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The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005 penis enlargement operation pnis enlargement pills cheapest penis enargement pills compare penis enlargment pills penile enlargement without pills do penis enlargement pill really work penis elargement surgery photo best penis enlagement pills

penis enlagement exercise

You are just with yourself and enjoying the company with “someone” that gives you profound sense of appreciation for everything that you come across- long drive that pass through the bridge over river where you’d love to bop, lip smacking foods and cozy environment but when the big moment comes you are unable to have an erection even though you are being sufficiently stimulated. Such cases are not to be seen in isolation. Growing number of populace experience a phase in their life when they’ve to face some form of Erectile Dysfunction. Erectile Dysfunction- when man is unable to have or sustain an erection. It is the impairment of erectile reflexes. There is whole range of medication available that claims to treat ED. The numbers of men who are seeking solace with the zenegra to treat their problem of erectile dysfunction are on the increase. Zenegra is the generic version of brand name drug viagra. Both contain the same active ingredient Sildenafil Citrate. Zenegra is a prescription drug and should be taken with physician advice. Even those men whom erectile dysfunction is not a problem are finding hard to resist the temptation of zenegra that gives a tremendous boost to enhance their libido. It is also reported that men using it feels great first- rank experience of sex drive sustained erection and quicker recharge. Only half of prescribed medication is enough to bring the potency at functioning level. But before using zenegra it would be advisable to discuss with physician about all the details of your medical life. Like kidney and intestine problem, any allergies (especially drug allergies), any penis conditions such as fibrosis, scarring, history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (such as leukemia or myeloma), or Peyronie's disease, eye problems (retina diseases). Liver disease, bleeding disorders or active stomach ulcers, heart diseases, stroke or severe high or low blood pressure. Refraining from alcohol while using zenegra would help to shun the side effects. Let your doctor know all your prescription or non prescription medication you may use especially any nitrate medicine and high blood pressure medicine. This drug taken by mouth as needed 45 minutes before the sexual activity take only as directed. Zenegra should be kept at room temperature between 59 and 86 degrees F (15 and 30 degree C). Zenegra and all the medication should be kept away from the reach of children. enargement forum free matter penis size penile enlargement tool free penis enlarement tip natural penis enhancement and lengthening penis enlargement review com enlargement penile penile pump compare penis enlargement pills vimax cheapest penis enlargement pills penis enlagement exercise

As long as people have been having sex for fun, there have been methods of birth control. Other than abstinence, which is not really very exciting, the next oldest method of birth control is the withdrawal method, sometimes known by its latin name, coitus interruptus. The withdrawal method is not very complicated. It´s most important feature is that the penis must be withdrawn from the vagina before intercourse. If ejaculation happens inside the vagina, or if semen comes into contact with the vagina, withdrawal has not been used. Withdrawal has been criticized from a number of angles. One of the most important criticisms is that many men do not have the discipline to consistently withdraw. As if may be difficult to know when to woman is ovulating, withdrawal must happen each and every time. Another criticism is that pre-ejaculate contains some sperm. This is sometimes true, which affects the overall effectiveness of the method. When it is used consistently, withdrawal is much better than not using any type of contraception at all. If you simply don´t want to abstain, and you don´t have any birth control available, using withdrawal is well advised. For people who do want to be a bit more prepared, there are many types of contraceptives available. Condoms, pills, devices, diaphragms caps and charts are some of the modern methods that are available to today's sexually active partners. herbal penis enlagement natural pennis enlargement and lengthening penis enlagement before and after picture vimax penis pillss in uk free penile enlargment video penis elargement patch free natural penis enhancement vimax free penis enlargement penis enlagement exercise

Sexual dysfunction, in one form or the other and in varying degrees, is common among both men and women. According to recent studies, a large percentage of all men and women encounter some sort of sexual dysfunction at some point in their lives. And as they grow older, such problems become increasingly common. In males, sexual dysfunction may be of different types like lack of desire, failure to obtain and/or maintain an erection, and other problems like premature ejaculation and ejaculatory impotence, or the inability to ejaculate in coitus. Erectile dysfunction, however, is certainly the cause for maximum concern. For the treatment of erectile dysfunction, three oral medications are available: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They boost the levels of nitric oxide, thereby relaxing the blood vessels and smooth muscle in the penis. As a result, the flow of blood is increased, and erection is achieved and maintained. Whatever may be the cause of erectile dysfunction, sildenafil, vardenafil, and tadalafil have proved themselves extremely helpful. In Europe, another drug under the brand name of Uprima (apomorphine) has hit the market, although it still awaits the approval of the U.S. FDA. Instead of increasing blood flow in the penis, apomorphine acts on the brain to enhance erection. These drugs should not, however, be used by those who have had a heart problem during the past six months, or those with serious liver or kidney ailments, certain eye disorders, and extreme levels of blood pressure. In females, lack of libido, failure to become aroused, lack of orgasm or anorgasmy, and vaginismus are the common sexual dysfunctions. Although no medications have yet been approved specifically for the treatment of female sexual dysfunction, research is continuing on the subject, which includes looking into the possibility of the use of sildenafil in females. A pharmaceutical major is now about to get the go-ahead for a testosterone patch for the treatment of low libido in postmenopausal women. Falls in testosterone levels are believed to be responsible to a large extent for lack of libido in both men and women. The proposed transdermal testosterone patch, to be marketed under the name “Intrinsa,” is worn on the lower abdomen. Further research will determine who should or shouldn’t use the testosterone patch, and its possible side effects as well. vimax pill cheapest penis elargement pills penile enlargement fact natural pnis enlargement exercise cheap penis enargement free exercise tip for penis enlargement do penile enlargment pills really work penis enlarement technique penis enlagement exercise

Quick, answer a question: Why do people buy from you? Bzzzzz. Wrong, if you answered with, • “Uhhh . . .” • Any description of your product or service. You get an “Incomplete” if you answered, • “Because we have great service.” • “We have the best quality.” This might seem rather basic to some of you, but if you quit reading I promise you're cheating yourself. Unless you have an inside-and-out understanding of all the possible reasons people buy from you, you're likely inviting objections. That's because you're probably selling what you want to sell, or talking about what the company's marketing department tells you are “benefits.” People buy for their reasons, not yours. Your goal on calls is to learn, remind them of, and understand their reasons for being interested in you, and ultimately buying. An Example Let's look at an example. A copy machine salesperson calls a smaller company, hoping to sell a copier. He speaks with the Office Manager who typically makes decisions like this one. After asking a few basic qualifying questions he learns the office has four people in it, and they now have a big old monster of a copy machine that has been in the office for about eight years. Thinking he has a hot prospect, the rep launches into a pitch about the latest techno-copier that does everything but write the documents for you. He overwhelms the listener with a point-by-point description of each of the “benefits”-or what he thinks are benefits (they indeed are, to some people). The prospect says, “What we have is working just fine now.” He retorts with some rendition of the “feel-felt-found” technique and rams into a brick wall. He writes this one off, and moves to the next. Same pitch, same result. What Went Wrong? So is the rep not skilled at closing? How about overcoming objections? Neither. You could make a case for him not being a skilled questioner, but that might not be fair. The fact is, he doesn't have a clear understanding of why people buy from him-from their perspective, not his. You see, in this case, the Office Manager was a technophobe. She just traded in her IBM Selectric for a computer for gosh sakes! And, she is paying $300 per year, plus a per copy charge for a maintenance contract on her current dinosaur copier-about half of what a new, smaller, more reliable machine would cost to buy! And that's not all. The prospect was really quite interested in the fact that the machine the rep was pitching could do enlargement and reduction. Her's couldn't, and she had to personally go down to the Quick Copy to have them done, and it was a tremendous hassle. But, the rep had already mentioned so many other “benefits” that were actually perceived negatives to the prospect, that she didn't think it would be worth it to talk about that one feature. However, in isolation, it could have sold her. Even if you think you have a clue about why people buy from you, do the following exercise. And do it often, since situations change regularly. Here's an exercise we work on in training seminars. It lays the foundation for everything else we do. 1. Identify all the different levels and types of buyers and influencers for what you sell. Describe them by title and/or function. For example, depending on the organization, you might have an Advertising Director as the buyer. In smaller companies it could be an Office Manager, or maybe even the President. 2. Taking each of these types of people, identify how they're typically evaluated in their job. A Purchasing Manager is evaluated differently than a sales manager-the former on conservation, while the latter on production. Why should we think about this? We all have a desire to survive-at the very least-in our jobs, and most of us want to thrive. Knowing how someone is measured in their environment provides insight to what makes them tick. 3. Regarding your types of product/service, what do they want and need most? Be as specific as possible. Saying, “They want good quality,” doesn't cut it. If you can't see, feel, hear, touch, or taste it, how can you describe it? Good quality manifests itself in the form of “A machine that requires virtually no servicing other than routine maintenance.” 4. Conversely, what do they want to avoid? Again, be specific, descriptive. Don't say “poor service.” Better: “They hate having to wait three hours to get an answer to a basic technical question.” Answering these questions is just a start. After you've compiled your list, then you use the answers to create questions to determine if, indeed, these possible benefits truly are benefits.