Exercise May Help Reduce Nighttime Urination Problems in Men

Waking up to urinate, sometimes repeatedly through the night, is a common problem in men ages 45 and older, but one study shows that regular exercise can help reduce this risk. The condition, known as nocturia, can disrupt sleep patterns and lead to problems in other areas of life due to lack of sleep. It is one of the most common and most bothersome lower urinary tract symptoms in men, making it something patients are often looking to treat.

The study, led by a Loyola University Chicago Stritch School of Medicine researcher Kate Wolin, was published in Medicine & Science in Sports & Exercise, which is the official journal of the American College of Sports Medicine.

Wolin and her colleagues studied a pool of men ages 55 to 74 who were eligible for a larger clinical trial. As part of the study, the men were evaluated on prostate and urinary-related conditions, including nocturia. The study also inquired about the level of physical activity for the men as well as other lifestyle factors.

The results showed that those who were active for one or more hours a week had a 13 percent lower risk of reporting nocturia and a 34 percent less risk
of reporting severe problems with nocturia compared to those who were not physically active. This could be due to many factors, including a smaller body size, better sleep, lowered levels of bodily inflammation and less sympathetic nervous system activity. The study reported that exercise should be explored as a management strategy for nocturia.

Nocturia can have a complex number of causes, and exercise is just one of several strategies to help. To learn more about this and other conditions related to the prostate gland, including BPH, visit Dr. Vorstman at
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New Recommendations for Urinary Incontinence Treatment in Women

In light of recent concerns over common surgical treatments for urinary incontinence in women, the American College of Physicians has published new recommendations for treating this common condition without surgery. These simple lifestyle changes can help many women avoid the stresses and risks of surgery in favor of a more natural approach to treating this common condition, leaving the surgery for those who cannot treat their urinary incontinence in other ways.

Urinary incontinence falls into two main categories. Stress incontinence, the first category, refers to incontinence problems that occur when the patient laughs, sneezes, coughs or puts another form of stress on the urinary system. Urgency urinary incontinence refers to the loss of urine for no clear reason immediately after feeling the sudden urge to urinate.

For stress incontinence, strengthening the pelvic floor muscles is one of the best defenses. Weight loss, which reduces stress on the urinary system, and exercise can also help. Systemic drug therapy may carry more risks than benefits, according to the report.

For urgency urinary incontinence ,the ACP report recommends bladder training. When bladder training does not work, medication may help the condition.

Some patients will experience both stress and urgency incontinence. Although Kegel exercises are often recommended, they are rarely effective. Weight loss for overweight women can also help.

Neuromodulation options such as posterior tibial nerve stimulation may also be effective.

Do these new recommendations mean surgery for urinary incontinence is no longer the best choice? The answer really depends on each individual case. Some women can benefit from safe surgical solutions to urinary incontinence, while others would be best served with lifestyle changes. The point of the article, however, is that lifestyle changes should be considered first to ensure that all potential treatments have been pursued before resorting to surgery.

Urinary incontinence is just one type of problem that a urologist can assist with. To learn more about this and other urologic conditions, visit Dr. Vorstman at http:/ /

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Pioneering Research May Provide Help for Overactive Bladder

The body has a natural rhythm known as the body clock. Researchers have recently found a new link between this clock and contractions in the bladder, and it is an unexpected variation on previously held beliefs. A new study, published in The FASEB Journal, shows that the body’s clock, which is controlled by genes, are also affected by the receptors that cause contractions in the bladder.

The central biological clock is still a relative mystery in the medical world. The underlying philosophy is that the brain’s central clock controls all of the clocks in other parts of the body. These clocks, then, affect the receptor molecules which affect the way the body functions.

Yet the new research shows that the receptors in the bladder actually control the clock, instead of the other way around. This finding is important in understanding how bladder diseases and conditions, especially those connected to aging, develop, as well as in creating treatments for problems like bladder overactivity.

The study shows promise in treating some urological conditions. For example, body clocks maintain physiological rhythms like those that control urination
and this research shows that influencing the receptors in the bladder may help maintain physiological rhythm, leading to new potential treatments for conditions like overactive bladder.

This research shows the importance of staying in tune with changes in the urology field, and Dr. Bert Vorstman is dedicated to offering his patients with
the latest innovations and research so they can make informed decisions about their treatment. To learn more visit Dr. Vorstman at exclusive-medical-reports/
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Biopsy Quality Crucial to Survival for Bladder Cancer Patients, Study Finds

According to research published by UCLA researchers, the quality of diagnostics staging using biopsy for bladder cancer patients is now directly related to the survival of those patients. This means that patients need quality care from the earliest moments of diagnosis, as those who do not have the ideal biopsies are more likely to die due to bladder cancer.

The UCLA study spanned a period of two years. Researchers studied patients diagnosed with “non-invasive” cancers in medical centers throughout Los Angeles. During that time, half of the bladder cancer patients who had biopsies had insufficient biopsies that did not retrieve any of the bladder wall muscle tissues. This lead to a failure to accurately stage the cancer. The UCLA research team then found that these poor biopsies and incorrect tumor staging were linked to a higher death rate compared to those who had accurate biopsies.

Unfortunately, bladder biopsies often take tissue only from the inner lining of
the bladder. The problem with this is that sometimes the cancer invades the muscle wall. If this has occurred, the only way to diagnose it is by taking a biopsy some of the muscle wall as well. Without the muscle wall tissues, the biopsies cannot say accurately whether the cancer has begun to spread or not, leading to inaccurate staging and choosing the wrong treatment choice.

The study findings were published on October 20, 2014 in the online edition of Cancer.

In light of these findings, patients should be able to ask more detailed questions about the staging of their cancers and the quality of their biopsies. Patients, and their doctors, should push for more optimal biopsies prior to choosing treatments in order to improve the chance of survival.

Studies like these help doctors make more informed decisions about how to best care for their patients. The urology field is always changing, and medical professionals must learn how to adjust with these changes. To learn more visit Dr. Vorstman at

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Bacteria May Be Cause of Common Incontinence

Urinary incontinence in women is often attributed to childbirth or pregnancy and sometimes even just the simple aging process. Researchers at the Loyola University Chicago Stritch School of Medicine found that the bacteria in healthy women’s bladders were different in women with a specific, and common, form of urinary incontinence. They published their findings in July in the American Society for Microbiology’s online journal called mBio.

According to the report, urgency urinary incontinence (UUI), which affects around 15 percent of women, may be due to a bacteria, researchers believe. For around half of the women who are diagnosed UUI, traditional treatments do not work.

The researchers collected catheter urine samples from 90 women, some of which had UUI, and analyzed the bacterial content using the expanded quantitative urine culture technique. This allowed the researchers to isolate bacteria not normally found in a standard urine culture. This may be the reason why these women failed to respond to antispasmodic treatment and a seemingly clear urine initially.

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Study Finds Reduced Deaths from PSA Screening, But Recommendation Is Surprising

Routine PSA screening programs of prostate cancer detection have been a source of debate for many years. While some argue that these screenings help reduce mortality rates, others warn that the negatives of treating men who do not need to be treated due to their PSA alone can outweigh the potential for reduced deaths. A recently published long-term study of over 162,000 men in Europe addressed this issue again.

The study, which began in 1993, was named the European Randomised Study of Screening for Prostate Cancer. Its goal was to decide whether screening men for PSA levels would, in fact, reduce deaths from prostate cancer. Following men between the ages of 50 and 74 from eight countries, the study randomized the group to give PSA screenings at regular intervals, or give no screenings at all for a control. If the PSA levels were higher than 3.0 ng/ml, then the men received biopsies.

The results, which were recently published, showed that screening may cut prostate cancer deaths by 15 percent in the first 9 years of screening. For the first 11 years, the rate increased to 22 percent. After 13 years, no further improvement was seen. Overall, the rate of death dropped by a fifth in the screening group compared to the control.

The truth is that the number of men that had to receive the screening and risky evaluation in order to save just one life was substantial. Furthermore, much of the improved survival was not from any cancer treatment but because of additional advanced medical therapies. Furthermore, there was liberal use of the all-inclusive prostate cancer label and we know now that the very common Gleason 6 (3+3) prostate “cancer” has none of the hallmarks of a cancer and behaves as noncancerous. Therefore, men being treated for the Gleason 6 disease are exposed to many significant complications but for zero benefit.

In conclusion, the researchers suggested offering men balanced information about the dangers of prostate cancer over-diagnosis and over-treatment and the options for screening.

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Genetics, Family History Play Role in Early Onset, Aggressive Prostate Cancer

Studies from the University of Michigan Comprehensive Cancer Center suggest that more younger men may be being diagnosed with the uncommon aggressive form of prostate cancer.

The most common age for prostate cancer occurrence is between the ages of 60 and 90. Most of these so-called prostate cancers detected are the Gleason 6 (3+3) “cancers” and on both clinical and molecular biology grounds, these have none of the hallmarks of a real cancer. In fact, the very common Gleason 6 prostate “cancer” behaves as noncancerous and is not a health-risk.

The University of Michigan researchers data however, suggested that younger patients with prostate cancer may be more likely to experience the uncommon aggressive form of prostate cancer. This particular form of prostate cancer demands attention and treatment but not through robotic prostatectomy.

In part, these aggressive forms of prostate cancer may be more advanced at presentation as younger men are not routinely screened for prostate cancer.

Family history may play a role. Researchers have found that men with a family history of prostate cancer have a two- to three-times greater chance of being diagnosed with prostate cancer. The more relatives who have the disease, the greater the risk is. However, only the uncommon high-grade disease is potentially lethal.

If you have a family history of prostate cancer, it is important to empower yourself. Dr. Bert Vorstman offers the latest information about prostate cancer and prostate cancer treatments at at Dr. Vorstman also blogs at

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Certain Bladder Cancer Patients May Be Able to Get Greater Results with Additional Treatment

Muscle-invasive bladder cancer is a difficult cancer to treat with a high mortality rate. A recent study published in the British Journal of Cancer indicates an option that may help doctors achieve better treatment with radiotherapy.

The study, which was funded by the Medical Research Council and performed by a team at the University of Manchester, found that certain bladder cancer patients were more likely to benefit from an additional treatment alongside radiotherapy. These patients had tumors with high levels of the HIF-1α protein, and they saw a greater benefit when carbogen, a carbon dioxide and oxygen mix, and nicotinamide were given in conjunction with radiotherapy. This treatment was called CON.

The study looked at the protein levels in 137 different patients, some of which had radiotherapy alone and some of which had radiotherapy with the additional CON treatment. The study found that the levels of the protein could predict which patients were going to benefit most from CON. Patients with high levels of the specific protein were able to better survive the disease after radiotherapy with CON. However, patients with low levels of the protein did not have a benefit with the addition of CON.

This is an important biomarker that doctors may be able to use to create the most effective treatment for patients diagnosed with muscle-invasive bladder cancer. For those with high levels of the HIF-1α protein, this information can lead to effective treatment and a lower risk of mortality. Further study is needed into treatments that will work for patients who are not in this group.

Muscle-invasive bladder cancer requires multi-modality treatment.

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Doctors Pushing for 15-Year Followup for Prostate Cancer Patients

For many cancer patients, surviving 10 years past cancer treatment is a cause for celebration, as they can be declared cancer-free. Yet prostate cancer is one form of cancer that has a higher risk of late recurrence or a recurrence occurring 10 to 15 years after a perceived successful treatment. Because of this risk of late recurrence, the American Urological Association recommends a 15-year follow-up after prostate cancer treatment.

Research presented at the 2014 meeting of the American Urological Association pointed to the need for this follow-up treatment. Researchers, led by Frank Critz, MD, of Radiotherapy Clinics of Georgia, attempted to determine how long treatment follow-up should occur. They found that a minimum of 15 years wasnecessary.

The treatment followed 2,808 prostate cancer patients from 1984 to 2002. The men were treated by radiotherapy and were declared disease free at their 10-year follow up. Of these men, 48 ended up with a late recurrence of the disease. The median time frame for the late recurrence was 12 years after treatment. The men had a medium time from the follow up to the recurrence of three years.

In addition, four of the patients had a PSA of less than 0.2 ng/ml at their 15-year follow-up, but went on to have their disease recur some 15-20 years after treatment. One of the men died after 25 years because of metastatic prostate cancer. The total recurrence rate was 3 percent at 15 years and 5 percent at 20 years. None of the patients had recurrence at 10 years, which is a common time span for being considered “cured”.

Prostate cancer is one from of cancer that is often misunderstood.

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