DEAR DR. DONOHUE: Please give me information on the long-term complications for operations on an enlarged prostate gland using the PlasmaButton versus laser surgery. How do I find a urologist with the most experience and the best success rate in my area? — K.K.
ANSWER: It's hard to keep track of new techniques for treating enlarged prostate glands. A novel approach seems to debut at least yearly, or every other year.
A too-large prostate gland makes it impossible to completely empty the bladder. A man with such a gland has to use the bathroom often during the day and even more often during the night.
The PlasmaButton is a tiny instrument shaped like a button and fixed on the end of a probe that can be inserted through the penis to the area of the prostate gland. When it reaches that site, the doctor turns the gadget on, and it produces bursts of energy that vaporize much of the gland. It theoretically causes little bleeding. It's an outpatient procedure.
A similar kind of procedure is Photo-selective Vaporization with the GreenLight Laser. The technique is the same, but here a laser beam removes excess prostate tissue.
And don't forget the standard procedure, a TURP, transurethral resection of the prostate, the most long-lived of all the procedures and the one best suited for a very large gland. Here a scope and cutting instrument prune the overgrown gland.
Head-to-head comparisons between the procedures still haven't produced definitive evidence of which is best. Oral medicines also can treat an enlarged gland.
My suggestion is to speak with a local urologist, and ask the doctor which procedure he or she uses and how much experience he or she has in performing the technique, and which technique is best for your situation. Interview a couple of doctors if you're not satisfied with the first one.
DEAR DR. DONOHUE: From a diabetic standpoint, what is the difference between sugar and sugar alcohol? — L.S.
ANSWER: Sugar is sugar. But sugar alcohol is neither sugar nor alcohol. Whoever named it has produced universal confusion. Sugar alcohols (sorbitol, xylitol, lactitol, mannitol, erythritol and isomalt) are sweeteners with fewer calories than sugar. Manufacturers can label foods that contain these products as being sugar-free. Chewing gum, ice cream, cookies and candies are but a few of the products sweetened with sugar alcohol.
If a product has less than 5 grams of sugar alcohol, you can eat it without adding it to your daily carbohydrate tally. If it has more, then divide the sugar alcohol grams by two in computing your carbohydrate intake.
DEAR DR. DONOHUE: My 50ish girlfriend of four years left me to go back to an old boyfriend she had 15 years ago. This man is a womanizer. When they were together, he got another woman pregnant. Explain the consequences of unprotected sex with someone like this man. What's the most dangerous disease? — Anon.
ANSWER: AIDS is still the most dangerous sexually transmitted disease. Even though effective medicines suppress the rampant propagation of virus, and even though the life expectancy of a person with AIDS approaches normal, AIDS patients have to continue to take daily medicines.
A catalog of other sexually transmitted diseases includes syphilis, gonorrhea, herpes, genital warts, cervical cancer (papillomavirus), Chlamydia and trichomonas. Untreated syphilis can cause great damage to the brain, heart and bones.
A sexually promiscuous male can infect his partner with any or all of these. That goes for a sexually promiscuous female, too.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.