An end to all this prostate trouble?

Proposed venous / “mechanical” treatment for BPH

• Core idea discussed: BPH and some prostate cancers may be driven by venous backflow (varicocele-like) bathing the prostate in excess testicular androgens; treating the veins could shrink the prostate.
• Concerns raised:
  • Durability: follow‑up work suggests new venous bypasses can form, so effects may not be permanent; repeat procedures might be hard.
  • Safety/technique: people worry about failure to fully occlude veins (risk of emboli), and that multiple interventions might not be sustainable.
• An interventional radiologist notes gonadal and prostatic vessels are usually considered different territories and is skeptical but intrigued.
• A startup (Vivifi Medical) joins the thread describing a minimally invasive vein “bypass” device, early trials (Central America), and a target around 2028.
  • Claims: no impact on sexual/urinary function because nothing goes through urethra; can be done before/after other BPH procedures.
  • Others push back on “no risk” language and on promotional tone, asking for long‑term recurrence data.

Existing medical management

• 5‑alpha‑reductase inhibitors (finasteride/dutasteride) and tadalafil are widely discussed:
  • Some call fin/dut + daily tadalafil their “favorite” long‑term regimen, also for hair loss.
  • Others emphasize side effects: reduced libido, breast pain/gynecomastia, ejaculatory suppression, possible sterility, and disputes over “post‑finasteride syndrome.”
  • Debate over semantics: daily pills are “management,” not a cure.
• Herbal options: Serenoa repens and broccoli juice are mentioned with mixed evidence and personal anecdotes.
• Dietary hypotheses: phytoestrogens, animal fat, and vitamin K2 intake are proposed as modifiers of BPH/cancer risk, with counterexamples from aggressive cancer in non‑enlarged prostates.

Evolution, aging, and “design flaws”

• BPH is framed as an evolutionary blind spot: weak selection after reproductive age.
• Others note it also causes infertility and suggest upright posture and venous valves are recent, imperfect adaptations.
• Long sidetrack on other “flaws” (eyesight, baldness, appendix, gallbladder, choking risk) and on whether modern late‑life reproduction could reshape selection.
• Another tangent explores gendered aging, media preferences for youth, and how much of that is biology vs culture.

Lifestyle, pelvic floor, and mechanics more broadly

• Several commenters stress simple measures: walking, pelvic floor (Kegel‑type) work, diaphragmatic breathing, iliopsoas stretching; some report improved symptoms and sexual function.
• A caution is cited against doing Kegels while urinating due to UTI risk.

Diagnostics, medicine, and AI

• Cheap tools like thermal cameras, stethoscopes with DSP, and home diagnostics are discussed as underused.
• Frustration with brief, laptop‑driven consults leads to enthusiasm for AI triage/diagnosis, with debate over LLM reliability vs benefit.
• On adoption delays: commenters cite funding conservatism, regulatory/insurance hurdles, and physician inertia as major brakes on new procedures.