[HN Gopher] An end to all this prostate trouble?
___________________________________________________________________
An end to all this prostate trouble?
Author : bondarchuk
Score : 750 points
Date : 2025-04-26 08:39 UTC (1 days ago)
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| marvel_boy wrote:
| So there is a cure for BPH?
| cs02rm0 wrote:
| Sounds like it reoccurs, but potentially the procedure is
| repeatable. I didn't see a frequency.
|
| I wonder how many potential answers to such problems are out
| there, known to a few but not acted on by the masses.
| cactusplant7374 wrote:
| > In any case, the paper makes no comment as to whether the
| problem can be solved the same way a second time; obviously
| in principle it can, but finding all the new bypasses and
| sclerosing them might be difficult in practice.
|
| Multiple surgeries is not sustainable. Too much uncertainty.
| kevin_thibedeau wrote:
| > they then have the patient close off the bottom of the
| vein with finger pressure while they inject a sclerosing
| agent into the vein
|
| It seems highly failure prone. If you don't block the flow
| are you going to stroke out?
| Supermancho wrote:
| > Multiple surgeries is not sustainable. Too much
| uncertainty
|
| I'm not sure where this is coming from. Multiple cardiac
| bypasses have a ton of uncertainty, but they are effective
| because efficacy is measured by quality of life * increased
| lifespan.
|
| Multiple surgeries (the time it takes to regrow major veins
| from capillaries that aren't blocked off) to relatively
| non-lethal parts of the body seems very sustainable for a
| human lifespan after 60 or 55 or whatever.
| gavinray wrote:
| You can use 5-alpha-reductase inhibitors like finasteride.
|
| One of the primary causes of BPH is from androgens,
| specifically the conversion of testosterone ->
| dihydrotestoerone via the 5-ar enzyme.
|
| The prostate is an androgen-sensitive tissue, and DHT causes
| enlargement.
|
| It's not guaranteed to fix it, but it's one option.
| amelius wrote:
| I've heard a theory that baldness is related to tension in
| the scalp, which apparently is more prevalent in men.
| hamstergene wrote:
| I wish we all could agree on a terminology where taking a
| pill daily is management, not a cure.
|
| A cure should be a one-off measure after which one stays
| cured. If not forever then at least for years.
|
| Something that needs to be repeated, esp. daily, should have
| a different word. That's not a cure.
| ekianjo wrote:
| Not a cure but Tadalafil works very well as a treatment.
| fredsmith219 wrote:
| It does. I suffer for almost 20 hours of I miss a dose. I'm
| very sure that doesn't happen.
| smitty1e wrote:
| > It's odd for there to be such an easily-removable design flaw
| in the human body; evolution tends to remove them.
|
| I wouldn't say so at all. Poor eyesight carries on smartly.
| Baldness. I enjoy both.
|
| But an old story about the controller code for a surface-to-air
| missile comes to mind.
|
| Someone looking at the memory allocator spots an obvious resource
| leak: "This code is going to crash."
|
| The reply was that, while the point was theoretically valid, it
| was irrelevant, since the system itself would detonate long
| before resource exhaustion became an issue.
|
| So too prostate cancer back in the day: war, famine and plague
| were keeping the lifespan well below the threshold of every man's
| time bomb.
| forinti wrote:
| There's also your back, your joints, your teeth, GERD.
| Everything starts getting flimsy in your late forties.
| Traubenfuchs wrote:
| It would probably take too long, but a human breeding program
| centered around the healthiest still fertile old men we can
| find and young women with spotless genetic heritage would
| uplift our whole species.
| lostlogin wrote:
| Older fathers increase the chance of autism, schizophrenia
| et al.
|
| https://en.m.wikipedia.org/wiki/Paternal_age_effect
| meindnoch wrote:
| Obviously you would use sperm harvested while they were
| still young, and kept frozen for 60 years.
| MyPasswordSucks wrote:
| But then you wouldn't necessarily know that their current
| sperm is valuable.
|
| A better method would be to confine the program to
| monozygotic twin pairs of young women with spotless
| genetic heritage, and inseminate one twin with frozen
| sperm and the other with current sperm. The "current
| sperm" child (CS) could be closely monitored, and the
| "frozen sperm" (FS) child fitted with an explosive
| chastity device which, in the event that CS is found to
| have developmental issues, are remotely-detonated to
| ensure the tainted line does not persist.
|
| Simple-as.
| toast0 wrote:
| I think you missed the idea. Your explosive device could
| still come in handy though.
|
| But you freeze the sperm at the peak of freshness. Then
| you wait and see how the donor does. If they live to a
| ripe old age without old age diseases, then go select
| their sperm. Otherwise, destroy it.
|
| You can probably do this with eggs too. When a child is
| desired, select an egg and a sperm off the shelf, and
| there you go. Easy peasy. Your device ensures only
| munitions experts can procreate outside the system, and I
| think we'll need a lot of munitions experts in the
| ensuing generations.
| MyPasswordSucks wrote:
| I would think the end goal would be to remove the need
| for frozen sperm, which we can do once we verify that the
| 60+ year old donors are still producing healthy swimmers.
| No sense in going just halfway with the Brave New
| Worlding.
| genghisjahn wrote:
| Sounds like the end of Dr. Strangelove.
| subscribed wrote:
| Ms Atwood would like a word with you.
|
| Mr Trump has also expressed his interest, especially if the
| women are very young.
| Eliezer wrote:
| Poor eyesight is evolutionarily recent (not enough sunlight
| exposure in childhood, rare to find in hunter-gatherer
| societies). Baldness won't kill you.
| cogman10 wrote:
| > not enough sunlight exposure in childhood
|
| Do you have any source for this? As someone born in the
| summer to a farming family with poor eyesight, I find it hard
| to believe that happened because I wasn't exposed to enough
| sun as an infant or child.
|
| I've worn glasses since I was 2.
| Traubenfuchs wrote:
| https://pmc.ncbi.nlm.nih.gov/articles/PMC6678505/
| cogman10 wrote:
| Interesting study. Myopia can definitely be caused by
| focusing too much on nearby things.
|
| I just so happen to have Hyperopia with astigmatism,
| neither of which came from a lack of outdoor exposure.
| (If anything, I needed less time outside).
|
| That's a bit of the issue I have with such a broad
| generalization. It's true that for some, a lack of time
| outdoors damaged their eyesight, it's not universally
| true that all or perhaps even most poor eyesight is a
| result of staying indoors.
| wkat4242 wrote:
| Don't forget that hunter-gatherers rarely lived much beyond
| 30. Modern society isn't so bad :)
| abathur wrote:
| This is an incorrect generalization from average life
| expectancies that include incredibly high infant/childhood
| mortality.
|
| The life expectancy cited by Wikipedia for the paleolithic
| is around 39 _additional_ years for those surviving to 15.
|
| https://en.wikipedia.org/wiki/Life_expectancy
| MyPasswordSucks wrote:
| I'd be interested to see sources for the claim that poor
| eyesight is evolutionarily recent.
|
| I strongly suspect it's more a matter of "won't kill you".
| Nearsightedness is far more common than farsightedness, and
| it's only in the last two hundred or so years that there's
| been any major benefit in seeing fine details at distance.
| The fuzzy shapes afforded by 20/80 vision are plenty enough
| to hunt a mammoth.
|
| Having 20-20 vision is _nice_ for avoiding lions and tigers,
| but it 's a luxury spec, because movement acuity doesn't
| decrease linearly with nearsightedness, and movement acuity
| (plus traveling in groups, as prehistoric humans were wont to
| do) can take care of business decently-enough on its own - so
| I wouldn't call it "evolutionary-pressure"-nice.
| rurban wrote:
| Samson and Delilah would like to have a word with you. Also
| with Japanese Samurai. You loose your mythological power,
| leading to lost status, suicide, ...
| gavinray wrote:
| > It's odd for there to be such an easily-removable design flaw
| in the human body; evolution tends to remove them.
|
| Your appendix and gallbladder would like a word with you ;^)
| lostlogin wrote:
| Wisdom teeth too.
| tazjin wrote:
| And tonsils!
| gavinray wrote:
| Speaking of, I had my tonsils and adenoids removed as a
| child due to chronic ear infections.
|
| What's up with those things?!
| davidmurdoch wrote:
| I once read that wisdom teeth don't fit anymore only
| because we use forks and knives now. Previously we would
| tear our food with our teeth, always widening our pallet.
|
| I couldn't find the source just now (in the 30 seconds I
| searched for it), but I always thought it was an
| interesting idea.
| Qem wrote:
| Also the intakes for trachea and esophagus being close to
| each other, causing chokes.
| subscribed wrote:
| Both appendix and gallbladder are important. Check the diet
| for people with gallbladder resection.
| Supermancho wrote:
| I don't have a gallbladder. My diet is that I eat less
| fried foods and avoid certain dark syrups.
|
| The gallbladder is not important for humans in the
| aggregate. The aorta, yes.
| cogman10 wrote:
| Evolution selects for one thing and one thing only,
| reproduction.
|
| The answer to every "why hasn't evolution done x" question is
| selection pressure.
|
| An enlarged prostate is something that people get in their 60s
| and later. Most people are done with reproduction long before
| that event. There is simply very little and very low selection
| pressure.
|
| It's pretty much the reason why most humans have peak health
| into their 40s.
|
| Don't expect evolution to "fix" anything for humans that
| doesn't commonly impact 20yos.
| freddie_mercury wrote:
| Weird that you pull the one quote but ignore the rest of that
| paragraph which is about how being the leading cause of
| infertility is exactly the kind of thing evolution normally
| fixes.
|
| "It's odd for there to be such an easily-removable design flaw
| in the human body; evolution tends to remove them. Since it
| strikes at advanced ages, BPH doesn't make a big impact on a
| man's ability to pass on his genes. But being the leading cause
| of male infertility sure does. Their explanation is that
| evolution hasn't had much time to work on the problem; in
| animals the spermatic vein is horizontal, and doesn't have or
| need one-way valves. It's our standing upright that yields the
| problem; in evolutionary terms that's a recent development."
| smitty1e wrote:
| Not only is it recent in terms of human history; back to my
| point, it is only in the last few centuries that men in
| gneral have reached ages that expose the posture shift as a
| flaw.
| jansan wrote:
| > I wouldn't say so at all. Poor eyesight carries on smartly.
| Baldness. I enjoy both.
|
| What is the problem with baldness other than having a cheap
| excuse for not being successful in life? I actually enjoy
| looking a bit like Larry Fink.
| AuryGlenz wrote:
| Most people find it less attractive. Usually things that
| happen when you age are viewed that way, which makes sense,
| evolutionarily.
| bladley wrote:
| For me it was mostly just a major psychological stressor
| because it happened at a young age. I felt like an old man
| at 20 years old.
| meindnoch wrote:
| Baldness and grey hair are indicators of male maturity. In many
| primate species elder males look different than younger ones,
| which guides their social dynamics. Similar reason why our kids
| stay small for their first 12 years or so - it's hard to teach
| someone who can physically overpower you.
| ownlife wrote:
| https://www.jstor.org/stable/2408423
| jasonthorsness wrote:
| > surface-to-air missile The one link I have at hand:
| https://devblogs.microsoft.com/oldnewthing/20180228-00/?p=98...
| blainm wrote:
| Issues like these reflects an evolutionary blind spot: selective
| pressure drops off after reproductive age, allowing defects like
| prostate dysfunction to persist. It's the same reason late-onset
| neurological diseases remain prevalent.
| mattigames wrote:
| We lucked out compared to other species, octopus develop
| dementia soon after breeding.
| amelius wrote:
| Yes, and there are spiders where the female eats the male
| after breeding. I bet their pr0n movies are a bit more
| interesting than ours.
| 7thaccount wrote:
| Isn't that usually only in captivity where it can't escape?
| card_zero wrote:
| Hmm. If we engineer late-life reproduction, that might create
| evolutionary pressure for healthy old age.
|
| _Hides long list of ethical problems with the concept_
| throwuxiytayq wrote:
| The main problem is that evolution is just not a thing at our
| modern civilizational time scale.
|
| And I don't see any problems with late-life reproduction,
| assuming we can make it reliable and healthy. If anything,
| some countries desperately need it.
| literalAardvark wrote:
| From my reading this is wrong in principle.
|
| Evolution is really slow on average, but locally it moves
| quite quickly and probably explains the large variation
| between members of a species.
|
| Add strong selective pressure to that high local speed and
| you can change a good part of the genotype within a couple
| of generations. See: animal husbandry. You can breed a new
| race of dog within 5-10 generations.
|
| Ethics aside we could probably breed people who can sniff
| out Alzheimer's in less than 250 years.
|
| Our current late reproduction style will very likely
| influence future generations health at older ages.
| giantg2 wrote:
| It's probably a wash. Sure people are reproducing later,
| but it's also more likely that they have recieved some
| major medical intervention to allow them to make it to
| that stage. For example, it could be stuff like freezing
| eggs before starting chemo.
| tomrod wrote:
| That in of itself is an external selection pressure
| though, having enough fit to gather resources to delay
| reproduction.
| throwuxiytayq wrote:
| > in less than 250 years
|
| I don't dispute any of your points in general. But at the
| same time, it brings a nostalgic smile to my face to
| envision starting a 250-year project in 2025.
| tomrod wrote:
| Someone needs to remain alive to provide, protect and raise
| the kids.
| inglor_cz wrote:
| Evolution is still a thing at relatively short time
| periods.
|
| Icelanders are a well-studied population when it comes to
| genetics. Frequency of some traits meaningfully changed
| among them in last 100 years.
|
| Source: this book: https://www.amazon.de/dp/0198821263?ref_
| =pe_109184651_110380...
| genewitch wrote:
| Also the moths that "changed" from white to black during
| and because of the industrial revolution. That was quick,
| and to me, the best example of how it all works.
| Workaccount2 wrote:
| We just have to get the media to portray geriatric men as
| sexy, and we'll be well on our way to living to 200!
| the_af wrote:
| I know you're joking, but it's women that get the short end
| of the stick in media.
|
| Men are (within reason) considered handsome in media even
| in old age. Wrinkles and gray hair can be seen as sexy
| (again, within reason), but only in men.
|
| Women are discarded or relegated to sexless granny roles
| (except maybe for comedic purposes, where sexuality is the
| butt of a joke). Actresses are replaced by younger women
| because they are not sexy enough even when their male
| equivalents aren't (looking at you, Top Gun: Maverick).
|
| I'm not saying there aren't exceptions in particular movies
| that deal with this topic; I'm talking about the general
| trend.
| Spooky23 wrote:
| When you ask men who they are attracted to, at least on
| the surface, it's always young women. I'm pretty sure the
| OkCupid stats showed that girls age 20 give or take were
| peak attractiveness. Reality is of course that guys will
| "work for food" or attention.
|
| Women are different. It ranges -- alot, and is more about
| EQ and scarcity. If you have a moderate baseline level of
| physical attractiveness, moderately fit (Jon two miles
| let's say), not an asshole, and not living with mom, a
| 40-60 year old guy is a hot commodity.
| fc417fc802 wrote:
| This all makes perfect sense from a fertility (and thus
| natural selection) perspective.
| the_af wrote:
| Agreed, but once you reach 60 (like Cruise and McGillis)
| you're well beyond the forces of natural selection and
| into the unnatural realm that our longer lives have
| granted us. Both of these actors are outcompeted in real
| life by younger people (sex/reproduction wise) yet one of
| them is still able to secure billing in "sexy roles" and
| the other isn't... and this is just _one_ example.
|
| This could be natural selection acting _against_ us, but
| since modern society is artificial anyway, why not make
| an effort to combat it?
| fc417fc802 wrote:
| > you're well beyond the forces of natural selection
|
| Are you? By all appearances this is a direct result of
| it. Visual indicators of age haven't been selected
| against in and of themselves as strongly with regards to
| men but a great many related things have been.
|
| Arguably your specific example might constitute an edge
| case that historically didn't occur with enough frequency
| to be selected against. Seems like little more than a
| curiosity to me.
|
| > why not make an effort to combat it?
|
| I don't follow. What are you arguing for here?
| the_af wrote:
| > _Are you? By all appearances this is a direct result of
| it._
|
| This is a result of it when it no longer matters, in
| adults who no longer matter for breeding purposes. When
| natural selection acts on humans of age 60+, it's mostly
| irrelevant. There's nothing to select, they've already
| done their part. It's just that natural selection is
| blind and doesn't "know" when to stop -- but we humans
| know better (this is what I meant later by
| combat/countering it).
|
| > _Arguably your specific example might constitute an
| edge case that historically didn 't occur with enough
| frequency to be selected against. Seems like little more
| than a curiosity to me._
|
| Why would it be selected against? All else being equal,
| natural selection wouldn't exert any particular pressure
| on old people after they've passed their genes. It's
| "blind" to them. It certainly doesn't know anything about
| being media star material! ;)
|
| But it's not an "edge case" for modern humans, especially
| as we live longer and keep working well into our later
| years. Modern society doesn't always resemble what the
| forces of natural selection act upon anyway.
|
| > _What are you arguing for here?_
|
| The same as the thread starter, only with a focus on
| women since they get the short end of the stick in this
| aspect (in media).
| hattmall wrote:
| Except this seems like a direct result of natural
| selection, because older men can still pass on their
| genes. Older women can not as readily pass them on.
| the_af wrote:
| Well, like I said, this is a result of it when it no
| longer matters. For reference, we're talking about 60+
| year old men.
|
| And, like I also said, modern humans and our society
| don't reflect natural selection anyway; many things we do
| are "unnatural".
| fc417fc802 wrote:
| > modern humans and our society don't reflect natural
| selection anyway; many things we do are "unnatural".
|
| That's simply not true. Don't get hung up on the word
| "natural". It's nothing more than the result of a biased
| random walk (at least until the eugenicists get involved,
| at which point it goes meta).
|
| Some of the things selected for can get pretty abstract.
| Cooperative behavior for example. Despite often being to
| the short term detriment of the individual it is observed
| in the wild.
| the_af wrote:
| I don't think it's false. The forces at play in modern
| society are no longer (alone) those of natural selection.
| This has been remarked on by people like Stephen Jay
| Gould. Society/culture evolves along different (faster)
| lines. We do a lot that makes no sense from the
| perspective of natural selection.
| fc417fc802 wrote:
| Yes, that was exactly my point. The edge case is the
| potential for the selected behavior to work against
| reproductive fitness - someone young finding someone old
| attractive even though they aren't likely to get good
| offspring out of it.
|
| I'm still not clear what you're arguing for. It isn't
| media giving women the short end of the stick, it's
| biology. What exactly are you proposing be done about it?
| I'm not even clear why it's a problem aside from the
| general desire that scientific advancement should
| eventually cure us of age related phenomena entirely.
| the_af wrote:
| Well, it's a problem for actresses for example.
| ccakes wrote:
| If you've never stumbled across the older OkCupid blog
| posts or Christian Rudder's book (Dataclysm[1]) then I
| can't recommend them enough. Super interesting content
| delivered by a smart and engaging writer
|
| [1]
| https://www.goodreads.com/book/show/21480734-dataclysm
| astura wrote:
| Exactly - there's no female equivalent of "silver fox."
| rpmisms wrote:
| Uh, yes there is. Pretty sure there's even an acronym for
| it.
| notesinthefield wrote:
| The kids call them cougars or MILF's
| the_af wrote:
| Even they have an earlier "expiration" date than men in
| cinema and TV. Women are considered sexy for a far
| shorter period of time.
| bear141 wrote:
| With this specific example, if McGillis had spent as much
| time and money and effort on appearing young and
| attractive as Tom Cruise has, maybe she would have been
| back in her role as well.
| the_af wrote:
| Oh, agreed! But it seems that men can remain "viable love
| interests" as long as they keep their rugged good looks
| (yes, with cosmetic help, of course), but in women this
| takes a stronger requirement of looking youthful.
| brigandish wrote:
| There would appear to be two poles of explanation - that
| either the media is reflecting desires and not
| influencing it, or that the media is influencing desires
| and not reflecting them - or somewhere in-between.
|
| The reflection of biological reality appears easier to
| justify: that men remain fertile for longer, that the
| attractive qualities that women care about most (e.g.
| wealth and personality) tend to improve with age; and
| that a women's attractiveness is most tied to her skin,
| which we all know shows aging the most on the body, and
| is a sign of her reproductive health or ability.
|
| I'm not sure what the argument for the media being able
| to influence males to the extent suggested would be?
| Older men were marrying younger women before the printing
| press, so where did this pressure originate? And what is
| its mechanism of action?
| the_af wrote:
| I'm not saying media is influencing this; this preference
| clearly showed before media! The media here clearly
| reflects a preexisting preference, but in my opinion, it
| also makes the world worse for old people, especially
| women and actresses.
|
| I'm saying media could be changed from this tendency,
| since this preference is less relevant in modern society
| and it hurts actresses. Media is a human construct that
| can be adapted to new needs, it's not a tool of natural
| selection!
|
| Changing media wouldn't change the sexual preferences of
| men, and nowhere am I arguing this. It's like inclusivity
| in media -- is it ever going to eradicate racism? No, but
| it will make the world a tiny bit fairer.
| FilosofumRex wrote:
| Men season, while women age - The media's portrayal of
| desirability of old people is a reflection of societal
| preferences, not the other way around.
|
| Men become wiser, skilled, kinder, more patient and often
| better providers. Women tend to become argumentative,
| quarrelsome, bitter (especially those who date often) and
| rewarded for it. They also tend to dissociate love from
| sex and manipulate one for the other.
| the_af wrote:
| I hope your second paragraph is not what you truly
| believe, but that you're describing a regrettable
| stereotype.
| halgir wrote:
| We missed the boat for that a few million years ago. If we're
| engineering anyway, we might as well engineer for healthy old
| age directly.
| the__alchemist wrote:
| Dawkins suggested this might be viable (In an abstract; not
| politically practical) way in _The Selfish Gene_.
| wkat4242 wrote:
| With our modern health systems we are pretty much a huge
| evolutionary blind spot ourselves. Many illnesses that would
| be filtered out because the carrier wouldn't survive, are now
| trivial. And on the journey hand we can screen for known
| illnesses.
|
| I think we are already post evolutionary, or control it
| ourselves. Not a big issue either IMO, it's totally ok that
| this is happening.
| derektank wrote:
| We are definitely not post-evolutionary; the selection
| pressures have simply changed. Before industrialization the
| big two were starvation and infectious disease. Now? Well,
| it's anybody's guess decade to decade. Certainly sexual
| selection is still with us.
| pavel_lishin wrote:
| I read a pretty entertaining novel where that was one of the
| sub-plots.
|
| The ethical problems were fun to read about! But would be
| significantly less fun to live through.
| justinclift wrote:
| Name of the novel?
| pavel_lishin wrote:
| It was one of Stephen Baxter's Xeelee series, I believe
| it was Ring.
| Qem wrote:
| We engineered it culturally already. Lots of people delaying
| childbirth until late 30s, early 40s today, often resorting
| to expensive treatments.
| magicalhippo wrote:
| If we're ignoring ethics, then we don't need late-life
| reproduction.
|
| Just kill all offspring if one of the parents die of some
| unwanted cause.
|
| Allows people to still get kids in the optimal age, yet
| applying old-age selection pressure.
| nonethewiser wrote:
| So widen the reproductive age (men only)
| hhh wrote:
| Why men only?
| ix101 wrote:
| I think OP was alluding to the fact that risks of
| complications with pregnancy increases with age.
| hhh wrote:
| wouldn't the intention be just to fix that as well
| nonethewiser wrote:
| How do you "fix" menopause?
| nonethewiser wrote:
| Not exactly that. Menopause.
| nonethewiser wrote:
| Because you can't for women.
| yapyap wrote:
| what? so are you implying that prostate dysfunction makes you
| less wanted as a father if it presents itself in "the
| reproductive age"?
| rubyfan wrote:
| I read the comment as insinuating people stop taking care of
| themselves as much after children and develop unhealthy
| habits.
| trollied wrote:
| No. The grandparent comment was essentially saying that we,
| as a species, were not designed to live as long as we do.
| It's only been <10 generations since medicine has been a
| thing. Cancers, dementia etc just weren't a thing before
| because we evolved to live long enough to bring our
| children up to be self sufficient and reproduce, then our
| job is done. Like the rest of the animal world do.
|
| Modern medicine has messed with this. We weren't meant to
| "old".
| jbd0 wrote:
| Shouldn't kids with grandfathers have an evolutionary
| advantage?
| natebc wrote:
| when humans were still primarily subjected to natural
| selection the life expectancy likely wouldn't have allowed
| for many grandfathers.
| Sharlin wrote:
| You only have to live to your 40s to become a grandparent
| in natural conditions, and your chances of living to _at
| least_ your 50s have always been pretty good _conditional
| on_ living long enough to reproduce at all.
| nkrisc wrote:
| Your 40s? A man could pretty easily be a grandfather at
| 26-28, possibly less.
|
| Perhaps less common but 30s would probably be more
| likely.
| readthenotes1 wrote:
| Iirc, historically, if you made it to 10 years of age, most
| humans make it to 60
| inglor_cz wrote:
| Medieval burial grounds, when examined by
| anthropologists, do contain some people over 60, but the
| majority of adults buried there died earlier, typically
| in the 45-55 bracket.
|
| It wasn't just disease, but also wars and famines. And in
| women, deaths during childbirth, which cluster in the
| 20-35 bracket.
|
| Cardinals of the Church, who led peaceful lives, didn't
| give birth and never went hungry, lived into their late
| 60s and early 70s even during the Middle Ages. But an
| average peasant wouldn't.
| bmicraft wrote:
| They didn't say drops to zero, but the advantage is obviously
| more limited
| georgeburdell wrote:
| If it wasn't in the past, I imagine it will be in the future
| with how common two working parents is now. We want more kids
| but we are getting zero grandparent help
| mensetmanusman wrote:
| Two working parents have far below replacement numbers of
| children, so it would actually cause it to disappear...
| const_cast wrote:
| Probably barely, and I think in some instances the opposite.
| You have to care for the elderly.
| Izikiel43 wrote:
| The problem there is with your definition of grandfather.
| Currently, the age for a grandfather in developed countries
| is 55+. For most of humanity's history, if there were
| grandfathers, they would barely make it to 55 years of age.
| saagarjha wrote:
| No, plenty of people made it to that age in the past. Life
| expectancy was significantly depressed by infant mortality.
| Izikiel43 wrote:
| > in the past
|
| What's "in the past" here? Last 200 years? 500? 1000? In
| evolutionary scale, those numbers are a blip.
| me_again wrote:
| The grandmother hypothesis
| https://en.wikipedia.org/wiki/Grandmother_hypothesis is
| reasonably well-established. The corresponding 'grandfather
| effect' has not really been demonstrated, as far as I know. h
| ttps://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2007..
| .
| lukas099 wrote:
| But the issue also causes male infertility, so that can't be
| why it's so prevalent. This is discussed in the article.
| wazoox wrote:
| Male infertility after 60 is probably not very impactful from
| a selective point of view. For 300 000 years, almost nobody
| reached 60 anyway.
| Qem wrote:
| Before. Now people are delaying childbearing. Anedacta,
| past year one of my work colleagues had its first child, at
| 62.
| PKop wrote:
| And delaying childbearing decreases fertility probably
| more than anything.
| MyPasswordSucks wrote:
| The article sort of mentions this in passing, but doesn't
| subject it to much rigor, and the (completely obvious?)
| counterargument is that by the time it causes male
| infertility, the affected have already reproduced.
| Traubenfuchs wrote:
| We already have one solution to the problem.
|
| Finasteride or dutasteride. They control BPH perfectly, while
| also treating male pattern baldness. Combine with daily tadalafil
| to offset any chance of the dubious sexual side effects, while
| also reducing gynecomastia (it's also an aromatase inhibitor!).
| Make sure to have regular 5ari-aware PSA screenings to make sure
| high grade cancers are caught and you are golden.
|
| fin/dut + tad are my favorite medications to keep men fresh for
| many more years than intended by nature.
|
| Have your children before you start though, as dut will probably
| make you sterile eventually.
| formerly_proven wrote:
| Giving 90% of the gender that looks actually great with hair on
| their head MPB is easily one of the biggest sleights evolution
| has committed against our species.
|
| I've personally had very little luck with official channels
| there. Most won't prescribe anything for hair loss, several
| dermatologists said to just get used to it, one would prescribe
| fin pills, i.e. systemic - which did eventually give me pain in
| the breast tissues (so I ceased using it), but not topical,
| citing that it's too new on the market. I was unable to find
| anyone who would or even could look at serum DHT. I eventually
| settled on just paying one of these apparently legal
| telemedicine vendors 20 bucks per topical fin prescription.
| Traubenfuchs wrote:
| > which did eventually give me pain in the breast tissues (so
| I ceased using it)
|
| You already decided to take one hormonal disruptor, so why
| not go all the way? Find a private andrologist that
| prescribes you fin/dut + an aromatase inhibitor. Daily
| tadalafil also acts as aromatase inhibitor by the way. Should
| be enough to offset the estrogen increase from finasteride.
| It's worth a try.
|
| I personally don't really believe in topical min/fin/dut: You
| are probably just getting the same effects and side effects
| you'd get from a lower oral dose.
|
| The studies on topical finasteride support this. You just
| believe it's not in your blood and thus there is no nocebo
| effect to give you ED but it very much is.
| seethedeaduu wrote:
| Serum DHT is not useful at all.
| qmr wrote:
| Just buy a razor.
|
| Let go.
| formerly_proven wrote:
| Telling people to sui is not very nice. (/s)
| manmal wrote:
| I've been holding off on fin because of some people developing
| post-fin syndrome. Is Tad addressing this hazard in your view?
| Traubenfuchs wrote:
| In a framework where one believes PFS to exist (I strongly
| believe it doesn't), tad would, at best, treat a few of the
| symptoms of PFS.
|
| I believe people with self diagnosed PFS have a mix of mental
| illness and (sometimes) non diagnosed physical illness.
|
| I'd like to see a self diagnosed PFS sufferer not get an
| erection, pumped up on 150 mg sildenafil + 10g L-Citrullin.
|
| > Is Tad addressing this hazard in your view?
|
| Let me address your question from a different angle: Being on
| an sufficient amount of daily tadalafil would certainly
| reduce the chance of you believing you got PFS, because it
| would guarantee you a working erection in any situation.
| manmal wrote:
| Thanks for sharing your view. I think the possibility of
| something like PFS existing is real, simply because 5ARIs
| have widespread physical effects - I mean they regrow hair
| and reduce sperm motility. Why would the brain or nervous
| system be excluded from being affected? Eg one male
| hormonal contraceptive pill study was aborted in 2016
| because one participant got suicidal.
| bladley wrote:
| Hi - there is no official diagnosis for "PFS". I have it in
| the sense that I have penile tissue scarring confirmed by
| medical imaging, with a urologist's opinion that
| finasteride was the likely cause. Yes, tadalafil does often
| help in my case, but the reduction in function is permanent
| and I doubt I will ever be my pre-finasteride self again.
| ta12653421 wrote:
| daily Taladafil in combination with daily Finasterid?
|
| Good luck :)
|
| I do not know about Finasterid in detail, but the small-
| printing for Taladafil says clearly its _not_ for daily use.
| Traubenfuchs wrote:
| Daily use of cyalis (tadalafil) is officially marketed.
|
| https://www.hims.com/blog/daily-cialis-costs-benefits
|
| https://investor.lilly.com/news-releases/news-release-
| detail...
|
| It's superior to taking it on an as-needed basis because it
| has positive long term effects on your cardiovascular and
| penile tissue.
| ta12653421 wrote:
| I'm in the EU; i tried this casually several times already
| - the Doc always says, do not throw them daily?
|
| Apart from that: I do not expect the skeletal pain after D2
| to be less when dropping it daily? :-D
|
| EDIT: Or i'm mixing up Sindenafil and Taladafil? Im not a
| medic :-D
| asdiovjdfi wrote:
| Yes, you must be confusing Sildenafil and Tadalafil. I'm
| also in the EU and Tadalafil is prescribed for daily use
| here.
| elric wrote:
| Two lifelong medications + frequent screening does not sound
| like "a solution" to me.
|
| That being said, the article does state that its proposed
| treatment doesn't last forever, though I couldn't find any
| numbers on how long it is expected to last.
| teknico wrote:
| I've been prescribed, and taking for a while now, daily
| Dutasteride plus Silodosin (Urorec). However, the latter has
| the unpleasant side effect of suppressing ejaculation.
|
| Tadalafil (Cialis) does not seem to do the same, however other
| potential side effects involving sight and hearing are listed.
|
| I'll ask my doctor if such a swap would be advisable.
| elric wrote:
| > Screening for this disorder is simple: use a thermal camera and
| compare testicular temperature sitting up (or standing) versus
| lying down, in each case waiting five minutes or so for
| temperatures to equilibrate, and taping the penis up so that it
| does not affect the measurement.
|
| Interesting. I wonder how many how many other issues we could
| screen for using such simple, low cost tools. Some scales can
| already detect reduced blood flow in the feet (which can be a
| sign of all sorts of nastiness).
| eternauta3k wrote:
| Stethoscopes are pretty cheap and versatile. Human doctors in
| general have lots of senses which they (in some medical
| systems) use for diagnosis before reaching for lab tests and
| MRTs.
| bshacklett wrote:
| If they bother. The vast majority of appointments I've had,
| in recent memory, are the provider typing a bit on their
| laptop, then sending me to someone else.
| rendaw wrote:
| Really? They just tell me it's stress, the prescribe me
| chinese medicine just in case and send me away.
| samssf wrote:
| Damn, they just tell me I'm getting old and wish me luck.
| malfist wrote:
| If you don't like your doctor, go to someone else
| BobbyTables2 wrote:
| Indeed but a tiring and expensive game when it takes 4-5
| tries with experienced specialists to get an actual
| diagnosis.
| roenxi wrote:
| One of the more exciting AI use-cases is that it should
| be about competent to handle the conversational parts of
| diagnosis; it should have read all the studies and so
| it'll be possible to spend an hour at home talking to an
| AI and then turn up at the doctor with a checklist of
| diagnostic work you want them to try.
|
| A shorter amount of expensive time with a consultant is
| more powerful if there is a solid reference to play with
| for longer before hand.
| fwip wrote:
| AI has a long way to go before it can serve as a
| trustworthy middleman between research papers and
| patients.
|
| For instance, even WebMD might waste more time in
| doctor's offices than it saves, and that's a true,
| hallucination-free source, written specifically to
| provide lay-people with understandable information.
| istjohn wrote:
| This study found that an LLM outperformed doctors "on a
| standardized rubric of diagnostic performance based on
| differential diagnosis accuracy, appropriateness of
| supporting and opposing factors, and next diagnostic
| evaluation steps, validated and graded via blinded expert
| consensus."
|
| https://jamanetwork.com/journals/jamanetworkopen/fullarti
| cle...
| pingou wrote:
| This study is about doctors using an LLM and it doesn't
| seem like it made them significantly more accurate than
| doctors not using LLM.
| roenxi wrote:
| If you look in the discussion section you'll find that
| wasn't exactly what the study ended up with. I'm looking
| at the paragraph starting:
|
| > An unexpected secondary result was that the LLM alone
| performed significantly better than both groups of
| humans, similar to a recent study with different LLM
| technology.
|
| They suspected that the clinicians were not prompting it
| right since the LLM without humans was observed to be
| outperforming the LLM with skilled operators.
| joshlemer wrote:
| In some countries like Canada you basically don't have an
| option.
| BobbyTables2 wrote:
| My primary care doctor doesn't even have an otoscope!
|
| Have no idea how they have such good reviews.
| tuatoru wrote:
| Stethoscopes are an example where tech can help and is
| helping. Some sounds (a slightly leaky heart valve, say) are
| subtle and easily missed, especially if there is traffic
| outside the doctor's surgery or other noise. Even with good
| earpieces.
|
| A stethoscope with microphone, analog-to-digital conversion,
| and digital signal processing can separate out heart sounds
| from lung sounds and amplify each separately, and AI analysis
| can learn to identify early stage problems that doctors can't
| yet hear.
|
| Of course the downside of that may be a loss of skill, as we
| see happening with ECGs. The ECG analysis algorithms are so
| good now that lots of doctors don't even bother with anything
| more than a glance at the waveform, they just look at the
| text the algo provides. Understandable, when you're near the
| end of a 12-hour shift.
|
| But potentially, AI based home diagnostic kits with these
| sorts of devices could save doctors' time.
| quantumwoke wrote:
| Women menstrual cycle tracking works off the same concept.
| raffael_de wrote:
| The text brushes over the importance of healthy muscle motion for
| venous blood flow against gravity. Staying physically active,
| including pelvic floor exercises into the routine and correct
| belly breathing utilizing the diaphragm are probably the best
| options for preventing issues with reduced venous blood flow from
| the testicles passing by the prostate back to the heart.
| mr90210 wrote:
| Thank you.
| wafflemaker wrote:
| Please also mention how easy those exercises are:
|
| Once per day, when peeing, do it differently. 1. Release the
| stream during the in-breath. 2. Stop and hold the stream on the
| outbreath. 3. If not yet bored or tired go back to 1. Else -
| finish peeing normally. That's it.
|
| And note that for most people, a week to few weeks of the
| exercise give stronger orgasms and ability to delay the
| ejaculation.
| anticodon wrote:
| > And note that for most people, a week to few weeks of the
| exercise give stronger orgasms and ability to delay the
| ejaculation.
|
| I've experienced all those benefits when I started walking
| two times a day, 8-10 thousands of steps a day continuously
| for several weeks. I haven't performed any other exercises.
|
| But it's really boring and you need to do it every day. I do
| it only because I need to walk a dog.
| beacon294 wrote:
| Walking is considered by einstein and pretty much all
| thinkers to be critical to deep work. It's also covered in
| Cal Newport's book "deep work" briefly. Which is a short
| audiobook worth reading.
|
| One such prescription would be to do deep work early in the
| day then walk after and walk again 2 hours before bed.
| Another would be split the deep work with a 1 hour walk and
| do the 2nd walk after the 2nd block.
|
| It may be more fulfilling with lots of interesting ideas
| rattling around. YMMV
| spookybones wrote:
| I desperately want to do this type of walking, but I live
| in a major city. There's always something to distract me,
| which is great for boredom perhaps, but ruins any sense
| of zen or reflection. I would say half of every walk
| involves people yelling, loud vehicles, and louder music.
| Noise-cancelling headphones are only useful for
| distraction through podcasts and music, not for
| decompressing. I'm starting to wonder if the solution,
| the sad solution, is to walk on a treadmill at a gym
| during off-peak hours.
| dayjah wrote:
| Have you considered earplugs? The firearms community have
| some pretty great ones which are readable and fit really
| well. Check out Axil x30i for example.
| pegasus wrote:
| You could try white/pink/grey noise on the headphones, or
| a binaural beat generator (I use the brainwave app on
| iOS).
| ajb wrote:
| I find thunderstorm noises superior to white/coloured
| noise - because it's a natural sound the brain filters it
| out, and obtrustive noises are camouflaged within it, and
| filtered out too. So the loudness required is less than
| the loudness needed for white/coloured noise to be
| effective.
| PKop wrote:
| All truly great thoughts are conceived by walking.
|
| -Friedrich Nietzsche
| Taek wrote:
| I don't find walking to be boring at all! Especially when
| I'm working on something new, I will walk as many as 10
| miles a day while thinking through all of the design
| corners.
|
| Even when I'm not working, I like taking long walks to
| think about family, friends, video games, etc.
|
| Its a great way to get into your head without the
| distraction of a phone or feed or forced message.
| haswell wrote:
| Two ways I've made walks less boring:
|
| - I started carrying a camera
|
| - I started using the Merlin Bird ID app
|
| Photography has made me realize how much I was previously
| ignoring. There's so much to see, and even when walking the
| same route over and over, there's an astounding amount of
| change over time. Often little things.
|
| The Bird ID app made me realize just how many unique birds
| were making up the sounds I was hearing. As I learned to
| distinguish between them, I found myself fascinated in a
| way that I'd never been before.
|
| Walks became almost meditative over time, and the sights
| and sounds a kind of salve for my often tired brain.
|
| I often feel like I can think more clearly when walking as
| well, and thought processes kind of just sort themselves
| out as I go.
|
| I highly recommend making walks more than just a way to
| move your body. They can be much more, and getting the
| benefits of movement almost feels like a happy side effect.
| IanOzsvald wrote:
| +1 Merlin. I also stop and do a few minutes with Duolingo
| in the park, then take a breath and just listen to the
| wind and birdsong.
| nkrisc wrote:
| I also recommend the Seek app by iNaturalist. Though if
| you're like me and use it to identify plants and every
| bug you see, you may not actually get that much walking
| accomplished.
| mikestew wrote:
| My wife and I have a running joke about the Seek app:
| "Dicots. It's always dicots."
|
| _Too often, pointing Seek at a plant results in
| "dicots", which is about half the flowering plants out
| there._
| ajkjk wrote:
| I feel like seek's IDs are not as good as they should be
| given the state of ML. Maybe a dataset problem but still.
| nkrisc wrote:
| Season likely plays a factor too. There are many plants
| that more or less look identical (to the untrained eye)
| until they either bloom or grow large enough.
| ajkjk wrote:
| true. it is also pretty bad at IDing things that are
| half-formed, eg a bud that hasn't bloomed yet, presumably
| because most photos in the dataset are of the blooming
| version.
| gedy wrote:
| Taking long walks daily was great but damn if it didn't
| increase my appetite. I gained weight over a couple years
| in spite of 4+ miles a day.
| tonyedgecombe wrote:
| Were you walking to the cake shop and back?
| gedy wrote:
| Haha no unfortunately
| YZF wrote:
| That's pretty much textbook why exercise on its own will
| not reduce weight. You need to control your intake as
| well.
| the_af wrote:
| I find walking very enjoyable.
|
| I do a lot of daydreaming when I walk, too (to my wife and
| daughter's impatience!).
| astura wrote:
| Podcasts help me with the boringness.
| Johnny555 wrote:
| >But it's really boring and you need to do it every day. I
| do it only because I need to walk a dog.
|
| I'm lucky enough to have a pedestrian path to do my long
| walks (so no cars or even bikes to contend with, bikes have
| a dedicated parallel path), so I listen to a podcast while
| walking around 1 hour/day.
| barrenko wrote:
| This is anecdotal as it gets, but I've developed prostate
| issues almost simultaneously with quitting photography.
| Didn't think about it until now.
| mgfist wrote:
| I often listen to podcasts while walking. Or I think. I
| also own a walking pad and walk while working (1h in the
| morning, 1h in the afternoon - not every day but most).
| hombre_fatal wrote:
| You must have been in really bad shape before if you're
| getting such noticeable health benefits from a rather
| modest exercise intervention like 8k steps.
| inglor_cz wrote:
| My average over the last year is ~13K steps a day. But I am
| usually not bored when walking, I enjoy it, in fact. So it
| is not a burden.
| alabastervlog wrote:
| Huh. So that "happiness through clenching your butthole
| daily" or whatever-it-was copy-paste troll that was so common
| on Slashdot back in the day, was... very close to being
| excellent advice?
| Spooky23 wrote:
| If true, maybe netcraft did confirm that OpenBSD is dead
| after all.
| h2zizzle wrote:
| Not quite. Focusing on your anus when clenching is a good
| way to develop hemorrhoids.
| Sharlin wrote:
| Different muscles, but you need practice to learn to
| control them independently.
| tchock23 wrote:
| Is there a name for this technique? Interested to research
| the why behind it.
| PaulHoule wrote:
| Kegel?
| astura wrote:
| Kegel exercise
|
| https://en.wikipedia.org/wiki/Kegel_exercise
| wafflemaker wrote:
| Wow, I was so sure it was PC or PV muscle exercise,
| because author of the book where I learned about the
| peeing exercise said that men don't have Kegels muscles.
| I stand corrected.
| mannycalavera42 wrote:
| <<Don't do Kegels while you urinate. Stopping your bladder
| from emptying could raise your risk of a bladder infection.>>
| https://www.mayoclinic.org/healthy-lifestyle/mens-
| health/in-...
| nkrisc wrote:
| But is stopping the flow of urine an apt description of the
| exercise? Is it a case of "do it as if you were doing that,
| without actually doing it while urinating?" If so, I think
| I'd be hard pressed to find a simpler way to describe it to
| any man (no idea if it applies to women as well).
| failrate wrote:
| Yes, and you also want to do fast and short Kegel's in
| different positions.
| wafflemaker wrote:
| Thank you! Didn't know I endangered people by suggesting it
| to them.
|
| I usually got bored halfway and after 3-6 breaths finished
| peeing normally. It was also because I've noticed that the
| exercise made it very hard to push out the last of urine
| from the bladder. Now I know it's also very unhealthy not
| to empty all the way.
| jvanderbot wrote:
| As with any internet post about exercise, someone must
| eventually come along and mention the good old weighted
| squat. Squats are well known to strengthen pelvic floor.
|
| My own anecdata confirms the benefits of pelvic floor
| exercises without any kegels, at least back when I
| regularly did lift weights.
| stavros wrote:
| Can't I just do kegels when I'm sitting or standing? It's not
| like they're obvious or take much effort, and the result
| should be about the same, no?
| mtalantikite wrote:
| I think people give the cue of stopping urination to help
| others find the muscles that you need to engage. Otherwise,
| yes, you absolutely can just do them any time you want. In
| yoga it's called mula bandha [1]. You're often instructed
| to engage it while practicing asana or pranayama. I even
| focus on engaging it when I'm out for a run or lifting
| weights.
|
| [1]
| https://en.m.wikipedia.org/wiki/Bandha_(yoga)#Mula_bandha
| stavros wrote:
| Thanks, I think I'll practice whole brushing my teeth,
| probably the easiest to not forget to do, as it's an
| everyday thing that I'm unlikely to ever stop doing.
| aruggirello wrote:
| BTW beware of snoozing or coughing while you're holding
| yourself.
| oarfish wrote:
| > including pelvic floor exercises into the routine and correct
| belly breathing utilizing the diaphragm are probably the best
| options for preventing issues with reduced venous blood flow
| from the testicles
|
| citation needed.
| jakedata wrote:
| So where's the temperature, pulse/pulseox and orientation
| monitoring jockstrap with linked smartphone app?
| wafflemaker wrote:
| Oura ring comes in many sizes. /s
| wkat4242 wrote:
| I'm sure companies like lovense will come up with stuff like
| that.
|
| The problem is really prudeness in society, especially the
| American one (the main market for many industries). It's
| holding back things like sex tech.
| edem wrote:
| I've been reading till...I don't know 40% of the article? Is
| there some sort of conclusion besides surgery?
| tickerticker wrote:
| Not a surgical procedure. It's catheter access to the spermatic
| veins.
| tacon wrote:
| In February I happened to attend a lunch 'n learn presentation at
| TMCi by a company doing clinical trials based on exactly this
| venous insufficiency principle. I think I may have been the only
| one in the audience with gray hair... TMCi is the startup
| accelerator attached to the Texas Medical Center in Houston.
|
| The startup company is Vivifi Medical[1] and they have clinical
| trials underway with ten men in a Central American country (El
| Salvador?). They claim that BPH reverses in a few months after
| their procedure. Their procedure uses a minimally invasive tool
| of their own invention to snip the vertical blood vessels that
| are backflowing from age and gravity, and splice them into some
| existing horizontal blood vessels. On their board of advisors is
| Dr. Billy Cohn[2], the wildly innovative heart surgeon who is
| famous for shopping for his medical device components at Home
| Depot. Dr. Cohn is on the team building the BiVACOR Total
| Artificial Heart. Vivifi presented their estimated timeline to
| FDA approval, with proposed general availability in 2028. My
| personal BPH will be at the head of the line for this procedure.
|
| As far as a startup, their TAM is about 500 million men. I had
| the Urolift procedure for BPH three years ago, and it cost about
| $15K on the Medicare benefits statement, though Urolift's clips
| amounted to only a few thousand dollars. Similarly, Vivifi's
| charges for this procedure are only a few thousand dollars per
| procedure, but it holds the promise of being a final solution.
| Currently Urolift is much less disruptive than TURP, which needs
| a couple of days in the hospital and almost always leads to
| retrograde ejaculation (into the bladder).
|
| [1] https://www.vivifimedical.com/
|
| [2] https://www.texasheart.org/people/william-e-cohn/
| unixhero wrote:
| Do you end up impotent or with incontinence?
| tusharsharma09 wrote:
| Not at all. Our device does not go through the penis, doesn't
| damage the urethra or resect prostatic tissue. As a result,
| there is no risk to any sexual or urinary functionalities.
| There is no post op catheter.
| sizzle wrote:
| Got an anatomical diagram for us visual thinkers?
| tusharsharma09 wrote:
| Not at this time, apologizes. As we move along, we intend
| on releasing data and images through publications.
|
| However, if you are into reading scientific papers, you
| can look up microsurgical anastomosis for varicocele
| treatment by Belgrano and Flati (separate bodies of
| work). That should give you an idea and good visual
| picture of the procedure.
| tusharsharma09 wrote:
| Thanks for the shout out. I am the CEO of Vivifi medical. We
| are building off the gat and Goren's work and making it better
| and more robust. More importantly making it more accessible to
| patients through urologists. Our early clinical trial data from
| Panama is looking highly encouraging and we are working hard to
| bring this to the market in the fastest manner possible.
| derektank wrote:
| Have you found that with your procedure, to quote the blog
| piece, "new venous bypasses grow to replace the destroyed
| spermatic veins," as found in Gat and Goren's work in follow
| ups? Or is the long term data not there yet?
|
| Thank you for taking a risk on this by the way. As someone
| who has family history it's heartening to know there are
| people taking this seriously.
| tusharsharma09 wrote:
| We actually bypass the spermatic vessels. There is
| historical evidence that bypassing the spermatic vessels is
| a superior way to treat varicoceles. So our procedure
| shouldn't have the recurrence (of varicoceles or bph)
| concerns. But this needs to be established through long
| term studies.
|
| Thanks for sharing your story. It's stories like yours --
| people with family histories and real-world experiences --
| that fuel everything we're doing.
| pstuart wrote:
| Is the procedure still possible/advisable after a TURP?
| tusharsharma09 wrote:
| Yes, our procedure could be done before or after any other
| BPH treatment out there, including TURP.
| aquafox wrote:
| I had a look at your trial description
| (https://clinicaltrials.gov/study/NCT06424912)
|
| Are you planning to publish the longitudinal data, esp. of
| endpoints 2 and 3 (prostate size, urinary flow). It would
| greatly add to the public understanding of this procedure.
| Why didn't you go for PSA? It's easy to obtain altough one
| probably wouldn't expect significant changes in this short
| time frame.
| tusharsharma09 wrote:
| Yes, that's the intent post study completion.
|
| We are collecting PSA data as well. It's a useful parameter
| for prostate cancer.
| tusharsharma09 wrote:
| We are currently gathering insights to better understand
| patient preferences and would greatly appreciate your input.
| If you are interested in participating in a short survey,
| please contact us at info@vivifimedical.com. Thank you for
| helping us shape the future of patient care.
| Izikiel43 wrote:
| Would this procedure be advisable on someone currently with
| varicocele, less than 40 years old, and with family history
| of prostate cancer (both grandfathers)?
| tusharsharma09 wrote:
| While we think this procedure has the potential to be a
| prophylactic treatment, there is no evidence to back that
| up.
|
| There is a recent study, however, published by Cleveland
| clinic that demonstrated higher prostate cancer recurrence
| rates in patients with high local testosterone levels
| (around the prostate) post prostatectomies.
|
| Also this procedure is not currently approved for treatment
| of prostatic issues. But if varicocele results in
| testicular pain, it's often times treated.
| cantrecallmypwd wrote:
| Excellent work, keep it up!
|
| On a selfish note, it'd be nice if it were available from
| Urology Austin sometime in the next 10-15 years.
| tusharsharma09 wrote:
| Thank you for the kind words!
|
| Urology Austin is certainly on our radar and we will reach
| out to multiple urology practices as we head towards
| product launch.
| bigfatfrock wrote:
| Super interesting, thank you for your candid post - keep
| crushing in life as it sounds like you already are, good
| person! Hope you are staying healthy.
| mmooss wrote:
| Nothing in the parent differs from a product promotion; there
| are no alternatives, no negatives, no considerations, nothing
| but praise - even of a member of the board of advisors.
| A_D_E_P_T wrote:
| > _there are no alternatives, no negatives, no
| considerations, nothing but praise_
|
| His account is over ten years old, and active. Maybe he's
| just impressed? Why don't you provide alternatives or
| negatives, if you can? Cynicism for cynicism's sake is
| pointless.
| aantix wrote:
| I have a really enlarged prostate. 4x the normal size.
|
| Had it biopsied because it showed a large PSA value (17).
|
| Biopsy came back negative. Psa density function actually puts
| my levels in normal range.
|
| I still have difficulties urinating.
|
| Currently taking medication to reduce the size of my prostate,
| but not happy about the meds because of the sexual side
| effects.
|
| Would this procedure help me?
| raffael_de wrote:
| Based on the simplified sketches and reasoning I'd assume that it
| made more sense to sclerose the two small vein sections
| connecting the testicles with the prostate. Does somebody know
| why that's not the suggested option?
| grok22 wrote:
| That makes sense to me too. Why wouldn't that be an option or
| is not really just a small vein between the two, but a bunch of
| "blood vessels"?
| loeg wrote:
| Based on the proposed mechanism, that would still leave the
| testicles with low oxygenation blood.
| themantalope wrote:
| I am an interventional radiologist. I've done procedures to
| embolize the prostate (helps shrink it), and gonadal vein
| embolization (for varices).
|
| The gonadal veins are in a different vascular territory from
| the prostate. The prostates vascular territory is the anterior
| division of the internal iliac. The gonadal veins arise
| directly from the inferior vena cava.
|
| I had not come across this research before it's interesting
| because as mentioned above, these organs are in different
| vascular territories but when venous structures begin to reflux
| the blood may find other collateral routes through other
| territories.
|
| I skeptical that this works, but it is really interesting.
| svilen_dobrev wrote:
| So how the usual otherwise-harmless treatment with extract of
| Serenoa repens works? Seems even that is not clear - [1] is
| ~2011, [2] is 2024
|
| it seemed to work for me, took it for few months, 10y+ ago.
| "Lasted" 8-9 years.. - until recently..
|
| [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3175703/
|
| [2] https://wjmh.org/DOIx.php?id=10.5534/wjmh.230222
| inquirerGeneral wrote:
| There is a reason we are smart enough to develop finasteride
| and dutasteride that are extremely effective and safe1 instead
| of relying on plants & herbs which are just weak versions of
| taking a drug anyway.
|
| 1 the science is sound, the safety is absolutely a guarantee.
| There is a group of about 10 individuals who have spent their
| entire life spreading their neurological issues and obsession
| with fake reports and exaggerations of the harmful made-up side
| effects that cannot be repeated in any study whatsoever
| anywhere..
|
| I actually could not believe the other day that they are still
| active and have managed to cause the FDA to issue a guidance
| that there might be higher side effect rates than otherwise
| were reported .
|
| It's actually ridiculous, and every news article and study
| about it are almost entirely mentioning people who's just start
| believing in their heads that they have side effects when they
| actually don't. And yet the news articles took this as evidence
| of a story that has been hidden or something .
|
| I really thought that those 10 or so individuals who you used
| to be able to read their forum posts back in 2006 when they
| tried to tell every young guy in the world not to take it for
| hair loss would have fizzled out by now.
| 01100011 wrote:
| Finasteride does seem to be able to cause some issues. It
| seems that DHT has many protective roles in the body and
| limiting it may cause problems:
| https://pmc.ncbi.nlm.nih.gov/articles/PMC7308241/
| bawana wrote:
| Finasteride was discovered because of a tribe in south
| america with a high frequency of a mutant allele in the
| gene responsible for protein that converts T to DHT. They
| had no BPH. This led to the search for a competitive
| inhibitor of that enzyme.While under patent it was
| extremely lucrative to big pharma. The incentives of fame
| and greed will continue to plague our civilization as long
| as we embrace aggregating structures like corporations,
| advertising, social media, and instant worldwide
| communication to amplify human traits that were useful in
| small scale tribes.
| begueradj wrote:
| >In women, breast cancer has a similar death toll, but the
| breasts have an excuse: they're much bigger; there are many more
| cells to go bad. They're also much more metabolically active,
| capable of producing enough milk to feed a baby; the prostate's
| output is tiny in comparison.
|
| Except that you make work your prostate everyday, multiple times,
| since your adolescence, whereas a woman doesn't breastfeed
| everyday since adolescence.
| pja wrote:
| Interestingly, daily masturbation appears to have a protective
| effect against developing prostate cancer, although no one
| knows why: https://www.webmd.com/prostate-cancer/ejaculation-
| prostate-c...
| juunpp wrote:
| From your own link:
|
| > There's no proof that ejaculating more actually lowers the
| chances of prostate cancer. For now, doctors just know
| they're connected. It may be that men who do it more tend to
| have other healthy habits that are lowering their odds.
|
| > Ejaculation doesn't seem to protect against the most deadly
| or advanced types of prostate cancer. Experts don't know why.
|
| I'm not the expert but, like all things, exercise, sleep and
| diet probably goes a long way.
| jasonthorsness wrote:
| Why do ideas like this take so long to be tested/adopted? Is it
| because the alternatives are "good enough"? I would think the
| evidence would lead to a fast shift; though maybe moving slowly
| is a good thing when it is surgeries.
| palijer wrote:
| We require heavy burdens of proof before we subject tens of
| thousands of people to potentially needless surgeries.
| wussboy wrote:
| And this area of human interest has been (and is) prone to
| abuse from unscrupulous individuals/organizations. Rigorous
| regulation prevents much of that as well.
| derektank wrote:
| Research and subsequently clinical testing is expensive so you
| have to acquire capital, usually from grant providers or
| working with private industry. Grant providers tend to be
| conservative and risk-averse so that means individuals with new
| ideas often won't be able to explore them until later in their
| career. Private industry is less risk averse but will only fund
| research if it has the potential to bring a patentable product
| to market before the parent expires.
|
| Even once you have funding secured, the regulatory approval
| process is long and requires hundreds of pages of
| documentation, reporting, and compliance. Then you have to get
| insurance to cover it, which can require a procedural code
| being generated for it by the AMA and requires convincing
| insurers it's worth it, particularly Medicare in the US which
| other insurers take their cues from. And even once a procedure
| is approved and a patient can get it paid for, you still have
| inertia from human physicians who have been trained to perform
| certain kinds of treatments and not others.
| amelius wrote:
| If safety regulations are really such a high barrier, then
| explain why this passed them:
|
| https://news.ycombinator.com/item?id=15834006
| derektank wrote:
| Safety regulations were just one of the many hurdles in the
| pipeline from idea to therapy.
|
| But to answer your question, that uterus transplantation
| was (a) an experimental therapy overseen by an IRB to treat
| a diagnosed medical condition, (b) almost certainly funded
| by grants acquired by Baylor and not insurance, and (c) the
| therapy is still in clinical testing and not available to
| indicated patients today in 2025, 8 years later, unless
| they are part of a clinical study, which demonstrates how
| lengthy the process is.
| inglor_cz wrote:
| Surgeries aren't regulated in the same way that drugs are,
| though. AFAIK the bureaucratic threshold for experimental
| surgeries is much lower.
| derektank wrote:
| You're entirely correct. I was trying to speak about
| medical therapies generally but the FDA doesn't regulate
| surgical techniques. Some new surgical techniques do
| require experimental medical devices which would require
| FDA approval though. And you still have to deal with the
| bureaucratic hurdles of acquiring grants for clinical
| trials and getting insurers to cover treatments of course,
| but it's certainly a lower barrier.
| hbarka wrote:
| What about the Breakthrough Device Designation or the
| Investigational Device Exemption?
| bawana wrote:
| At 50 cents a capsule on amazon , prostamol uno (serenoa repens)
| is more expensive than finasteride so it will forever remain an
| unrecognized herb. Also, remember we dont really know how these
| pills are made. Remember the story of that miracle herb, PC-SPES?
| Widely regarded as a miracle drug when it started selling over
| the counter, it did indeed significantly improve voiding symptoms
| as well as out even advanced prostate cancer into remission. It
| became so widespread that the California Department of Health
| Services (CDHS) investigated PC-SPES and discovered that it was
| adulterated with drugs, including warfarin, alprazolam, and
| diethylstilbesterol (DES). Each capsule had potent estrogens in
| it! Then the FDA recalled it.
|
| Although the rest of the world benefitted from this research, it
| was the US that paid for it and did it. I am sad that we are now
| entering a 'transactional democracy' (you only get as much
| democracy as you can afford) but then again, that's where the
| rest of the world has been since WW2. Anecdotal data has driven
| 'old wives tale medicine' for millenia. I am hoping though that
| big data, the internet, AI, and the judicious use of Bayes'
| theorem can distill real knowledge from the vast sea of
| misinformation that surrounds us.
| xvector wrote:
| I really do think AI will be key here. It's critical to
| accelerate towards ASI as quickly as possible.
| compiler_queen wrote:
| Typical patriarchal attitudes, whenever any disease affects women
| or non-binary people then it's a shrug of the male shoulders and
| on to talk about Star Wars.
| n2d4 wrote:
| This is a silly argument. Breast cancer awareness (rightfully)
| gets a lot of attention; it's also fine to have an article
| about prostates every once in a while.
| const_cast wrote:
| Right, if anything I'd say men's reproductive health is under
| looked in general. Men rarely go to Urologists and issues
| with the prostate and penis are very much treated as just a
| fact of life, as opposed to something to look into it. And,
| even when we do look at these issues, we do it in such an
| overly pragmatic sense.
|
| Like, how men feel about their penis not working or their
| muscle atrophying doesn't matter. What matter is does their
| penis work, literally? We approach it in such a blunt and
| apathetic manner. We don't really think about the more
| emotional side of hormonal changes or changes with age.
| SamBam wrote:
| Besides the fact that, as others have mentioned, breast cancer
| gets a ton of attention, I'm not sure what being non-binary has
| to do with anything. Surely the only question is whether one
| has a prostate (or breasts) or not?
| rurban wrote:
| For more insight into "all" this prostate trouble watch the film
| "Oslo: Love" currently in some cinemas.
| tpoacher wrote:
| I read this with great interest, because about a decade ago, I
| was convinced I had prostatitis (but NHS screwed the diagnostic
| process up - the GP didn't do a digital rectal exam because the
| ultrasound would be more diagnostic anyway, and the ultrasound
| scan was cancelled because the GP didn't do a digital rectal exam
| which was part of the criteria for going through with the scan
| -\\_(tsu)_/- ), and ended up reading quite a bit about it, and
| how I might try to make things better for myself in the absence
| of antibiotics.
|
| I ended up on this page which I no longer remember (something
| something prostatitis foundation maybe?), from which I remember
| two things.
|
| The first was this turkish doctor, who against all advice was
| suggesting a "Brocolli juice therapy" as a prostatitis cure. Fast
| forward to 2025 and there's lots of studies supporting this.
| Anecdotally I tried this back then and it really helped the
| prostate pain I had at the time for months go away within a week.
|
| The second, which is more relevant here, was this guy who had a
| very interesting hypothesis, that a lot of the prostate troubles
| are actually "musculoskeletal" in origin, and muscle imbalance /
| weakness of the iliopsoas muscles in particular. And that this
| imbalance affects venous return which "somehow" causes the
| condition. But he was just a lay person, and the "somehow" was
| unclear. So this completes that image perfectly. It's interesting
| that this article mentions the venous insufficiency link, and
| that veins rely on valves to direct flow, but doesn't mention the
| muscular link at all.
|
| In any case, this person was saying that in his case, doing lots
| of iliopsoas stretching and exercises effectively 'fixed' his
| chronic prostatitis problems. So I've timidly started including a
| couple of iliopsoas stretching exercises before any workout I do.
| Anecdotally, I think it helps, but I can't know for sure. But
| thought I'd mention here in case someone shows interest or can
| make that link more solid.
|
| PS. found the turkish doctor page (or at least a mirror of it):
| https://www.oocities.org/iastr/ebroc.htm
|
| I wish I could find that comment about the iliopsoas ... but alas
| I think it's probably lost in the sands of time now.
|
| UPDATE: Well what do you know. Found it:
| https://web.archive.org/web/20230203201759/https://prostatit...
|
| (and
| https://web.archive.org/web/20230127101206/https://prostatit...
| more generally)
| BobbyTables2 wrote:
| It also seems to me that a lot of "prostatis" cases have
| nothing one to do with bacterial infection but rather pelvic
| floor issues or is referred pain from spinal issues.
|
| Men's medicine is in the dark ages.
| mixmastamyk wrote:
| What exactly does the broccoli do? And why does it have to be
| boiled? I didn't get many details from the page above.
| theptip wrote:
| > The theory here is largely mechanical
|
| I've long felt that the reliance on population-statistics (RCT)
| rather than individual diagnosis highlights how little we really
| know about medicine.
|
| A mechanic wouldn't try to fix a car based on a checklist of
| symptoms interventions that work X% of the time across the
| population of cars; they would actually inspect the pieces and
| try to positively identify e.g. a worn/broken component. Of
| course, this is harder in the human body.
|
| I'm hopeful that as diagnostics become cheaper and more
| democratized (eg you can now get an ultrasound to plug into your
| iPhone for ~$1k), we'll be able to make "medicine 3.0" I.e. truly
| personalized medicine, available as standard rather than a luxury
| available to the 0.1%.
| potato3732842 wrote:
| What makes professional mechanics fast (and therefore makes
| them good profit) is knowing from experience when you can shoot
| from the hip like that.
|
| But yeah, you won't find people doing things that way in any
| setting where it Actually Matters(TM) (e.g. expensive things
| where you really can't justify not fixing it right the first
| time)
| thehappypm wrote:
| This sounds a lot like the pitch for Theranos
| bear141 wrote:
| Which was a great pitch because it's what people want. It
| just has to be based in reality.
| Robotbeat wrote:
| So?
| bobthepanda wrote:
| Diagnostics only really tells you that something is happening
| but not why; and it is so impractical if not impossible to
| observe mechanisms of action for much of the body.
|
| Heck, we don't even know the mechanism of action for
| acetominophen, and that's one of the most popular, oldest OTC
| drugs out there.
| deelowe wrote:
| My brother is a mechanic and he definitely goes on technet to
| review a checklist when doing diagnostics. Especially on cars
| he doesn't see a ton
| Spivak wrote:
| Yeah, how can this take possibly be on HN when this approach
| works on software. We even manufacture the population samples
| ourselves (fuzzing).
| neves wrote:
| What is Technet? I've googled it, but there are just a bunch
| of generic sites.
| SoftTalker wrote:
| I don't know about the name "technet" in particular but there
| are services that aggregate technical service bulletins
| released by car manufacturers to make them more easily
| available to independent (non-dealer) mechanics.
| Matumio wrote:
| This kind of thinking, that everything can be broken down into
| pieces and studied in isolation... it has brought us very far,
| but it has some hard limitations. Especially in biology, where
| any leak you find may serve some function.
|
| In medicine, the primary goal is to help, rather than
| understanding why something works exactly. Sure, understanding
| is an important goal too, it's just much harder to achieve than
| being able to help. And less important than knowing that your
| treatment will work, without any major side-effects, for the
| kind of patient in front of you.
| drumttocs8 wrote:
| The other difference, of course, is that the mechanic can just
| RTFM
| pif wrote:
| Please, do not compare an engineer working on something built
| by humans with publicly available documentation, and a
| scientist working on something built by nature without event a
| single hint of documentation, nor assurance of any logic
| behind.
|
| They work in different contexts, with wildly different
| constraints and wildly different expected outcomes.
| jdyer9 wrote:
| Nitpicking on the mechanic point, but this is pretty common,
| just not at the same level of detail as medicine. Certain
| brands, models, and parts are more likely to fail in certain
| ways, so if a model comes in with symptoms of a known, high
| frequency problem, many times that work will be done first
| rather than taking more of the car apart to inspect individual
| parts.
|
| Certainly I didn't think there's huge bodies of work on those
| statistics the same way there is for medicine, but any car
| repair forum online will give you some sense of this
| LegNeato wrote:
| I worked at an auto parts retailer growing up in high school. I
| had very basic knowledge of cars. After working there for a
| year, someone could come in and describe what they were seeing
| and hearing and 80% of the time I could tell them what is wrong
| and what is needed. You'd be surprised at how a large
| population is similar for different 'paths' through the problem
| and solution space
| derefr wrote:
| > The theory here is largely mechanical; and it's not just
| psychiatrists like Scott who are weak at mechanical explanations;
| it's doctors in general as well as medical researchers and
| biologists.
|
| A tangent here, about not just "mechanical" _explanations_ , but
| "mechanical" _treatments_ --
|
| IMHO, the insistence in modern medicine on treating recurrent
| bacterial infections _purely_ with antibiotics is wrongheaded,
| and the cause of a lot of resistant strains of bacteria.
| Especially for topical /mucosal/epithelial infections, where the
| infected tissue is accessible without invasive surgery.
|
| In a recurrent bacterial infection, the reservoir of the
| infection is one or more (almost always macro-scale) biofilms or
| plaques. And antibiotics just don't do much to biofilms/plaques.
| (If they could, you could spray Lysol on the walls of an under-
| ventilated shower that's developed "pink slime" biofilms -- and
| all the slime would dissolve, or detach and run down the drain.
| But it doesn't do that, does it?)
|
| Even if you kill most of the bacteria, the biofilm itself -- the
| "fortress" of polymerized sugars which the bacterial cells have
| secreted to secure their position -- is not destroyed by
| antimicrobal compounds. And the few bacteria that remain have a
| great position to regrow from.
|
| What does work to clean a slimy shower wall?
|
| Scrubbing. Scraping. Peeling. Together with targeted chemicals,
| that 1. get water out of the polymer (because these biofilm
| surface polymers are often lubricative when wet, and thus
| resistant to abrasion -- but this effect breaks down when dry),
| and 2. rough up the surface of the biofilm/plaque a bit, to get a
| better grip on it.
|
| Biofilms and plaques _adhere to themselves_ -- so, when you can
| break the biofilm or plaque into chunks, you can then get entire
| chunks out. (And also, by removing chunks, you create paths for
| antimicrobials to then _get past_ the biofilm surface polymer.
| You 're breaching the fortress.)
|
| If you picture a strep-throat infection -- spots on the tonsils
| and on the throat, etc -- those spots aren't a _symptom_ ; they
| _are_ "the enemy" you're trying to fight. Remove them --
| mechanically! -- and you go from using antibiotics (picture tiny
| cellular infantrymen) to effectively "fight a war of attrition
| against an enemy with a secure position", to "a defeat in detail
| of an enemy with nowhere to hide."
|
| ---
|
| Interestingly, there _are_ certain medical _specialties_ that
| think mechanically about infection.
|
| * Dentists, obviously, know that you must abraid dental plaque
| away. There's no chemical that you can put in your mouth every
| day that will keep plaque from forming, or reduce it once it has
| formed. (In fact, ironically, antimicrobial oral rinses [of e.g.
| chlorhexidine] _accelerate_ plaque formation, because bacterial
| cells killed "in place" inside their biofilm fortresses will
| _deposit and enrich_ the surface polymer layer of the biofilm --
| much as dead sea creatures deposit and enrich limestone
| sediment.)
|
| * Audiologists know that there's ultimately nothing you can do
| with drugs or topical treatments to get an ear clear of
| wax+fat+dust+anything else trapped in there. You have to go
| digging. Chemicals can _soften_ the wax, to make it easier to
| remove; but, due to the shape of the ear, and the lack of ability
| to "come in from behind" (there's an eardrum in the way!), the
| softened wax will never come out on its own.
|
| * Dermatologists know that a cyst can't _just_ be drained +
| treated with antibiotics. The body forms a defensive pocket
| around a cyst -- but the inside surface of this pocket ironically
| provides the perfect medium for a biofilm to grow on, and thus
| for an infection to recur after drainage. Cysts are only
| considered well-treated if the pocket itself is removed -- thus
| removing the biofilm.
|
| ...and yet, when you look at most other disciplines, you see
| completely the opposite.
|
| * An ENT is very much _not_ willing to abraid biofilms out of
| your sinuses or throat "if they can help it", despite those
| surfaces being accessible to an endoscope without breaking past
| any barriers. They will always try first to treat
| "pharmacodynamically", with e.g. oral antibiotics + an
| antimicrobial sinus rinse -- presumably in the hopes that you'll
| _accidentally_ do something mechanically in the process of
| treatment (e.g. snorting really hard to get the remnants of the
| rinse out) that will dislodge the biofilm. You have to go through
| _years_ of back-and-forth with an ENT before they 'll actually
| bother to look further up inside your sinuses than they can see
| with an otoscope/anterior rhinoscope. (And IMHO this is why so
| many people suffer from idiopathic chronic sinusitis, developing
| into nasal polyps et al. Nobody's ever been willing to go deep up
| their nose with an endoscope, find impacted biofilm plaques, and
| say "alright, let's clear those out.")
|
| * Kidney stones, once symptomatic, are treated ultrasonically
| (lithotripsy); but the thinking on follow-up prevention is
| entirely about preventing _accretion_ -- not in removing the
| cause. [In many cases, the cause of (struvite or apatite) kidney
| and /or urinary stones, is very likely a bacterial biofilm within
| the kidney, spalling off bits of biofilm, which denature into
| plaques after exposure to the harsh pH of the
| kidney/uterer/bladder; get caught on some tissue; and then act as
| nucleation sites for mineralization (stone formation) as
| dissolved minerals pass through.] Once someone gets one kidney
| stone, they are generally thought to just be "prone to kidney
| stones", and will likely get them randomly for the rest of their
| life. A lot like the old -- pre-infectious-origin -- thinking
| that someone can be "prone to peptic ulcers"!
| bawana wrote:
| Unmentioned is the significance of dietary modificatioon. In one
| study, Japanese men had 10% of the incidience of problematic bph
| as americans. The offspring of the japanese in Hawaii had half
| the iincidence. The second generation had no difference. The
| analysis suggested that phytoestrogens in tofu, tempeh,etc are
| responsible of prostatic involution.
|
| Animal fat contains elevated levels of lipid soluble hormones and
| diets high in fat (meat) are associated w bph as well as elevated
| risk of prostate ca.
|
| Finally, this craze of T replacement is greatly increasing the
| risk of symptomatic bph (along with other cardiovascular risk
| factors)
| loeg wrote:
| > Finally, this craze of T replacement is greatly increasing
| the risk of symptomatic bph (along with other cardiovascular
| risk factors)
|
| TRT does not increase the risk of BPH; this is discussed in the
| article, along with a hypothetical mechanism. Nor does TRT seem
| to have CVD risk.
| qmr wrote:
| > craze of T replacement
|
| Please explain how it's a "craze".
|
| T levels and sperm count are tanking. Possibly from micro
| plastics.
| alejohausner wrote:
| This work by Gat and Gornish gives a great explanation for
| prostate enlargement. There's an article by Donaldson [1] that
| suggests a connection to vitamin K2:
|
| A large study from 2014 by Nimptsch et al found a strong inverse
| correlation between intake of vitamin K2 and prostate cancer [2].
| Dairy foods with K2 had the most effect (K2 is soluble in
| butterfat).
|
| Vitamin K2 helps remove calcium from the elastin in artery and
| vein walls, reducing their stiffness. Donaldson hypothesizes that
| K2 improves venous flow, and hence might reduce the varicoceles
| that lead to too much free testosterone getting to the prostate
| and causing enlargement.
|
| So eat more grass-fed butter, or take a K2 supplement. At worst,
| you might also improve your bone strength. At best, men might
| prevent prostate cancer.
|
| 1: DOI: 10.1016/j.mehy.2014.12.028
|
| 2: DOI: 10.1093/ajcn/87.4.985
| kmbfjr wrote:
| I had my prostate removed six weeks ago due to Gleason 8 score
| cancer. The pathology revealed an aggressive cancer.
|
| My prostate was not enlarged, my PSA at the end was 4.2. Only
| because my doctor was overly cautious about the slope of the
| PSA rise did he send me for an MRI starting the diagnosis. It
| remains to be seen if it escaped containment.
|
| The point here is, I don't think enlargement and cancer are
| that intertwined. Cancer happens for any number of reasons,
| pinning hope that it can be staved off by diet and vitamins
| seems to ignore tons of other environmental factors.
| xxbondsxx wrote:
| I hope you'll be OK!
| alejohausner wrote:
| Wow, that sounds scary. I hope it doesn't come back. Weird
| about the 4.2 PSA; that wouldn't have raised alarms,
| normally. I guess acceleration is as important as absolute
| values.
| brigandish wrote:
| All the best. I had a check up for prostate cancer recently,
| and fortunately have been told I don't have it, but until
| that moment I felt the stress of wondering and worrying, so
| you have my sympathy.
|
| I'm also glad you found a good doctor, the first I found did
| no checks _at all_. Told me I 'm too young to have any
| problems (I'm definitely not) and sent me away with some
| herbal medicine and all that stress I mentioned. The second
| doctor I found was thorough and reassuring, and shocked by
| the behaviour of the first.
| damnitbuilds wrote:
| TL;DR: Very likely not.
| vakde wrote:
| Did no one check the base website (yarchive.net)?
|
| He's archived a mindbogglingly large number of usenet posts, each
| being extremely high signal
| bccdee wrote:
| Good article, but very weird to scroll to the bottom and see "(c)
| Norman Yarvin" at the bottom. Curtis Yarvin's brother wrote this.
| I don't have an opinion about that, I just find it strange.
| gwking wrote:
| I merely saw the domain name 'yarchive' and had a strange
| inkling that there might be a connection. A quick search
| yielded this:
| https://unlimitedhangout.com/2021/08/investigative-
| reports/t....
|
| I have no opinion of unlimitedhangout.com or the veracity of
| that article. But in response to "I just find it strange", I'm
| beginning to associate this sort of intensely intellectual
| inquiry into disparate topics with equally intense political
| positions.
|
| I was first introduced to Urbit as if it was a purely
| technical, humorous and extremely nerdy lark. It was a joke
| thing my friend got me to sign up for, to own a slice of an
| imaginary universe (in a quantity called a "frigate" or
| whatever it was). When I learned years later about how serious
| the worldview behind it was, I was quite shocked.
|
| Since then, and especially since the NYT outing of Scott
| Alexander in 2020, I've become more attuned to the pattern.
| These hyper-analytical blogs often come with a lot of political
| implications below the surface.
|
| Again, I'm not taking sides here. If anything, the takeaway for
| me is that the world is very complicated. We have these rare
| polymath personalities who go deep into topics, have a strong
| voice on the internet, and they end up with all sorts of valid
| criticisms of the status quo. This in turn can align with
| extreme political views.
| ryanobjc wrote:
| This article is literally the definition of TL;DR. It's fairly
| hard to get thru, I spaced and skipped the conclusion, that the
| treatment isn't permanent and can be undone.
| SamBam wrote:
| I was interested through the first 20-25 paragraphs, and then
| the thing just kept going and going and going. It would have
| been fine, though, if it had some sub-headings and stuff to
| help guide one through.
| irjustin wrote:
| This is incredible.
| silexia wrote:
| Fantastically well written article. I read the entire thing in
| one go with my tiny attention span and learned about an
| interesting possible procedure.
| acyou wrote:
| Here is my pet theory, it's not intended to be political, just
| thinking about evolutionary biology.
|
| There is an optimum lifespan for peak evolutionary population
| fitness in any group of organisms. Too short a lifespan means not
| enough time to gather resources and reproduce. Too long a
| lifespan could mean competing with future generations for scarce
| resources, which might in theory marginally improve individual
| fitness, but in the aggregate decreases overall population
| fitness, and is therefore not selected for.
|
| Over billions of years, organisms evolved built-in control
| mechanisms to ensure that they live/survive for the optimum
| amount of time. The evolution of these mechanisms is driven in
| part by the fact that an older organism under stress being
| eliminated from the environment will probably improve the
| population fitness of close relatives.
|
| I believe this is what cancer is. It's one of many, many built-in
| mechanisms, reinforced by hundreds of millions of years of
| evolution, to kill us off when our time has come.
|
| So, if there are tons and tons of evolved mechanisms that exist
| just to knock you out when your time has come. That is the
| ultimate reason why men die from heart attacks: they have evolved
| in past generations that if they have extreme exertion at an
| advanced age, it's an indication that they aren't contributing to
| population fitness in a useful manner, and that extreme exertion
| would be more efficiently done by younger individuals. At an old
| age, they should be at the top of the food chain, guiding and
| educating and valued and lazy and consuming, and if they are not,
| better for the tribe for them to die quickly than lingering on.
|
| And there is hope. If we can eliminate stress from our lives, we
| send a signal to our bodies that we will improve population
| fitness by continuing to exist, and our bodies may reward us.
| That's a big reason for longer lifespans. Better diet and
| moderate exercise is great for sure, but less stress makes a big
| difference.
|
| But this is only one of a multitude of dynamics that is happening
| in the complicated system that is the existence of life, and is
| not necessarily a dominant dynamic.
|
| For prostate cancer, you might get around it temporarily, but
| something else will get you. Lifestyle changes, medication,
| placebo and other interventions that reduce stress probably have
| a better overall shot at increasing your lifespan than any single
| magic bullet.
|
| I suspect that prostate cancer has to do with being old and not
| having sex, if you're an older male. An older male who doesn't
| have sex would have lower individual fitness than an older male
| who does have sex, and would be competing for resources with
| younger individuals who might have higher evolutionary fitness.
| So, there's another solution to prostate cancer that doesn't
| involve surgery (or even necessarily having sex), I think I read
| another article that mentioned that, I won't spell it out.
|
| Given that breast cancer happens more to women who have not
| breastfed after carrying to full term (citation needed), you can
| draw a parallel. Females who are decreasing population fitness by
| not having children, and by extension have lower individual
| fitness, breast cancer and ovarian cancer are some of the main
| mechanisms. They also think that breastfeeding reduces the risk
| of breast cancer. Certainly, even females that don't reproduce,
| but still breastfeed, probably improve population fitness, even
| if they don't have good individual fitness.
| GoatInGrey wrote:
| Not to be antagonistic to your theory, I think you might find
| this alternative theory thought-provoking:
| https://osf.io/preprints/osf/smzc4_v1
| varjag wrote:
| Fascinating. I wonder what are the consequences of long term zero
| gravity flight for this.
| phront wrote:
| i am curious to know can we plan a better vein system and somehow
| "implement" it
| abhaynayar wrote:
| Love the writing-style. Quite "to-the-point", without any fluff,
| and with a nice flow and purpose.
| someonehere wrote:
| I'm glad we're starting to talk about the prostate because I feel
| like for a long time. Men have been reluctant to talk about this
| more and more in society. I feel like women have their fair share
| problems as they get older, but men have equal amount of problems
| too we just don't like to talk about it.
| ycombinator_acc wrote:
| Just take finasteride. As a nice side effect, you won't go bald.
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