Treatments abound for enlarged prostate

DEAR DR. DONOHUE: I am a 76-year-old man who suffered a disabling stroke back in 1996. My body is paralyzed on the right side.

Just a couple of months ago I was diagnosed with an enlarged prostate. It blocks my bladder. My doctor put me on Flomax, but I still have a difficult time emptying my bladder. My doctor says surgery is out. Are there other procedures that could help me? — S.C.

ANSWER: An enlarged prostate gland is something that happens to just about every man as he grows older. About half of those in their 60s have a large gland, and close to 80 percent of those past 70 have one. Not all of them, however, need treatment, for not all have symptoms.

The urethra — the tube that drains the bladder — runs through the prostate. An enlarged gland compresses it and can make completely emptying the bladder an impossibility. The consequences are frequent, small urinations, difficulty starting the urinary stream and nighttime sleep shattered by many trips to the bathroom.

Flomax eases the grip of muscles strangling the urethra as it passes through the enlarged gland.

Another class of medicines, ones that block the action of testosterone on gland growth, can shrink the gland. Avodart is an example. It can be used in conjunction with Flomax, and the double effect can be doubly rewarding. It takes months for Avodart to achieve an effect, so patience is a must for all users.

There are many office procedures that can relieve urethral compression from the prostate. TUNA — transurethral needle ablation — is one. It’s done right in the doctor’s office under local anesthesia. Radio-frequency energy waves pare down the overgrown gland.

TUNA is only one such procedure. Others involve the use of lasers. Why not ask your doctor if you are up to one of these office-based methods for relieving prostate-caused obstruction?

The prostate gland booklet outlines this gland’s many problems and treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 1001W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: In the past year, my voice began to quaver. I mentioned it to my doctor, and he said it was a family tremor. Really? Nothing else on me shakes. My hands are as still as a sheet of ice. Is there treatment for this? — R.J.

ANSWER: Familial tremor, also known as essential tremor, usually involves the hands. They shake when performing a specific task, like bringing a cup of coffee to the mouth.

Muscles control vocal cords, and familial tremor can, therefore, lead to a quivering voice.

If treatment is truly necessary, you might try a beta-blocking drug like Inderal.