Tag: prostate

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Enlarged Prostate

Inventions to Treat BPH

It is estimated that at some point in their lives, 8 out of 10 men will experience the uncomfortable symptoms caused by an enlarged prostate.

It is estimated that at some point in their lives, 8 out of 10 men will experience the uncomfortable symptoms caused by an enlarged prostate. However, this occurrence isn’t anything new.

Doctors have been working to find cures and develop treatments for this very common condition for centuries.

In fact, in our last few articles, we took a deeper look at the origin of the diagnosis of an enlarged prostate, and when it was first documented. And, we looked at some of the many attempts to treat or even cure the condition- Some of which actually made things worse.

Fortunately, as time went on, and medical advancements continued to be made, medical experts and physicians were able to find newer and better ways to treat men with this prostate condition.

A real turning point in the development of treatment procedures for an enlarged prostate, occurred in 1904 when Dr. Hampton Young perfected the surgical procedure known as a “radical perineal prostatectomy”.

By perfecting the perineal approach and developing specialized instruments for the procedure, Dr. Young was able to lower the mortality rate for those undergoing prostate surgery.

While open surgeries for treating an enlarged prostate continued to develop, another method was emerging called the transurethral method.

The transurethral method is a treatment based on the idea of increasing the lumen of the prostatic urethra by destroying or damaging the prostatic tissue so that it would contract.

Several instruments for transurethral removal of bladder neck obstruction by ‘valves’, were created, however, the procedure was done blindly, and though effective at times, it also came with the high risk of hemorrhage, and many patients were left with urinary incontinence.

Fortunately, physicians continued to develop better and better techniques for transurethral procedures, including using a wire loop cautery. As well as treatments that included a thermogalvanic destruction, which is when cautery is introduced through the urethra, requiring a cautery plate and a cautery knife.

However, one of the biggest issues with these methods was that,  just like with the previous procedures, all of them were done blindly. That is until various new instruments were invented and came into use, such as the irrigating cystoscope, which allowed for visual control during these procedures.

The irrigating cystoscope was a real game changer, even more so, as Dr. Young worked to modify it, making it better and bed.

Young is credited with adding illumination to the external end of the tube, by way of a small electric bulb. And then, just a few years later, Young replaced the cutting tube with an electrically heated cautery tube and made the outer tube double-walled so that water could circulate to cool it. Young’s basic design was the forerunner of a great variety of subsequent operations.

In our last article of this series on the history of diagnosing and treating an enlarged prostate, we will take a look at some of the procedures that emerged after Dr. Young’s irrigating cystoscope, and begin to explore the modifications and improvements that have been made to these techniques.

 

Categories
Enlarged Prostate

Early Treatment Methods

By the late 1800s, physicians found a link between prostate size and a man's age, as well as between prostate growth and testosterone.

By the late 1800s, physicians had found a link between prostate size and a man’s age, as well as between prostate growth and testosterone.

This discovery set the foundation for developing various treatment methods in order to relieve the uncomfortable symptoms caused by an enlarged prostate.

Though it wasn’t until centuries later that the more effective treatments that we use today, such as transurethral resection of the prostate, medications, and prostate artery embolization, became available- These procedures owe a debt of gratitude to the many physicians that came before, who opened the path to finding the best treatment for what would later be known as benign prostate hyperplasia.

Unfortunately part of this journey involved making mistakes along the way.

One notable example is a procedure performed by some physicians in the 1800s who thought that the condition of an enlarged prostate could be cured by removing the testicles. Yikes.

Fortunately, this method fell out of practice shortly thereafter. And, fortunately, many other physicians did not use this technique, and instead, continued to study the enlarged prostate and the impact that it can have on a man’s health. All in an attempt to find the most effective and efficient way to treat the condition.

One of the turning points in the development of prostate procedures to treat an enlarged prostate, took place in 1891.

A physician in Arizona had found a way to treat the prostate condition by removing prostate tissue through an incision made in the perineum—the area between the scrotum and rectum. This would later be called a perineal prostatectomy.

Following this breakthrough procedure, all sorts of other prostate surgeries began to pop up.

Eugene Fuller, a New York City Physician, developed the  “suprapubic procedure.”

The suprapubic procedure is the surgical removal of the prostate through an incision made in the lower abdomen and bladder.

The suprapubic procedure showed promising results and opened the door for another physician, Hampton Young to get even better results by using the same perineal incision to remove the prostatic mass.

Dr. Young, a urologist at Johns Hopkins Hospital also discovered that if he pushed the gland upward from the rectum, it could ease and complete the excision, making the removal more complete.

Hampton Young went on to become known as the “Father of American Urology,” and continued to refine and perfect his technique for treating an enlarged prostate.

In our next article, we will continue looking at the history of treating benign prostate hyperplasia, by diving deeper into the impact that Dr. Hampton Young had on the treatment of it, as well as take a look at the advancements made by the many physicians that followed.

Categories
Enlarged Prostate

Early Physicians and BPH

There are many physicians to which we owe a debt of gratitude for their contributions to the treatment of benign prostate hyperplasia.

There are many physicians to which we owe a debt of gratitude for their contributions to the treatment of benign prostate hyperplasia.

Most historians agree that the prostate was first anatomically described in the mid-1500s by the Italian doctor and anatomist Nicolo Massa.

In his book, “Anatomiae libri introductorius,” which translates to “Introduction to Anatomy,” Massa noted that the bladder rested on a “fleshy gland”, the gland of course being, the prostate.

Although it is debated that the fleshy gland wasn’t called a prostate until, around the same time in history, when the French anatomist Andre du Laurens used the name “prostate”, or “prostatae”- In more recent years, historians have discovered that the French anatomist did indeed call the fleshy gland a prostate, but it was actually the French surgeon Ambroise Paré in his anatomy book, who years prior had referred to this part of the male reproductive system as the prostate.

So what’s the point of all of this? Why should we care who named the prostate gland?

The point is, the male prostate gland has been an area of the male body that has been extensively studied and examined for centuries.

Why is this?

Well for starters, it affects a lot of men.

The enlargement of the prostate gland and the connection that it has with urinary retention and other symptoms in men prompted extensive research and development on finding the cause and figuring out how to treat it.

In our next article, we will dive deeper into the history of treating an enlarged prostate, and the