Tag: The History of Discovering and Treating BPH

Categories
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

Advances in Prostate Care

In the early 20th century, a young doctor developed a procedure that would revolutionize the way prostate conditions are treated.

In the early 20th century, located right here in our neck of the woods, a young doctor was developing a prostate procedure that would revolutionize the way prostate conditions are treated and open the door to the many other treatments that would follow.

This man was urologist Dr. Hugh Hampton Young, who due to his position as the chief of surgery in the Genitourinary Surgery Division at Johns Hopkins Hospital became known as the “Father of American Urology.”

Among his many contributions to male prostate health, Dr. Young is best known for his development and perfection of radical perineal prostatectomy, while working at The Johns Hopkins Hospital in 1904.

This procedure, which to this day, remains the oldest continuously employed treatment for prostate cancer, was developed at a critical time when previous open prostatectomy surgeries had a 20-percent mortality rate.

Fortunately, by perfecting the perineal approach and developing specialized instruments for the procedure, Dr. Young was able to reduce the mortality rate to 2 percent.

During his many years working at Johns Hopkins, Dr. Hampton Young developed a number of innovative instruments and techniques.

The first known instrument he created was known as the “punch,” which was used for the resection of an obstructing bladder neck, and prostatic tissue.

This then led to the development of numerous other punches, particularly at the Mayo Clinic where several of his students perfected the instrument.

In 1912, Dr. Young, using this instrument, successfully relieved railroad entrepreneur James Buchanan Brady’s prostate condition brought on by an obstructing bladder neck, and prostate tissue.

Upon doing so, Brady went on to fund the construction and creation of the Brady Urological Institute.

While there, Dr. Young went on to do much more, including establishing a new design for a urological operating table and developing a detailed approach to performing radical perineal prostatectomy which became the standard for prostate cancer surgery.

Dr. Young went on to found The Journal of Urology which he edited until his death in 1945. However, one of his biggest contributions was the creation of a detailed plan for the training of young urologists, which went on to become the model for all other training programs in the United States.

In our next article, we will continue our series on the history of treating benign prostate hyperplasia, by looking at some of the early surgeries, some of which are still performed today.

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