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A little bit of medical history

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Microwave Thermotherapy is a non-surgical, office-based, long-lasting treatment used to relieve the annoying symptoms caused by prostate enlargement. The answer to the question “Is this treatment for everyone?” is – “almost everyone”, as long as the diagnosis has been correctly made. So how is the diagnosis of benign prostate hyperplasia, commonly known as “BPH”, made? My teacher in medicine, I am proud to say was Professor Isidore Snapper (1889-1973).

Dr. Snapper fled Holland in 1938 to escape the NAZI onslaught and came to the Rockefeller Foundation in New York. From there he enjoyed an illustrious career as professor of medicine in major universities and teaching hospitals throughout the world including Peiping Union Medical College in China, Mount Sinai Hospital in New York, Cook County Hospital in Chicago and finally the Beth-El Hospital in Brooklyn, which he transformed into the Brookdale University Hospital and Medical Center, one of the three major teaching hospitals in Brooklyn.

Before the invention of sonograms, MRI, CAT and PET scans, Dr. Snapper taught that a correct diagnosis depended primarily on obtaining an accurate history of the illness. That meant taking the time to listen carefully to the patient and asking pertinent questions.

Second in importance was the physical examination and third were the results of laboratory and X-Ray studies. Non-the-less, even today, with all the new and wonderful diagnostic tools, the history remains the preeminent and most valuable tool in establishing a diagnosis.

When the patient describes that he is suffering with a variety of symptoms including a slow stream, hesitancy in starting the stream, an interrupted or intermittent flow, urinary frequency, urgency, incomplete emptying, prolonged urination with dribbling, incontinence, the need to push or strain to urinate, sleep deprivation, caused by night time urination, and blood in the urine, the diagnosis that comes first to mind is benign prostate enlargement.

The most common cause of blood in the urine in men ages 40 to 90 is benign prostate enlargement. Of course, other causes of bleeding must always be ruled out. Cancer of the prostate on the other hand does not usually cause urinary bleeding. All these symptoms described above do not usually occur all at the same time and when they do occur, present with varying degrees of severity and in many different combinations. It’s the carefully taken history that permits the doctor to recognize the familiar patterns of symptoms that lead to the correct diagnosis.

These days, when the diagnosis of benign prostate enlargement has been correctly made, the treatment of choice for most men is one medication to shrink the prostate’s glandular tissue and another to relax the prostate’s muscular tissue. When the patient is unable or unwilling to endure a lifetime of medication, microwave thermotherapy should next be considered. This non-surgical treatment, successful in the great majority of patients does not require hospitalization or anesthesia.

Have a Question? Call Dr. Okun at 718-241-6767

Updated 5:05 pm, July 9, 2018
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