Does Tea and Coffee Aggravate BPH?
Prostatic enlargement is regulated principally by the male sex hormone. Tea and coffee does not affect prostatic growth. However excessive tea and coffee increase the production of urine. Patients who already have bothersome symptoms secondary to BPH may find it difficult to cope with the increased production of urine.

 

Can We Prevent or Treat BPH by Dietary Measures?
 

Until now there is no definite evidence that BPH can be prevented or treated by dietary measures. However in patients with mild to moderate BPH, medication such as 5-alpha reductase inhibitors and alpha blockers may improve their symptoms.

 

Does Tea and Coffee Promote Urinary Stone Formation?
 

Significant amount of oxalate is found in tea and coffee. As most urinary stones are formed by calcium oxalate, excessive ingestion of tea and coffee can lead to increased urinary excretion of oxalate and hence promote stone formation.

 

Can Urinary Stones be Dissolved by Dietary Means?
 

Dietary measure is an important adjunct in stone management as it may help to prevent stone formation and recurrence. However for stones that are already formed, no evidence exists that it can be dissolved by dietary means. Some uric acid stones can be dissolved by alkalinizing medications.

 

What are the Symptoms of Urinary Tract Infection?
 

Patients with lower urinary tract infection (cystitis) usually present with dysuria (burning sensation on micturition), frequency and urgency. The urine may appear cloudy and have a bad odour. Fever and loin pain are uncommon symptoms unless the kidneys are involved. Other disorders such as bladder stone and cancer etc. may occasionally mimic cystitis.

 

What are the Early Symptoms of BPH?
 

Symptoms of BPH can be broadly divided into irritative symptoms such as nocturia (frequent urination at night), frequency and urgency in micturition; and obstructive symptoms such as poor stream, terminal dribbling, hesitancy, intermittency and straining when passing urine (may be associated with incomplete emptying of the bladder).

 

Is It Normal to Have Bubbles in Urine During Micturition? Why?
 

It is common to see bubbles when urine hits the toilet bowl during micturition. However it become abnormal if bubbling of urine happens around the penile meatus (tip of the penis) at initiation of micturition. These may indicate presence of a ‘fistula’ (i.e. connection) between the bladder and the gastrointestinal tract. As further investigations may be required to confirm the diagnosis, an opinion from the urologist will be essential.

 

Does Sexual Intercourse Cause Urinary Tract Infection?
 

Sexual intercourse can lead to urinary tract infection by introducing bacteria that normally colonizes around the perineum into the bladder. This happens more commonly in females due to the shorter female urinary passage.

 

What are the Side Effects of Medication Therapy for BPH?
 

Medication therapy for BPH can be divided into alpha-blockers and 5-alpha reductase inhibitors. Side effects of alpha-blockers is mainly dizziness secondary to postural hypotension (Sudden drop of blood pressure due to change of body posture). On the other hand, 5-alpha reductase inhibitor is generally tolerated well with rare side effects

such as decreased libido (3.3%), impotence(3.1%). There are no feminising side effects.

 

In Patient with Hematuria, is it Necessary to Undergo Cystoscopy in the Presence of a normal Intravenous Urogram Finding?
 

A normal intravenous urogram will exclude most significant abnormality in the upper urinary tract. However the bladder is often not visualized very well. Therefore in these patients, cystoscopy would be warranted despite the absence cancer, as the cause of hematuria.

 

What Causes Elevated PSA (Prostate Specific Antigen)?
 

PSA is a marker specific for prostatic disease. However it lacks sensitivity to determine the exact pathology in the prostate. An elevated PSA can be due to BPH, prostatitis (inflammation of prostate and cancer of the prostate).

 

Does Transurethral Resection of Prostate (TURP) Increase Future Risk of Prostatic Cancer?
 

There is no evidence to suggest that TURP increases risk of patients developing carcinoma of prostate in the future. However since TURP only removes the central portion of prostatic tissue (most prostatic cancer arises in the peripheral prostate), patients are still exposed to the same risk of prostatic cancer development.

 

Is “Urine Holding” Harmful?
 

The ability to inhibit voiding is fundamental to maintain urinary continence. However unnecessary and prolonged inhibition of voiding when bladder is full may expose the

bladder to risk of detrusor dysfunction (weakening of bladder muscle) due to over stretching of the detrusor muscle.