer any feeling in the penis? Because if there's feeling, you don't need an erection . . . unless, of course, you're a missionary.

[OldGuy]

Does that mean there's no longer any feeling in the penis? Because if there's feeling, you don't need an erection . . . unless, of course, you're a missionary.

Having a prostate removed doesn't necessarily mean you will have no feeling in the penis nor be unable to have an erection -- I know first hand. It can cause that but it doesn't automatically mean that. It does mean you will produce little to no seminal fluid.

[Rysdad]

Finasteride (aka, Propecia. Yes, the stuff that grows hair.) It's supposed to help reduce prostate size and has the possibility of hair growth as a side effect.

I'll let you know if it works in another four months or so.

[LouisB]

BTW, men who have had their prostates removed do not have to stop having sex.

And also BTW, if you have an enlarged "prostRate," it probably means that you take up too much space when you're lying down.

Picky, picky, picky; I made a spelling error. It is only one of several thousand I make over the course of time; I doubt it threw confusion into the minds of the huddled masses.

MY father, later in life, told me his sex life was finished when his prostate gland was removed. I believed him. Whatever his other shortcomings, he wasn't a liar. YMMV

[LouisB]

Does that mean there's no longer any feeling in the penis? Because if there's feeling, you don't need an erection . . . unless, of course, you're a missionary.Or unless you happen to be repressed devout evangelical Southern Baptists who came of age during the 1920s.

[LouisB]

And, for the modern old goat, there is this:

http://boards.straightdope.com/sdmb/showthread.php?t=426485

[barbitu8]

And, for the modern old goat, there is this:

http://boards.straightdope.com/sdmb/showthread.php?t=426485

Well, no. Recently, laser surgery is used, which was the situation in my case. My urologist calls it "the green light."

[LouisB]

Well, no. Recently, laser surgery is used, which was the situation in my case. My urologist calls it "the green light."I think I might have been the subject of a trial run; that particular urologist now uses laser; i really wish he had used it back then.

[barbitu8]

I think I might have been the subject of a trial run; that particular urologist now uses laser; i really wish he had used it back then.

Laser surgery to remove prostate tissue has been available for about six years only. Mine was done in early 2005, and it was new then.

[kunilou]

Finasteride (aka, Propecia. Yes, the stuff that grows hair.) It's supposed to help reduce prostate size and has the possibility of hair growth as a side effect.

I'll let you know if it works in another four months or so.

Well, I can tell you for sure it's not helping the hair growth thing. And because of the possibility of birth defects, they won't take my blood anymore.

As for the OP, the original treatment for BPH was to go to the bathroom every hour or so, day and night.

[Qadgop the Mercotan]

Before medical treatment for BPH, there were urethral sounds ("http://www.dundee.ac.uk/museum/medical/DUNUC8362.jpg) of varying sizes, to dilate open the prostatic urethra.

I actually saw a set of sounds used back during my urology rotation, in the early 1980's. With the patient lying supine, the doc would slip a small one in, rapidly remove it, then insert the next larger size. This was repeated until the sound inserted was very large indeed. The effects might last for a few days to a few weeks, or even a few months, before needing another treatment.

Some patients would go to the black market to acquire their own set and use them at home on themselves.

[aceplace57]

My dad took minipress for years. It's a blood pressure medicine, and it also was used to help urination. I'd assume flomax has eliminated the need for minipress.

Prazosin is also useful in treating urinary hesitancy associated with prostatic hyperplasia by blocking alpha-1 receptors, which control constriction of both the prostate and ureters.
http://en.wikipedia.org/wiki/Prazosin

Another common side effect of prazosin (and doxazosin) is priapism.
Odd, I don't recall dad mentioning this side effect. ;) Pee better and have a boner.

[minor7flat5]

Before medical treatment for BPH, there were urethral sounds ("http://www.dundee.ac.uk/museum/medical/DUNUC8362.jpg) of varying sizes, to dilate open the prostatic urethra.

I actually saw a set of sounds used back during my urology rotation, in the early 1980's. With the patient lying supine, the doc would slip a small one in, rapidly remove it, then insert the next larger size. This was repeated until the sound inserted was very large indeed. The effects might last for a few days to a few weeks, or even a few months, before needing another treatment.

Some patients would go to the black market to acquire their own set and use them at home on themselves.I had a Navy urologist use those to clear up a urethral stricture in the mid 80s.
I'm not sure what was worse: the guy reaching for steel rods thicker than a pencil or the fact that they had invited in fifteen corpsman students (male and female) to stare at the whole procedure.

Made a good piss go like a fire hose, though.

[KlondikeGeoff]

I remember hearing of prostate problems when I was a kid about the end of WWII or so. What was the treatment back then?
Pretty much what has been posted: prostatectomy, but it was a risky procedure. It isn't all that great now, and almost all patients have impotence and incontinence afterward for months or years. Depends widely on the patient and the skill of the surgeon. I understnad Viagra helps. At my age (82) that is no longer a problem. Unfortunately.

Now there are a wide range of other choices, including "watchful waiting," brachytherapy (inplanting of radioactive seeds), shaped external radiation and others.

I had the external radiation eight years ago and my PSAs were around 0.01 for years, but a few months ago, it jumped. Bioposy showed the damned cancer and returned. I'm now investigating all the possibilities, but will probably go with the brachytherapy.

Bummer!

[Qadgop the Mercotan]

Bummer!
Bummer for sure. :(

Keep us posted, man.

[Qadgop the Mercotan]

I had a Navy urologist use those to clear up a urethral stricture in the mid 80s.
Heh. Sailors.......

Yeah, the sounds were used more often on non-BPH related strictures. Many of which were caused by STDs. A friend of mine who used to be a urologist in the Ukraine tells me a good chunk of his practice was caused by urethritis, which some guys just kept getting over and over and over......

[barbitu8]

Pretty much what has been posted: prostatectomy, but it was a risky procedure. It isn't all that great now, and almost all patients have impotence and incontinence afterward for months or years. Depends widely on the patient and the skill of the surgeon. I understnad Viagra helps. At my age (82) that is no longer a problem. Unfortunately.

Now there are a wide range of other choices, including "watchful waiting," brachytherapy (inplanting of radioactive seeds), shaped external radiation and others.

I had the external radiation eight years ago and my PSAs were around 0.01 for years, but a few months ago, it jumped. Bioposy showed the damned cancer and returned. I'm now investigating all the possibilities, but will probably go with the brachytherapy.

Bummer!You are referring here to prostate cancer. This discussion has been on BPH.

[KlondikeGeoff]

You are referring here to prostate cancer. This discussion has been on BPH.
If you will look at the OP you will see he also asked, "I remember hearing of prostate problems when I was a kid about the end of WWII or so. What was the treatment back then?"

So I wrote about a prostate problem. What bothers you about that?

[Qadgop the Mercotan]

You are referring here to prostate cancer. This discussion has been on BPH.
Prostatectomy has been a treatment option for BPH for many decades now, even before WW II. KlondikeGeoff's comments as such are quite germane to the topic at hand.

[LouisB]

Laser surgery to remove prostate tissue has been available for about six years only. Mine was done in early 2005, and it was new then.In that case, lasers were available when my little procedure was done; I've no idea why a laser wasn't used.

[banjoDavid]

Has anyone tried Flow-max or other Rx drugs and had negative side effects, i.e., loss of libido, erectile dysfunction, etc.? The saw palmetto doesn't seem to do anything, and the list of side effects on the Rx drugs is scary.
The side effects of the surgery sound way worse, however.

[barbitu8]

If you will look at the OP you will see he also asked, "I remember hearing of prostate problems when I was a kid about the end of WWII or so. What was the treatment back then?"

So I wrote about a prostate problem. What bothers you about that?

I'm sorry to hear about your prostate cancer. It doesn't bother me, but the discussion up to this point had been about BPH.

banjoDavid, I used Flomax without negative effects, but this, apparently, did not help. Saw palmetto also did not help. When I was unable to urinate, my tp was shocked -shocked!- that I had gone off Flomax and was relying upon saw palmetto, but that was all right with my prior urologist (who had since relocated). My tp gave me a handful of Flomax and expected that would resolve my problem, but it didn't. Both Flomax and saw palmetto use the same biological pathways and their effects should be similar.

[Ignatz]

Laser surgery to remove prostate tissue has been available for about six years only. Mine was done in early 2005, and it was new then.

Any adverse effects?

[barbitu8]

Any adverse effects?

None whatsoever. Following that surgery, my urologist told me to discontinue Flomax. I have not been on any medicine since.

[davekhps]

Before medical treatment for BPH, there were urethral sounds ("http://www.dundee.ac.uk/museum/medical/DUNUC8362.jpg) of varying sizes, to dilate open the prostatic urethra.

FYI, there's a sexual fetish involving sounds, called appropriately enough, "sounding." Generally a gay thing, but you'll also find it in medical BDSM scenes.

I assume that like many things, when it's done in the doctor's office for medical reasons it hurts like hell but when you do it on your own it feels much better.


The internet has shown me waaay too much in my lifetime.

[minor7flat5]

Heh. Sailors.......

FYI, there's a sexual fetish involving sounds, called appropriately enough, "sounding." Generally a gay thing, but you'll also find it in medical BDSM scenes.

I assume that like many things, when it's done in the doctor's office for medical reasons it hurts like hell but when you do it on your own it feels much better.


The internet has shown me waaay too much in my lifetime.
Not sure what the good doctor is implying above, but I can assure you that my urethral stricture existed long before I entered the Navy :)

Anyway, the most surprising thing about the ... urethral dilation ... was how little pain was involved. As you watch the doctor picking up a device that is thicker than a pencil, you brace yourself for the worst agony, but I don't remember any pain at all.

[Qadgop the Mercotan]

Not sure what the good doctor is implying above, but I can assure you that my urethral stricture existed long before I entered the Navy :)
Historically sailors of all varieties are stereotyped as picking up STDs at their ports of call. These invariably cause a certain number of cases of urethritis which result in urethral strictures, and the need for dilation.

[Ignatz]

Historically sailors of all varieties are stereotyped as picking up STDs at their ports of call. These invariably cause a certain number of cases of urethritis which result in urethral strictures, and the need for dilation.

A urethral stricture is different from bph, right?

Could a simple NSU cause a stricture 20 years later?

Does the Green Light Laser treatment involve anesthetic? Hospital admittance overnight?

[minor7flat5]

Historically sailors of all varieties are stereotyped as picking up STDs at their ports of call. These invariably cause a certain number of cases of urethritis which result in urethral strictures, and the need for dilation.Woosh ;)

Anyone who has served is more than aware of this. Indeed, I had to endure a bit of ribbing about it when I told my shipmates why I had gone to the doctor—nobody believed my claims of innocence.

[Qadgop the Mercotan]

Woosh ;)
I know what you meant, but this is GQ, so I try to provide what clarity I can here.

[Qadgop the Mercotan]

A urethral stricture is different from bph, right?
right

Could a simple NSU cause a stricture 20 years later?
Very unlikely. But recurrent urethritis, or chronic untreated urethritis which remains mostly asymptomatic over time can eventually result in a stricture down the road.

Does the Green Light Laser treatment involve anesthetic? Hospital admittance overnight?
Not my area of expertise, so I'll let someone who knows respond to this part.

[barbitu8]

Does the Green Light Laser treatment involve anesthetic? Hospital admittance overnight?

No and no. It is entirely painless. IIRC, you are given a relaxant not an anesthetic. The doctor gave me the option to stay in the hospital overnight to see if I were able to urinate. I refused, and it took another 12 hours before I was able to urinate.