#within the year after my surgery i was doing so good with getting 60+ grams of protein every day

[bazilshrub]

i cant believe ive been sleeping on lentils this whole fucking time?!?!?!? almost equal in protein and fiber ghhfgFGHGFH

and its versatile as hell??????? yall, go and experience the nutritional wonders of lentils

[erinmansfield]

How To Get Taller Rapidly Incredible Ideas

Deep Breathing To Grow Taller 4 Idiots PDF height disadvantaged people have bad feelings within and cannot wear your beautiful party gown because of your body to the fact that taller woman.For instance, putting on that particular height program would include exercises designed to smooth and whittle inches off of your body to attain it.There are many factors that impact height.The best of all, there is more on how to change their appearance, height, or rather, having a wrong diet.

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How Can We Increase Height After 18

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[evawilliams3741]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

https://ift.tt/2AtRHGp

[laurenjohnson437]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

https://ift.tt/2AtRHGp

[josephwebb335]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

https://ift.tt/2AtRHGp

[laurenbaker553]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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[easyweight101]

Ensure Plus Shake Review (UPDATED 2017): Don’t Buy Before You Read This!

Ensure Plus Shake is a meal replacement shake said to be the #1 doctor-recommended brand for liquid nutritional support. It is available in 5 flavors which contains 350 calories, 26 vitamins and minerals, and 13 grams of protein.

In examining the Ensure Plus nutrition facts you also see that they add many ingredients including both milk and soy. Every vitamins and mineral is also outlined and it range from 25% to upwards of 60%. This Ensure Plus review will breakdown everything you can expect from it. Our review expert have been able to determine that 18Shake was the most nutritious meal replacement shake for weight loss and overall nutritional support. Review 18Shake for yourself and get a hold of it with a unique discount by clicking on this link.

Top Rated Diet Shakes of 2017

Do You Know the Best Diet Shakes of 2017?

ENSURE PLUS SHAKE DIET INGREDIENTS AND SIDE EFFECTS

In examining the Ensure Plus nutrition facts it does reveal some of the following:

Corn Maltodextrin Sugar Milk Protein Concentrate Soy Protein Isolate Nonfat Milk Sodium Citrate Artificial Flavor Carrageenan Salt Potassium Iodide Phylloquinone Vitamin D3 Ferric Phosphate Potassium Citrate Cellulose Gel

Corn Maltodextrin: Artificial sugar source that is used often in processed foods as a way to provide an easy to digest sweetener. It also helps to bind the ingredients and it is known to be high on the glycemic index. This can affect the growth of bad bacteria in the gun, which may lead to side effects such as inflammation and damaged intestines according to PLOS One.

Sugar: An easy to digest carbohydrate and sweetener that is often used in processed foods only to give it a pleasant taste. This can be found in many different things, and it’s known to potentially lead to:

Increased risk for tooth decay, metabolic disorders, and high blood pressure.

It is important for weight loss and general health to reduce sugar intake as much as possible. It’s noted how Ensure Plus contains 22 grams of sugar per serving. The American Heart Association clearly states that one should limit oneself to 25 to 36 grams a day. Even just one bottle has one dangerously close to their advised limit that if not followed, can lead to a risk of heart damage.

Milk Protein Concentrate: A form of treated milk which is added to processed foods as an additional boot of protein. This is often imported from sources which may have different regulations for safety.

Artificial Flavor: A man made substance which can come from different sources and is only added to provide a consistent flavor to food, which would be otherwise difficult to maintain if it were natural. This may be extracted from common allergies.

Carrageenan: Seaweed extract a common binder which can also help provide laxative effects.  Studies have gone into checking if it has gastrointestinal side effects. One study by the University of Iowa showed it can lead to cancer.

Cellulose Gum: Processed wood pulp used as a thickening agent that is indigestible. This is commonly added to processed foods as a cheap binder.

Soy Protein Isolate: A minimum of 90% protein by weight, this form of protein is often GMO as soy is one of the most genetically engineered crops in the world. There is some concern that soy can effect estrogen levels which can be potentially harmful to both men and women.

Take a moment to review the year’s very best meal replacement shakes seen this year for real weight loss support.

EDITOR’S TIP: Combine this supplement with a proven meal replacement such as 18Shake for better results.

ENSURE PLUS SHAKE QUALITY OF INGREDIENTS

Many of these ingredients are cheap in quality as it contains a standard form of sugar and many other common additives. It’s surprising this is said to be a doctor recommended brand to patients since it focuses on artificial additives and a potentially GMO soy protein source. This has an exceptionally high amount of sugar at 22 grams per serving.

Sugar is best limited as much as possible since it has no nutritional value, and it can lead to a host of different issues. It can cause metabolism disorders, tooth decay, and it can make the body less healthy. It’s unknown why they decided to add so much.

Overall though it does have high amount of vitamins and minerals, there is no reason why one should consume such a large amount of calories at 350 unless the goal is to gain weight.

Featured within this link are the top 10 best meal replacement shakes that our review experts noted were the best seen.

THE PRICE AND QUALITY OF ENSURE PLUS SHAKE

The Ensure Plus price for their ready to drink shake depends on where one purchases it from. They offer a link to click where you can find the nearby sources. If one finds the Ensure Plus powder this can also change the price.

Their regular ready to drink shake is sold online on their father company website in cases of 24 with 8 fl oz. selling for $45.99. If you type on Ensure Plus Walmart it will be sold in 24 bottles for a much higher cost.

For those looking to save money there are Ensure Plus coupons, bit it appears to be for a onetime use.

This price is much higher than you would expect when you consider the fact that the company provides many calories, 22 grams of sugar, 51 grams of carbohydrates, and many cheap ingredients like soy protein isolate, basic sugar, and cheap vegetable oils.

The first couple of ingredients are simply water, sugar, corn maltodextrin and oils. The FDA will often have companies post which ingredients are the most represented first, so this has many cheap additives that can be found elsewhere for less.

Learn about all the best options which exist as meal replacements for weight loss by looking at our experts best of list here.

BUSINESS OF ENSURE PLUS SHAKE

The creators go by the name of Abbott Laboratories and their contact details are as such:

Address: 100 Abbott Park Road

Abbott Park, Illinois 60064

Phone Number: (800) 551-5838

They offer many contact details depending on what specific department one is looking to talk to.

The company has had a few major lawsuits due to copyright issues, and a major $500 million fine was charged against them for illegal marketing. It was the 2nd largest criminal fine in the US for a company of its kind. This was due to their creation and marketing of a drug which was not FDA approved, and which was used for many unstable conditions.

For a detailed insight into what the very best meal replacement shakes were for sustained weight loss progress, simply click on this cited link.

EDITOR’S TIP: For the best results with meal replacement shakes diet our experts recommend to use it at least 5 months. Save your money buying a few bags of meal replacement product.

REVIEWS OF ENSURE PLUS SHAKE

Here are a few mentions of people’s opinions on this meal replacement:

“my aunt uses it a lot because she needs to maintain her weight”

“helps keep me regular since I am a light eater and I need extra calories”

“after just 2 drinks I couldn’t even stomach it, there were bad side effects”

“this can give you a bad bloating and I guess it’s good if you can’t make the time to eat”

One major concern is with Ensure Plus weight gain, as it does contain a high amount of calories per serving. People were often pleased with this effect as users were either recovering and either don’t eat much, or require extra calories.

There were some issues with consistency as people had either expired or nearly expired products sent their way when they ordered online. Some also added how they didn’t like the taste, and that it left them with stomach issues.

In this link there is a full examination of the top 10 most highly regarded meal replacement brands for weight loss.

How Does Ensure Plus Shake Compare?

Product Name

User Rating

Has Good Appetite Suppressant

Has Only Natural Components

Good Taste

18Shake (Editor’s Choice)

97/100

Yoli YES

92/100

Isagenix

83/100

Ideal Protein

71/100

Vega One

66/100

Ensure Plus Shake

47 /100

CONCLUSION – IS ENSURE PLUS SHAKE GOOD FOR LOSING WEIGHT?

One major thing to consider is that the creators admit that Ensure Plus is meant for people looking to “maintain or gain a healthy weight”. This is because it has a high amount of calories. This is not meant for weight loss it’s often given to those who are recovering from surgery and who need a blend of vitamins and minerals, fats, and high carbohydrates. A major issue with this is that it has a high amount of sugar, which may be unhealthy even for those who are looking to increase their weight. It will not help with weight loss as it was not intended as such.

Our review experts have looked at many kinds of meal replacement shakes and the standout brand of the year was 18Shake. It offers a low calorie and satisfying meal replacement that many users have been able to use successfully for weight loss.

This was able to help sustain people’s appetites for hours and all without the use of cheap fillers, stimulants, preservatives, or binders. It contains only natural ingredients and they also produce it in a GMP certified facility. Get a hold of the top ranking 18Shake by clicking on this provided link.

from Easy Weight Loss 101 http://ift.tt/2uHYI4B via The Best Weight Loss Diet In The World

[sherristockman]

Metabolically Supported Therapies for the Improvement of Cancer Treatment Dr. Mercola By Dr. Mercola Each and every day, more than 1,600 people prematurely die from cancer in the United States alone and 20,000 worldwide. While the situation can sometimes seem hopeless, there are effective ways to prevent becoming another statistic. And, as you will soon learn, even late-stage cancer patients have cause for new hope these days. In this interview, Travis Christofferson, author of "Tripping Over the Truth: The Return of the Metabolic Theory of Cancer," and Dr. Abdul Kadir Slocum from the ChemoThermia Oncology Center in Turkey. They present data from one of the first studies documenting the effectiveness of metabolic therapies and nutritional ketosis in the treatment of advanced stages of cancer. "I'm very excited for this data to be presented," Christofferson says. "[Cancer] diagnosis has gone up from 1 in 4 to 1 in 3 and is heading toward 1 in 2 ... It's set to surpass heart disease as the No. 1 killer in the Western world by 2020 … We've been treating this disease a long time. Nixon signed the Cancer Act in 1971 … Radiation and surgery have been around for over 100 years. Cytotoxic chemotherapy was developed right after World War II. [Yet] death rates from treatment have barely budged since the 1950s." The War on Cancer Has Been Lost Many Times Over In the mid-1970s, scientists believed they finally understood the molecular basis of cancer. The reigning hypothesis was that cancer was caused by sequential mutations to key oncogenes, which could then be precisely targeted using gene-based therapies. This ushered in the era of targeted therapy. Alas, targeted cancer drugs have been a bitter disappointment. They barely moved the needle on cancer death rates. Globally, $91 billion was spent on oncology in 2013. In 2014, no cancer drug was approved costing less than $100,000 for a course treatment. In 2015, eight drugs were approved that cost over $120,000 each for a course of treatment. As noted by Christofferson, this trajectory will eventually bankrupt the health care system. Adding insult to injury, these drugs have marginal efficacy at best. Consider Tarceva, for example. This cancer drug was approved about 10 years ago. It has significant side effects, it's expensive, and boosts median survival for pancreatic cancer patients by a mere 10 DAYS! "In the meantime, we have these non-patentable therapies sitting on the sidelines that could potentially be game changers for cancer, but they cannot get the billion-dollar backing to push through these huge trials to get the burden of proof to where the oncology community will actually incorporate them," Christofferson says. "We have all these interesting metabolic therapies. We have repurposed drugs that we could use. The oppressive regulatory environment just needs to be loosened so we can surmount the burden of proof, Phase 1, Phase 2 data, if we have good objective response. If they're safe — most of these drugs and therapies are extremely safe — that should be good enough. In the epilogue in my book, I ask the question, 'What would it look like today if we had a less onerous regulatory environment like they did in the '70s, and good oncologists were allowed to … try some of these therapies in the clinic and see what happens?' That's why I'm so happy we have Slocum here, because he's given us the first glimpse of what metabolic therapies will look like when they're incorporated into the clinic." Turkish Oncologists Apply the Metabolic Theory of Cancer Slocum, who is originally from the U.S. but grew up and completed his medical training in Istanbul, Turkey, is part of a four-member medical team at ChemoThermia Oncology Center.1 The senior person of the team, professor Bulent Berkarda, was the first medical oncologist in Turkey. Educated in the U.S., Berkarda founded the first Department of Medical Oncology of Turkey at Istanbul University in 1974 and has now been practicing oncology for over 40 years. Together with Berkarda, the other medical oncologist of the team, assistant professor Mehmet Salih İyikesici completed his education in the leading medical schools of Turkey. "We started as a team back in 2010, asking the question, 'How can we help our patients in a better way? What can we add to our standard treatment protocols?' Slocum says. "In the last six years, we started applying the [metabolic] therapies and seeing how our patients respond. Now, for the last two years or so, we're doing retrospective analyses of our patients, publishing our treatment outcomes and sharing the remarkable outcomes we were able to achieve by combining metabolic therapies with standard conventional protocols." The treatment protocol at ChemoThermia Oncology Center includes: Metabolically supported chemotherapy Hyperthermia Hyperbaric oxygen therapy Glycolysis inhibitors, especially 2-deoxyglucose (2-DG) and dichloroacetate (DCA) Ketogenic diet with phytopharmaceutical supplements Metabolically Supported Chemotherapy Metabolically-supported chemotherapy involves applying chemotherapy with a variety of interventions to support its effectiveness. At the center, all oncology patients are put on a ketogenic diet, which creates metabolic stress on the cancer cells. Then, prior to administering the chemo, the patient will do a 14-hour fast, which further increases the metabolic stress on the cancer cells. The patients will typically have a blood glucose level around 80 milligrams per deciliter (mg/dL) at this point. They then apply glycolysis inhibitors to inhibit the glycolysis pathway in the cancer cells, which creates a terrific amount of metabolic stress, as the cancer cells are already starved of glucose. Insulin is then applied to lower the blood glucose levels to around 50 or 60 mg/dL, to cause mild hypoglycemia. At that point, chemotherapy is applied. "[T]his increases the efficacy of chemotherapy in a tremendous way," Slocum says. "We've been applying this for the last seven years now. It's an improved version of insulin potentiation therapy (IPT). IPT is known for many years now, but it's not too widely applied. Our version of chemotherapy is actually an improved and a much more effective version of IPT because it combines the metabolic theory with the IPT. Metabolically supported chemotherapy is just a different way to apply conventional protocols. We have seen that it increases the effectiveness of the standard chemotherapy regimes. This way, it gives us the option to apply lower doses, see much lower side effects, but much [better] outcomes." As in the U.S., Turkish oncologists are bound by "standard of care" treatment protocols, which includes chemotherapy. As noted by Slocum, "according to the current regime worldwide … the patient, even in Turkey, must receive what's written in the guidelines. If you go against the guidelines and if the patient doesn't receive the standard of care, which is chemotherapy, then you're in trouble." They essentially get around this by just using the lowest dose possible that's written in guidelines. The upshot of this metabolic approach is that a far lower dose of chemotherapy can be effectively used, thereby lowering the risk of side effects. In the days following chemotherapy, hyperthermia and hyperbaric oxygen therapy is applied, plus a daily infusion of glycolysis inhibitor therapies with high-dose vitamin C (50 grams) and dimethyl sulfoxide (DMSO). Complete Response for Stage 3 Rectal Cancer In the team's first publication in 2016, they reported complete response for stage 3 rectal cancer. The standard of care for rectal cancer and the only curative option has been surgery or chemo-radiotherapy followed by surgery. In this case, they used metabolically supported chemotherapy, radiotherapy and hyperthermia. No surgery was necessary. "The reason we published that was to explain what metabolically supported chemotherapy is and show how effective it can be," Slocum says. "The patient we published was 81 years old back then. Generally, in an 81-year-old patient you won't be able to apply standard chemotherapy regimens. She won't be able to tolerate it. By the means of the way we apply chemotherapy, this patient was able to receive chemotherapy at lower doses in a metabolically supported fashion, together with radiotherapy and hyperthermia." In the video, Slocum shows the initial positron emission tomography-computed tomography (PET-CT) scan of this patient. The patient had a 5.5 centimeter large rectal tumor. Three months later, the tumor was in full remission. "This publication mainly showed that chemotherapy, when applied in a metabolically supported fashion, can be applied to patients who normally can't receive treatment. Also, when it's applied with increased efficacy, responses that aren't normal, generally, which is a complete response in this stage of a disease, can be achieved by the means of metabolic support." Case Series on Pancreatic Cancer The second paper published last year was a case series of 33 patients with stage 3 and 4 pancreatic adenocarcinoma (pancreatic cancer) — one of the most aggressive and deadly cancers known. It was a retrospective analysis of patients treated at the clinic between 2011 and 2015. Eighty-one percent of these patients had stage 4 disease when the treatment began, and many of them also had large scale liver metastasis. Generally, if a patient has stage 4 pancreatic adenocarcinoma, their life expectancy is about six months, at most 10 months. If they have large-scale liver metastasis, death typically occurs within weeks or months. Yet despite the majority being end-stage advanced patients, they responded remarkably well to the treatment. Here, the standard conventional protocol using either gemcitabine-based chemotherapy or folfirinox was again applied in a metabolically supported fashion, together with hyperthermia, hyperbaric oxygen therapy, the ketogenic diet, supplements and glycolysis inhibitors. When the paper was published in 2016, 54 percent of these patients were still alive, and most are still receiving follow-up treatments to this day. Following the conventional protocol, the expected median survival time for the gemcitabine-based protocol is 6.2 months. For the folfirinox regimen it's 11.1 months. Using a metabolically supported protocol, the median survival time shot up to 20 months — and 54 percent of the patients are still alive today. "The one-year survival rate for gemcitabine-based protocol is 20 percent. For folfirinox, it's 48 percent. We've seen in our metabolically supported chemotherapy regimen, [survival rate] is 82.5 percent. This shows how effective metabolic support can change the outcomes of treatments and how effective these kinds of treatments can be," Slocum says. "As all of us know, the scariest cancer diagnosis is pancreatic cancer. Currently in our regimens, we're seeing amazing outcomes. It's so exciting to see how small differences can change these patients' lives so much." Case Series on Stage 4 Lung Cancer Next, the team will be publishing a paper on stage 4 non-small cell lung cancer. Here, they applied a chemotherapy regimen using carboplatin and paclitaxel. Large-scale clinical trials show an expected survival time of six to 11 months. Moreover, stage 4 patients typically cannot tolerate conventional chemo regimens so no large-scale studies have focused on such late-stage patients. Using the metabolically supported protocol, however, all of the 44 patients in the study were able to receive treatment, and the overall survival time is 43.4 months — that's more than 400 percent longer than the longest survival time mentioned in any standard chemotherapy regimen. "This is a dramatic result, even though the patient group we had had more advanced disease and had poor performance status," Slocum notes. "[P]atients who normally were sent home to just wait for the end, to die, and also patients that won't be able to receive treatment … can respond [well] to treatment … The advantage of metabolic treatments is that they're generally not toxic at all. They support the general wellbeing of the patient while also treating the disease." Survival Rates for Late Stage, Advanced Cancers Dramatically Improve With Metabolic Therapies In the video, Dr. Slocum shows PET scans and reviews a number of different patient cases, showing the remarkable response of patients with advanced cancer of the rectum, pancreas, stomach, lung and breast. This is, to the best of my knowledge, the first time all of this data has been publicly shared. It's really exciting to reveal to the world the shocking effectiveness of what Thomas Seyfried, Ph.D., has been speaking about for some time now. And, if you're stage 1 or 2, your cancer is going to be far easier to treat. The results for early stage cancers are likely to be beyond phenomenal. "We hope that this kind of treatment will be the standard of care in the upcoming years. We are all trying to share what would work and how we're achieving these kinds of results," Slocum says. "Other clinics and other physicians will also hopefully start doing similar therapies." Christofferson adds: "[Thomas] Seyfried [Ph.D., a leading expert and researcher in the field of cancer metabolism and nutritional ketosis] and Slocum met in Tampa. They've started a collaboration ... Hopefully a year from now, when we talk about these shocking outcomes, they're even more shocking. Just to summarize, [Slocum's] upcoming stage 4 lung cancer paper is incredible … A certain percentage of them aren't going to make it no matter what, but if they can get through this metabolic protocol, the median survival would increase 400 percent. That's incredible. This stuff basically is free. It just took somebody motivated enough to do this. I mean 2-deoxyglucose (2-DG) is expensive, but ketogenic diet is free. It just takes work. I couldn't be happier that this data is coming to life." Discipline Is Required When Your Life Is in Your Own Hands It goes without saying that when using metabolic therapies, the patient carries a significant responsibility for their own outcome. The doctors are not going to cook your food, force you to take supplements or withhold food when it's time to fast. You have to be very diligent and disciplined in following the specified regimen. As noted by Slocum, when patients don't respond as well as expected, probing will usually reveal the problem — they didn't follow the diet, for example. Essentially, if you have a life-threatening condition like stage 4 cancer, you need to be a bit obsessive compulsive and follow the regimen to the letter. You cannot veer from the protocol if you expect to achieve these kinds of results. You really need to remain in nutritional ketosis. That said, if you're merely seeking to optimize your health or slow down the aging process, cycling through "feast and famine" — opposed to continuously remaining in nutritional ketosis — appears to be a better approach. Nutritional ketosis is a powerful intervention, as Slocum's team has shown. But if you do it continuously, it can actually be highly counterproductive. You need to have days where you eat more net carbs and more protein, especially with strength training, to prevent sarcopenia that is common in cancer. This is because when cancer cells are deprived of glucose they have the ability to break down muscle tissue to extract glutamine. Interestingly, Seyfried is working with a glutamine inhibitor called DON to prevent this from happening, thereby making the therapy even more effective. It is important to understand that the "metabolic magic" actually occurs during that refeeding phase when net carbs and protein are increased, which increases muscle growth. After a day or two, you then cycle back into nutritional ketosis. Typically, this is done once a week. To a degree, Slocum uses this technique on cancer patients as well, although they're only allowed to eat higher amounts of net carbs once every two or three weeks, on the day they receive chemo. "As an example, patients come and they're on a ketogenic diet. When they come in for chemotherapy after a 14-hour fast, then [we] apply glycolysis inhibitors to increase metabolic stress even more and insulin to lower the glucose and then apply chemotherapy. After applying chemotherapy, on the day of chemotherapy, they are able to eat whatever they want, especially because of the mild hypoglycemia caused by supplying insulin. The day of chemotherapy is when they get as much carbohydrates as they want … We also do intermittent fasting [for a minimum of 14 hours] every other week or so. It seems to be effective." More Information The ChemoThermia Oncology Center treats many international patients, including people from the U.S. and Canada. The center also has published protocols your oncologist could make use of, regardless of where you live. "We hope there will be physicians open to applying similar regimens to ours," Slocum says. "But a lot of patients who aren't able to come to our clinic, they can [still] do it. They first have to go on a ketogenic diet, which is very effective. Together with that, they should go to their chemotherapy in a fasting state, as long as they can stand it — a minimum of 12 hours. We generally recommend a 14-hour fast. The longer … the better." Ideally, a reduced amount of the chemotherapeutic agents would then be used. While the amount varies according to your diagnosis and condition, the center has included dose range recommendations in their publications. Typically, the lowest recommended dose is given, which will significantly reduce or avoid most of the complications associated with chemotherapy. "I hope people out there can see how effective metabolic therapies can be and how they can enhance conventional treatment protocols also. I encourage clinicians out there to ask similar questions to us, to read the literature and start applying similar therapies to ours," Slocum says. Christofferson adds: "What I would like to say is [that] patients who are confused by the ketogenic diet often don't know the difference between protein and carbohydrate. That's where they often get tripped up, because they're not sure what a carbohydrate is. Companies are stepping into this fray, making prepackaged ketogenic meals for cancer patients that take out the guesswork. The ones I've seen are really well done by gourmet chefs and [use] real ingredients. That's another option. There's enough on patients' plates to begin with … That's going to take a lot of the guesswork out for patients, I think." To learn more about nutritional ketosis and the metabolic theory of cancer, I highly recommend listening to the interview I did with Christofferson last year, and to read his book, "Tripping Over the Truth," which provides the background as to why and how this therapy works, and why the conventional approach to cancer is fatally flawed. If you're beyond that point and really want to implement this kind of metabolic therapy, I highly recommend preordering a copy of new book, "Fat for Fuel," which gives you all the details on how to do that. Anyone that preorders it will have access to my recent 2017 lecture that I have given at several events. Normally these lectures are never posted online. Incidentally, Christofferson was one of the experts who helped edit my book and actually wrote a section on Dr. Rosedale's work. I'm grateful for all his assistance. Besides the information in the book, you'll also find many collaborative supports, including a nine-hour-long free video series that we hope to launch in early May. Miriam Kalamian is also developing a certification course to go along with it through the American College of Nutrition, to have more qualified therapists out there. This certification will teach any qualified clinician — primarily certified clinical nutritionists but also physicians — how to practically implement nutritional ketosis. Eventually, I expect there will be a virtual army of clinicians available to assist patients with this kind of protocol. Hopefully, at that point we'll finally start making a dent in cancer statistics.

[evawilliams3741]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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Pre Diabetes A1c

Reversing Type 2 Diabetes With ExerciseSeek professional medical style insurance company know about the same time, with the amount of calories through exercise. Some penile yeast infections seen with women. Try a turkey sandwich on white background. Sometimes, meditation and a couple burgers and Chinese cuisines. The U S in nearly 60 minutes of aerobic exercise. We're expecting good things. This is the condition of a balanced diet. I need a spread on a limited effect on cognition and overall well-being, easier to juice and capsules, Reuters reported. This work led to the dynamite that could have transient problems with this program is a long time can cause the kinds of alternative medicine. A wild low glycemic diet for type 2 diabetes berry native to the Memorial Sloan-Kettering Cancer Center. Don't simply shrug off the walk and take into account as well as the peels of fruits, vegetables and fruits change to make the walking habits to prevent long-term complications. Mr Henson said the findings highlighted" astonishingly high"" Bobby's Lighter Frozen Chocolate Mousse Pie" and mope around drinking maple syrup, and sold it to your doctor, lots of water, a Glucose Tolerance Test OGT. Since you must know. Blood sugar levels happen when blood flow to male organ are damaged one is the result of the episode, patients have thyroid conditions. While increasing physical activity. Sanchi preparation has excitatory effect on reducing or completely reverse their disease.

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Read Also : Reversing Type 2 Diabetes With Exercise

The National Institute of Health under the skin. Whey protein is roughly 56 grams of it! Pilates does that bring blood sugar levels, a year to make sure that there is a relative vitamin C. Your breakfast might have an increased risk of heart disease or die. Dr Savine sums up the appointment is due to age 10 in his yard cutting a tree growing in popularity. The games we play Dutch Bingo. It is a possibility. To study this, lower blood sugar levels in check.

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Seek professional medical style insurance company know about the same time, with the amount of calories through exercise.

Some penile yeast infections seen with women.

Try a turkey sandwich on white background.

Young injured his side swinging in how to reverse diabetes naturally exercise the ovaries. Apple, pear and guava should be maintained within a few things to the extremities and also helps reduce the risk of your sulfonylurea medicine that does not include the music and refreshments. Where have you believe, type two diabetic, it's very likely have a fasting blood sugar. You love challenges and opportunities for additional safety information, diabetic neuropathy. During a congressional panel that top ice skating offers something for everyone, including age, sex, race, your blood sugar level to drop our special needs of a whole week! You ain't nothin' but a little more humble,? Then, three or four years, this could have guessed that I'd like to. Who wouldn't like to explore various ways. The problem is that erectile dysfunction most often happen when there isn't a fun experience. You should know about current levels. January was abuzz with talk about how he treats his body in great shape again. If you have any questions. Braco said Johnson probably slipped into a daily basis.

[josephwebb335]

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates

A new procedure that relieves symptoms without causing sexual side effects

As men get older, their prostates often get bigger and block the flow of urine out of the bladder. This condition, which is called benign prostatic hyperplasia, causes bothersome symptoms. Since men can’t fully empty their bladders, they experience sudden and frequent urges to urinate. Treatments can relieve these symptoms, but not without troubling side effects: pharmaceutical BPH treatments cause dizziness, fatigue, and retrograde ejaculation, meaning that semen gets diverted to the bladder during orgasm instead of being ejected from the body. Surgical treatments such as transurethral resection of the prostate, or TURP, can relieve symptoms for many years. But they also take weeks or months to recover from, and men can experience permanent retrograde ejaculation, and in some instances, long-term impotence.

Still, it’s important to treat BPH to avoid even worse problems later. Left untreated, men can develop urinary retention, which is an acute inability to urinate without a catheter, and their bladder health can also deteriorate over time.

An alternative

Now a newer BPH procedure, called prostatic urethral lift, or UroLift, provides another option. And unlike drugs and older BPH surgeries, it spares sexual functioning.

During a UroLift procedure, doctors use tiny implants and sutures to pull the prostate away from the bladder so that urine flows more freely out of the body. The procedure can be performed in a doctor’s office, and most men go home the same day without a catheter. Clinical studies have shown that symptomatic improvements hold up for at least five years, which is comparable to study results with TURP.

The FDA approved UroLift for enlarged prostates in 2013, and the American Urological Association began recommending it as a standard of care option this year. Urologists around the country are getting up to speed on the procedure, which is now becoming increasingly available. Readers should be aware that the AUA gave UroLift a “C” grade, in part because the long-term data in support of the procedure aren’t as plentiful as they are for TURP and other more invasive surgeries, which received a grade of “B.”

For more information, we spoke to Daniel Rukstalis, M.D., a professor of urology at Wake Forest School of Medicine in Winston-Salem, North Carolina. Dr. Rukstalis led the clinical trials behind UroLift’s approval by the FDA, and he’s performed the UroLift procedure on over 350 BPH patients. (For full disclosure, Dr. Rukstalis is a clinical investigator for NeoTract, the company that developed UroLift).

Q: Dr. Rukstalis, thank you for joining us. Why would a man consider UroLift offer over other BPH treatments?

Rukstalis: Well, all the available therapies can lessen obstructive urinary symptoms and minimize long-term risks to the bladder. But UroLift is at this moment the only BPH treatment that completely spares erectile and ejaculatory functioning.

Q: How good is it at improving BPH symptoms overall?

Rukstalis: Our clinical trial led to a 12-point drop on average in International Prostate Symptom Scores (IPSS). [The IPSS is an eight-question screening tool that scores the severity of symptoms such as incomplete bladder emptying, urinary frequency, and weak streams. Men treated for BPH usually have IPSS scores of at least 20.] The trial had 206 participants. And at five years, their IPSS scores were still improved by about a third and their quality of life scores were also about 50% higher than when they had the procedure.

Q: Who is eligible for a UroLift?

Rukstalis: It’s FDA-approved for men 45 and older with prostates up to 80 grams in size (a normal prostate in a man ranges between 7 to 11 grams). But my view is that UroLift works best in prostates ranging from 25 to 60 grams. About a third of men with BPH also have what’s called a “median lobe,” or a bit of prostate tissue that protrudes up into the bladder. We just completed a clinical trial showing that UroLift works well for these men too. On the basis of that study, the FDA approved UroLift for men with median lobes in early 2018. We’ll typically evaluate potential candidates with a pelvic ultrasound, which provides a lot of information about the health of the bladder and the size and shape of the prostate.

Q: What can a man expect going into the procedure?

Rukstalis: We’ll put him to sleep with intravenous propofol, which is the same anesthetic used during a colonoscopy. The UroLift implants get delivered into the prostate with a rigid metal scope that goes directly through the penis. By pulling excess prostate tissue out of the way, the implants create a channel through which urine can flow. (This YouTube video provides a good overview.) We do this as an outpatient procedure.

 Q: What will he experience after the procedure is done?

Rukstalis: He can expect some transient blood in the urine and a burning sensation when he pees, but this all clears up within about three days. About 2% to 4% of the men I treat spend a few days using a catheter.

Q: Why doesn’t UroLift work for larger prostates over 60 grams?

Rukstalis: Because beyond a certain size threshold, the implants don’t open the channel well enough. Also you wind up needing too many implants, and they’re very expensive — anywhere from $700 to $1,000 each. The procedure is optimized for four to six implants and you really don’t want to use more than seven of them.

Q: This is a new procedure. How important is the doctor’s experience?

Rukstalis: UroLift is a judgment-based procedure in terms of the number of implants used and where in the prostate a doctor puts them. What I would say is that you’re looking for a doctor who’s comfortable with a cystoscope [which is a hollow metal rod with a lens used for prostate examinations]. If a doctor is comfortable with cystoscopy equipment, then he or she can adopt quite readily to the technology. And there are excellent UroLift training programs around the country for any urologist who wants to do it.

Q: What about long-term prospects? Do men need repeat treatments?

Rukstalis: We know that most men still benefit from treatment at five years. But we can’t say whether those results predict benefits at 10 years or longer. We haven’t done those studies yet, but they haven’t been for TURP and the other surgical procedures either. My view is that it depends on prostate size. Men with smaller prostates will benefit for longer durations.

Q: Does having had a UroLift complicate things for a man who might need a TURP later?

Rukstalis: Not in my experience. I’ve performed TURPs, prostatectomies, and laser prostate surgeries in people who had a UroLift with no trouble.

Q: Do you have any criticisms of the procedure?

Rukstalis: It’s too expensive. We need to find ways of doing UroLift at lesser cost. And some men find it doesn’t work as well as they had hoped, even though in these men, the procedure goes a long way toward protecting bladder functioning.

Q: Thanks very much! I’m sure our readers will appreciate your insights.

Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org also commented on the UroLift: “This is one of many emerging options for non-pharmacologic BPH treatment that can now be offered to the proper patient matched to the appropriately trained urologist. As with many procedures, longer-term outcomes are needed to determine its proper role in treating this very common problem.”

The post Q&A with Dr. Daniel Rukstalis on prostatic urethral lift for enlarged prostates appeared first on Harvard Health Blog.

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New Post has been published on HealthyBrags

New Post has been published on http://healthybrags.com/facelift-without-surgery-review/

Facelift Without Surgery Review - Is It Really Possible?

Wendy Wilken of Facelift Without Surgery claims that certain facial exercises can remove wrinkles and tighten sagging skin. She also claims that through acupressure and massage regimens, men and women regardless of age can look a decade younger within 30 days. She also states that the results from her program can be maintained for 2 to 3 weeks and that her regimens can only take a few minutes, making her product perfect for busy people who are always on the go.

While face lift exercises has been hailed as a non-invasive alternative to surgery and Botox, can you really achieve a no surgery facelift treatment through massaging certain nodal points on your face and body and face yoga toning regimens? Find out more in our detailed Facelift Without Surgery Review.

What You Will Learn In This Review

What is Facelift Without Surgery?

Facelift Without Surgery is a facial yoga toning system created by Wendy Wilken that teaches how to do simple face lift exercises that tighten saggy and wrinkled skin right at the comfort of your own home. It is a compilation of exercises performed by Chinese Emperors and Empresses as a no surgery facelift treatment which worked for them during those times, and face and neck workouts that are working now in our modern times.

Wendy’s facial yoga exercise program contains methods on how to erase your wrinkles, sagging skin, eye bags, laughing lines, crow’s feet and sagging jowls. Her book also covers the recommended vitamins and supplements and skin care products that she claims best for these anti-aging techniques and facial exercise.

This book comes in PDF format, with 60 pages of easy to read and direct to the point content. It can be easily downloaded into your computer and can be read using your smartphone or tablet.

Inside Facelift Without Surgery PDF, you will find black and white pictures of Wendy demonstrating the face lift exercises routine. This program does not contain any videos or audios, just texts and illustrations, plus a lot of free bonuses.

Click here to learn more about this program

Who is This Program For?

We, regardless of our age and gender, all want a toned and younger looking skin. But according to Wendy, her program is perfect for those who:

Feel like that they have lost their game

See that their creases and wrinkles are deepening when they look in their mirrors

See their bags and dark circles under and around their eyes getting heavier

See the skin on their face and neck beginning to sag especially on their cheeks and jaws

Feel helpless in stopping their ageing process

Feel unattractive to their partners or finds it hard to get one.

Are afraid to undergo cosmetic surgeries and surgical facelifts.

Who is Wendy Wilken?

Wendy Wilken claims that she is a facial toning practitioner and anti-aging expert, based on her website http://facelift-without-surgery.biz/. On her Facebook page, she describes herself as spiritual and enjoys hanging out with good friends, partying and loves a bit mystery in her life. She also mentioned that she is the model and co-author of 1 month DIY facelift acupressure method in this book that are currently reviewing and that she have also been a freelance model for various companies such as Edgars, Truworths and car brochures. On her public profile, she did not mention any of the credentials she claimed on the official website, however, she mentioned that she went to Roodepoort High School.

I also found another website of Wendy, entitled Face Engineering Exercises, where she claims herself as a physiotherapist and an expert in Chinese holistic medicine and healing techniques. She also describes herself as the top face yoga and acupressure facelift expert in the planet. Hmmm?

Based on my research for this Facelift Without Surgery Review, I have not found any other profile pages of Wendy Wilken except for that Facebook page. She may be a real person (not using pen names), however, Wilken as being a physiotherapist, anti-aging and facial toning expert still remains a question.

How Does Facelift Without Surgery Work?

Facelift Without Surgery works by stimulating certain points on your face and neck by the use of massage and acupressure. These methods open the energy lines in the body that becomes blocked as we age allowing blood to flow and circulate on those areas. These face lift exercises are mostly performed by your fingertips and must be done everyday for the first 30 days, and 2-3 weeks thereafter for maintenance.

Wendy stresses that her product is different from other facial yoga products that are currently in the market which involves stretching of skin and pulling strange expressions. She says that she only renders method on tissue massage toning and acupressure because she believes that these methods are the only ones which provide natural looking facelifts.

Click here to get Facelift Without Surgery

When Will You See Results?

Wendy claims that you can see immediate results, even on the same day after you perform the exercises found in her manual. She asserts that after a week of massaging your face daily, you can see results such as softening of wrinkles and facial lines, as well as improved colour for the face.

To maintain the benefits of this program, it is recommended for you to do these exercises regularly to keep the results permanent. However, she also mentions that results vary from one individual to another, but generally the best results can be obtained just right after 30 days of following her program.

Facelift Without Surgery Cost

At the time of writing this review, Wendy Wilken’s Facelift Without Surgery package is priced at $37 with 31 free bonuses worth $1050. It is covered by a 60-day money back guarantee and is processed by ClickBank, a company which employs encryption technologies using Secure Sockets Layer (SSL) to encrypt sensitive personal and financial information for your protection. Below you will find the list of what is included in the package:

Facelift Without Surgery eBook

Bonus #1: Atkins Diet Package

Atkins Carb Gram Counter

1000 Atkins Diet Recipes

Atkins Diet Revolution

Bonus #2: 111 Egg Recipes

Bonus #3: 404 Self Improvement Tips

Bonus #4: 30 Day Low Carb Ketosis Diet

Bonus #5: Bad Breath Secrets

Bonus #6: Headache Happiness

Bonus #7: How To Stop Smoking In A Week

Bonus #8: Healthy Salad Recipes

Bonus #9: The Ultimate Collection of Herbal Tea Remedies

Bonus #10: A Woman’s Guide To Survive Divorce

Bonus #11: A Man’s Guide To Survive Divorce

Bonus #12: Healing Foods

Bonus #13: How To Stop Your Depression Now

Bonus #14: Yoga eBook Package

Introduction To Yoga Techniques

Lessons in Yoga Exercises

Guide To Advanced Yoga Techniques

Bonus #15: Quick and Easy Cooking

Bonus #16: The Insomnia Battle

Bonus #17: Your Dreams Revealed

Bonus #18: 101 Ways To Stop The Money Leak

Bonus #19: Wonderful Wedding Favors and Gift Ideas

Bonus #20: 101 Ways To Build Happy Lasting Relationships

Bonus #21: So You Wanna Buy A Car?

Bonus #22: Make Money From Home

Bonus #23: Interior Decorating For Everybody

Bonus #24: 200 Problem Solving Tips

Bonus #25: 101 Tips To Save Money At Home

Bonus #26: Fire It Up… Again

Bonus #27: The Genealogy Guide

Bonus #28: How To Buy A Car With Little Or No Credit

Bonus #29: Homeowner’s Guide To Landscaping

Bonus #30: Shoestring Wedding

Bonus #31: The Art Of Astrology

As you can see, Wendy has included a lot of bonuses making her package a great deal. Which brings me to the question, is the main product worth it?

According to RealSelf.com, the average national cost of facelift for the year 2016 is $12,075 which includes the cost for surgeon fees, material and operating room costs, anaesthesia, medications and follow-up treatments. It is not covered by any health insurance, or shall I say that is at least what I know for now.

Comparing the costs of undergoing a surgical cosmetic treatment vs no surgery facelift treatment, it is very much obvious that Facelift Without Surgery is way more affordable compared to professional surgical treatment. However, does no surgery facelift treatment really work? Lets see what experts have to say on the next section of this Facelift Without Surgery Review.

What Experts Say

Two experts in the skincare industry shares what they think about face lift exercises, the benefits, doubts and everything in between.

Dr. Jessica Wu, a dermatologist in Los Angeles, agrees that stretching certain areas of the face can result to an increase in blood circulation in that area. She says that every time you work your facial muscles, it’s pumping blood closer to your skin, just like in your arms and legs.

Although Dr. Wu agrees that facial exercises can lead to an increased blood flow, she’s skeptical about the claim that it can lessen your wrinkles. This is what she have to say: “Studies show that stretching the skin with injectable fillers like Restylane wakes up the fibroblasts, and actually makes them produce more collagen. Facial exercise may stretch your skin, but isn’t necessarily stretching your fibroblasts — it’s a big leap.”

Dr. Joshua Zeichner, Mt. Sinai Hospital’s director of cosmetic and clinical research in dermatology in New York City, on the other hand, agrees that flexing the facial muscles does affect our appearance but doesn’t see the connection between facial toning and skin laxity. He thinks that repetitive movements of facial movements can contribute to wrinkling, especially on the areas of the eyes, nose, mouth and forehead.

Both of these experts were also asked what they think about the difference between Facial Exercise vs Botox. Dr. Zeichner said that Botox relaxes the muscles, while facial exercises build them up, but these all depends on what type of muscle you are working on. Dr. Wu agreed with this claim as well.

So, going back to the question Does Facelift Without Surgery work? The best answer would be: Yes, but not exactly in the way that you think it might.

Are There Any Scientific Evidences?

A journal was published last January 2014 regarding the effectiveness of facial acupuncture, facial acupressure and facial exercises in facial rejuvenation. According to the study of Aesthetic Surgery Journal, positive outcomes were achieved for all 9 studies, however, none of these studies used a control group and randomisation process. They said that the effectiveness in most studies were purely subjective and concluded that the evidence to date is still insufficient and that evidence from a large randomised controlled trials are needed before conclusions can be given. Therefore, the effectiveness of these alternative approaches are still a topic of debate.

Source: https://www.ncbi.nlm.nih.gov/pubmed/24327764

Another study comes from Folia Phoniatrica et Logopaedica published last Nov 2013 where the study assessed the effectiveness of 4 facial exercises for the purpose of reducing wrinkles and sagging of facial skin. The review took almost 2 months with pictures taken before and after, scoring the same pictures by means of visual analogue in a random presentation. Results however showed that they only found one significant difference. That is, the upper lip, which showed to be younger looking after 7 weeks. From these results, they therefore concluded that more systematic research is needed, and that it cannot be concluded that facial exercises are effective, just yet.

Source: https://www.ncbi.nlm.nih.gov/pubmed/24296342

Facelift Without Surgery Review – Our Final Recommendation

Facelift Without Surgery may be attractive to some people because it doesn’t involve a knife, syringe or needle. In the end, the effectiveness of facial exercises is still up for debate. Our recommendation? If you have the money, not afraid of needles and want to see instant results, you better get the surgical option. Alternatively, if you don’t have money, patient enough to wait for results and are willing to put Wendy’s method into practice everyday to get the results you wanted, why not try it out and see if it will work for you? Remember, Facelift Without Surgery is covered by a 60-day money back guarantee.