Benign Prostatic Hyperplasia (BPH)

BPH is an enlargement of the prostate. The epithelial and stromal cells of the prostate increase in size, resulting in the formation of large nodules in the peri-urethral region close to the prostate.

They become fairly large and the nodules compress the urethral canal, making urination difficult.

Other symptoms are
-Frequent urination
-Urination at night
-Weak urinary stream
-Prolonged urination
-Incontinence
-Urination dribble
-Painful ejaculation

The cause is unknown, but is linked to the hormone, testosterone. Hence, men who have been castrated do not develop BPH.

It is a common condition and risks men of urine retention, urinary tract infection and bladder stones (due to crystallisation of salts in residual urine)

BPH starts to develop in a man's 30's and progresses till symptoms appear in the 50's. It does not lead to prostate cancer.

TREATMENT
-Watchful waiting
-Drug of choice is alpha1 adrenergic receptor antagonists such as doxazosin,
terazosin, silodosin etc
-Surgery

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Amazing Mechanism of Ejaculation

Ejaculation is the ejection of semen out through the urethra of a man.

During sex or masturbation, semen collect in the ejaculatory duct. Ejaculation begins when a man has received enough sexual stimulation through kissing, stroking etc which leads to accumulation of pre-ejaculatory fluid.

Under the control of the sympathetic nervous system, rhythmic contractions occur within the muscles in the urethra, prostate gland and the perineal muscles.

About 10-15 contractions occur before ejaculation. Once the first contraction has occurred, the man will have no control over the ejection. This is known as Ejaculatory Inevitability.

At the start of ejaculation, pulses of semen begin to flow from the urethra. They reach a peak discharge and diminish in flow.

The discharge could shoot a distance of 30-60cm.

After ejaculation comes the REFRACTIVE PERIOD, during which most men are unable to get another erection until after about 15 minutes . This is a period of relaxation.

Quantity of semen in 10mls (2 teaspoonfuls) and is dependent on the duration of abstinence from sex.

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Erectile Dysfunction - Causes and Management

 

Erectile dysfunction, also known as impotence occurs when a man can no longer get or keep an erection firm enough for sexual intercourse.  It is a common type of male sexual dysfunction. Men with this condition have trouble getting or keeping an erection.

What causes Erectile Dysfunction?
 
The potential causes of ED are numerous. They include:

• cardiovascular disease
• diabetes
• damage from cancer or surgery
• injuries
• stress
• anxiety
• relationship problems
• drug use
• alcohol use
• smoking

 

Management


ED is a treatable condition. There are a number of ED treatments available. The type of treatment generally depends on the underlying cause of ED.   Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help. 

Treatments for ED range from counseling and lifestyle changes to drugs and surgery. If you suffer from ED, it is important to talk to your doctor. A doctor can help identify the cause of your ED and figure out the most appropriate treatment.

Because it can be embarrassing to discuss ED, many men look for treatment options online. However, not all treatments are safe for all men.

It is primarily treated by tackling the cause of the problem, whether this is physical or psychological.
The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these cases your GP may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease. This may help to relieve your symptoms as well as improving your general health.

You may also be given medication to treat atherosclerosis, such as cholesterol-lowering statins and drugs to reduce your blood pressure.

A number of treatments have been successful in the treatment of erectile dysfunction. Medication, such as sildenafil (sold as Viagra), can be used to manage it in at least two-thirds of cases. Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases.

Psychological treatments include cognitive behavioural therapy (CBT) and sex therapy.
Overall, treatments for erectile dysfunction have improved significantly in recent years. Most men are eventually able to have sex again.

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