Growing adenoma may cause three important changes:

1- Urethra -the channel that empties bladder- becomes obstructed by the adenoma.

2- Prostate enlarges as a whole.

3- The real prostate tissue becomes a capsule that surround the adenoma.

Urethral obstruction leads to the development of symptoms like:

These symptoms usually develop in a long period of time and some patients with severe obstruction may get adapted to the symptoms and accept their situation as normal.

The degree and severity of obstruction can easily be determined by the test called uroflowmetry (measurement of urinary flow rate). It is a very simple and non-invasive test and must be performed before the treatment decision.

Significant difference between a normal and obstructed uroflowmetry graphic can easily be observed.

HoLRP has been in clinical use since 1994, and today, it is accepted as a revolutionary development for the surgical treatment of BPH.
This technique is equivalent to TUR-P:
the enlarged adenoma is resected into pieces and removed via urethra, but a special laser called HOLMIUM LASER is used for the resection process instead of high-frequency electrical current.
Because of this:

Especially in early stages, prostate cancer is an insidious disease. It doesn’t have specific symptoms or signs. DRE + PSA test is the only way of early diagnosis and carry a vital importance because if the disease can be diagnosed when confined to the prostate, it can be cured. The operation called RADICAL PROSTATECTOMY (total removal of the prostate) is completely curative. EVERY MAN OVER 40 YEARS OF AGE MUST BE EXAMINED ANNUALLY BY A UROLOGIST (Digital Rectal Examination: DRE) and THIS EXAMINATION MUST BE COMBINED WITH A SPECIAL BLOOD TEST CALLED PSA.

If it can not be diagnosed in early stages:
Cancer will invade neighboring organs and tissues (rectum, bladder base, urethra) and this will lead to urethral + rectal bleedings, difficult urination, etc.

Cancer will not only progress locally, cancer cells may spread through the lymphatic channels to distant parts of the body (distant metastases).

Prostate cancer can also be effectively controlled after distant spread (metastases), so the biggest mistake that a man can make is to abstain from a medical examination for fear of having cancer. Delayed diagnosis and treatment will inevitably lead to the distant spread of the disease and control will be much more difficult.

Metastases may cause a variety of symptoms depending on the affected organ:
Severe bone pain and pathologic fractures, problems with blood cell production in advanced stages, respiratory problems, bleeding, liver insufficiency are some of the serious problems that may accompany advanced prostate cancer.

Prostate cancer can be seen in every man after age 40

The only way of early diagnosis is digital rectal examination combined with the blood test PSA.

Radical prostatectomy (complete removal of the prostate) can be life-saving in early diagnosed patients

1. Is the use of polyurethane condoms recommended by CDC?

The FDA has approved the male polyurethane condom for sale in the United States, but has not allowed the manufacturer to make any claims about the prevention of pregnancy or STDs until ongoing studies are completed. Laboratory testing has shown that particles even as small as sperm and viruses like HIV cannot pass through this polyurethane material. An actual “recommendation” by CDC has not been made yet.

2. Latex condoms are regulated in the United States and must meet FDA standards. What kind of standards will polyurethane condoms need to meet?

Standards are currently being developed.

3. Are there microscopic holes or pores in polyurethane? How are we sure that polyurethane pores are small enough to keep HIV out?

There are no pores or holes in polyurethane.

4. Is there any information on reliability rates?

Laboratory testing has shown that particles, even ones as small as sperm and viruses like HIV, cannot pass through this polyurethane material. However, the manufacturer has not completed the clinical trials necessary to prove protection against pregnancy, HIV, and other STD’s. Studies are now underway.

5. Can someone be allergic to polyurethane? If so, how does one recognize the signs and symptoms?

Theoretically yes, but it would be rare. A person should consult their physician if they notice any abnormal change in their genitals.

6. How does a person recognize allergy to latex (which might lead them to consider using polyurethane)? What are the signs and symptoms?

A person should consult their physician if they notice any abnormal change in their genitals.

7. Does it make a difference if the man is not circumcised? How would he put it on if it doesn’t fit like a latex condom? If the condom is loose fitting would an uncircumcised man still need to push back the foreskin?

No. The polyurethane condom fits similar to the latex condom.

8. Will water-based lubricants be effective with polyurethane condoms?

Water or oil-based lubricants can be used with polyurethane condoms.

9. Are there substances that should not be used as a lubricant?

Examine the labeling on the lubricant for any warnings or precautions.

10. Since polyurethane is tougher, can you use polyurethane condoms more than once? If so, how do you clean them?

Polyurethane condoms should only be used once, then properly discarded.

11. Does the wearer need to wait to achieve an erection before putting on polyurethane condoms?

The wearer should follow the same directions as for using latex condoms.

12. Can we expect guidance from CDC on the reliability and use of condoms (latex and or polyurethane) for anal and oral sex at the same time the reliability information on polyurethane condoms for vaginal sex is published? If not, when?

To our knowledge, there are no ongoing studies examining the efficacy of condoms for anal or oral sex.

13. Do you still leave a space at the tip of this condom to prevent leaking, as you do with a latex condom?

The wearer should follow the same directions as for using latex condoms.

14. Should you remove as much air as possible before/while putting it on?

The wearer should follow the same directions as for using latex condoms.

15. Should spermicide be used with it? Will it come with spermicide like latex condoms?

The wearer should follow the same directions as for using latex condoms. Whether spermicides are included with polyurethane condoms is the manufacturer’s decision.

16. How will you be able to tell if it’s defective? (Brittle? discolored, etc.?)

Awaiting response from FDA.

17. Is there a specific storage temperature? Could they be stored in the trunk of a car in the summer? Carried in a wallet?

The wearer should follow the same directions as for using latex condoms.

18. Can two be used at once?

The wearer should follow the same directions as for using latex condoms.

19. When using a lubricant, should it/can it be placed on the inside of the condom?

The wearer should follow the same directions as for using latex condoms.

20. When using the polyurethane condom, does the penetrating partner have to withdraw as soon as an ejaculation has taken place?

The wearer should follow the same directions as for using latex condoms.

21. Can the latex and polyurethane condoms be used together (double bagging)? Can a polyurethane condom be put on over a latex condom?

Yes. Yes.

If for religious or other reasons it is not possible to produce the sample by masturbation the laboratory has special condoms that may be used instead. Ordinary condoms cannot be used because they contain substances that kill sperm. Some men feel anxious about producing the sperm sample. Any concerns should be discussed with the doctor or the laboratory staff.

Reporting of results
The reporting of the results of a semen analysis varies between laboratories. Preferably the test should be done in a specialised laboratory where they have a lot of experience and where they use the approved methods of the World Health Organisation. A number of parameters are measured and the normal values for these are:

Sperm count
The number of sperm is an indicator of potential fertility but needs to be looked at in relation to the other parameters measured. If everything else is normal but the count is less than 5 million per millilitre, the chance of pregnancy is still 25% within a two-year period.

Sperm movement
If the sperm count is low, the number of moving sperm is also often low and it is not always possible to understand the cause of this. If both the sperm count and number of moving sperm are low, the chance of spontaneous pregnancy is very low and IVF or ICS may be the only chance of achieving a pregnancy.

Shape
Even in normally fertile men, the number of abnormally shaped sperm is often greater than 50%. As little as 15% normally shaped sperm is regarded as normal. Fertility is severely reduced if the percentage of normal sperm is less than 5%.

White blood cells
If there are more than the expected white blood cells in the semen this may be due to an infection. The infection can affect the sperm quality and should be treated.

Sperm antibodies
Some men produce sperm antibodies and these cause the sperm to clump together and reduce fertility.

The semen analysis results gives an indication of the man’s potential to father a child. However, sperm quality varies over time and unless there is no sperm present at all it is still an imprecise measure of male fertility.

Other factors will affect the chance of pregnancy occurring, for example:

• the age of the woman and whether she also has infertility problems,
• the timing of intercourse
• the period of time the couple has been trying to have a baby.