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CASE REPORT
Year : 2017  |  Volume : 49  |  Issue : 1  |  Page : 34-39

Effect of a yoga module on an enlarged prostate in elderly patients: Two case studies


Department of Scientific Research, Kaivalyadhama S.M.Y.M. Samiti, Lonavla, Maharashtra, India

Date of Web Publication16-Jun-2017

Correspondence Address:
Pratibha Hemant Rajbhoj
Department of Scientific Research, Kaivalyadhama S.M.Y.M. Samiti, Lonavla - 410 403, Maharashtra
India
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DOI: 10.4103/ym.ym_7_16

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  Abstract 


Prostate gland and its enlargement is a common problem in aging males. Surgery may not be advisable in all cases of enlarged prostate, as the aging people often have other problems such as asthma, diabetes, and blood pressure (BP) and may not often be physically fit to undergo a safe surgery. Case studies were undertaken on two male patients of age 62 and 79 years, respectively. The parameters studied were ultrasonography, pre- and post-void urine volume, and serum prostatic-specific antigen (PSA) along with other physiological and biochemical parameters of BP and diabetes. The patients were tested after 7 days and also after 14 days of yoga practice. In case 1, it was seen that the prostate size, on sonography readings, was reduced from 144 to 37 cc by just 1 month of yoga practice. Prevoid urine volume was 230 ml and postvoid was 180 ml, and after 1 month of yoga practice, it was 694 ml and 19 ml, respectively. Serum PSA initially was 25.24 ng/ml, while at the time of posttesting, it was 0.82 ng/ml. In case 2, the postvoid urine volume was 50 ml initially. On the 14th day of yoga practice, it was nil. Serum PSA was 128.5 ng/ml at the time of pretesting, while on the 14th day, it was 16.35 ng/ml. The prostate size was 91 cc on sonography examination at preyoga testing, while on 14th day of yoga practice, it was 23.6 cc. The yoga module, used in this study, is recommended to be employed to help patients of enlarged prostate.

Keywords: Enlarged prostate, pre- and post-void urine volume, prostate size, serum prostate-specific antigen, ultrasonography


How to cite this article:
Pathak SD, Rajbhoj PH, Bhogal RS. Effect of a yoga module on an enlarged prostate in elderly patients: Two case studies. Yoga Mimamsa 2017;49:34-9

How to cite this URL:
Pathak SD, Rajbhoj PH, Bhogal RS. Effect of a yoga module on an enlarged prostate in elderly patients: Two case studies. Yoga Mimamsa [serial online] 2017 [cited 2019 Jun 19];49:34-9. Available from: http://www.ym-kdham.in/text.asp?2017/49/1/34/208281




  Introduction Top


Prostate is a gland situated at the neck of urinary bladder encircling the urethra. This is a part of the aging process. It causes a major problem in old age. Due to costs involved in its treatment, morbidity and mortality is increasing in this group of people who are mostly neglected by their offsprings as if they are a burden on them from physical and financial point of view. Due to advancements in modern medicine and techniques, it has become easy to treat this. As life expectancy has increased from 50 years of age to 70–80 years, in India, this problem of increased size of prostate is becoming a major factor in our senior citizens' day-to-day life. Hence, whether medical science or complementary and alternative medicine has any methods which can keep the prostate size under control and make their life comfortable? As clinical observations had shown, at the yogic hospital of Kaivalyadhama, yoga practices were reported to have ameliorating effect on prostate, it was thought worthwhile to undertake these case studies.

Structure of prostate gland

A healthy human prostate is classically said to be slightly larger than a walnut. Mean weight of the “normal” prostate in adult males usually ranges between 7 and 16 cc. It surrounds the urethra just below the urinary bladder and can be felt during a rectal examination.

Description

The prostate has got two lateral lobes, anterior, posterior, and a median lobe. The posterior aspect of the prostate gland, which surrounds the distal urethra, is usually the seat of cancer in it. This zone surrounds the ejaculatory duct. The central zone accounts for roughly 2% of cancer in that area which is more likely to invade the seminal vesicles. The part of prostate, surrounding the proximal urethra, is the seat of benign enlargement.

Physiology

The function of the prostate is to secrete a slightly alkaline fluid, milky or white in appearance, that usually constitutes 50%–75% of the volume of the semen, along with seminal vesicle fluid. The prostatic fluid is expelled during ejaculation together with most of the spermatozoa.

Prostate gland increases as age advances. Usually, it starts after 50 years of age. When it increases in size, it presses the urethra causing difficulty in passing urine. Sometimes, it undergoes malignant (cancer) changes too.

Symptoms of enlarged prostate

  • Increased frequency of micturition, usually more at night time (sleep gets disturbed)
  • Difficulty in passing urine
  • Unable to pass urine
  • Weak urinary stream
  • Burning of micturition
  • Passing blood in urine.


Investigations

The following investigations are done in case of prostate enlargement disorder:

  • Physical – per rectal (P/R) examination by surgeon
  • Ultrasonography (USG) to measure size of prostate, pre- and post-void urine volume
  • Urine flowmetry
  • Serum prostate-specific antigen (PSA).


Treatment

The following treatment is advised in modern medicine to patients suffering from prostate enlargement disorder:

  • If small, it can be treated with medicines
  • In case of its big size, the following type of surgery can be done:


    1. Prostatectomy by open method (cutting on the lower abdomen and reaching gland)
    2. Through cystoscope transurethral resection of prostate.


As this is a major surgery and usually the patient is old, he is likely to have some of the diseases such as diabetes, hypertension, asthma, and myocardial infarction, causing an increase in morbidity and mortality. Such patients, if given yogic practices, can keep themselves physically fit. With some specific yogic practices, the size of the prostate can be kept in a normal size range, resulting into reduced symptoms, thus avoiding major surgery at old age.

The following yoga practices were advised to the patients in this case study (designed by yoga expert Shri O. P. Tiwari, secretary, Kaivalyadhama, Lonavla, Maharashtra, India).

For an optimal effect of the yoga module, one should not have constipation. So, to avoid constipation, one should take more salad, plenty of oral fluids, and may supplement the same with light laxative such as Isabgol or Kayam churna in the night. Patients should avoid Udid dal, Gawar, and Brinjal.

Yoga module for an enlarged prostate

  1. Preparatory yoga practices:


    • Shavasana – 5 min
    • Prana-dharana – 2 min
    • Kapalbhati without forceful exhalation- 30 strokes per min.
    • Ujjayi Pranayama – Three rounds
    • Jala-neti
    • Shitali – Three rounds
    • Kriya Yoga:


      1. AnulomaViloma Pranayama – ten times
      2. Omkar/Aameen/Aamen – ten times
      3. Gayatri Mantra or any other mantra of one's own religion – ten times.


  2. Specialized yoga practice:

    Pelvic Uddiyana with Mula Bandha (three rounds).


  3. The following asanas should precede the yoga module above for a maximal advantage:


    • Ardha halasana – 1 min
    • Pawana Muktasana – 1 min
    • Kativakrasana – 1 min
    • Makarasana – 2 min
    • Niralambasana – 2 min
    • Bhujangasana – 1 min
    • Naukasana – 1 min
    • Dhanurasana – 1 min
    • Dandasana – 1 min
    • Parvatasana – 1 min
    • Vajrasana – 2 min
    • Vakrasana – 1 min
    • Gomukhasana – 1 min
    • Chakrasana – 1 min
    • Tadasana – 1 min.


General guidelines

  1. These asanas were performed under expert teacher's guidance so as to get the best results
  2. A forceful performance of asanas was avoided. Time allocation, shown above, for respective yoga techniques, was achieved cautiously and gradually over a period of time under an able guidance only. Patients were strictly advised not to exert himself, forcibly, to attain the ideal posture/performance or maintain asanas for an unduly a prolonged period of time so as to avoid unwarranted injuries. Patients were also advised to, if they get any problem while performing yogic practices, stop the practice immediately and seek a yoga expert's opinion.



  Case Reports Top


In this article, authors present two case reports wherein the prostate gland has shown a total regression in size and a marked reduction in associated symptoms. This has also been confirmed convincingly by medical reports.

Case 1

A 62-year-old male was admitted in Lonavla with severe urinary tract infection and gastroenteritis for 2 days.

Later on, the patient was admitted to a hospital at Pune:

Date of admission - May 23, 2013.

Date of discharge - May 25, 2013.

The patient came with c/o increased frequency of urination, nocturia, and loose motions for 4–5 days. Also, the patient had a history of fever with chills, 3 days prior to it [Table 1].
Table 1: Values of biochemical parameters and treatment given prior to yoga intervention for Case 1

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Investigations

General examination:

  • Afebrile
  • Pulse – 78/min
  • Blood pressure – 130/80 mmHg.


Systemic examination:

  • RS – AEBE, clear
  • Cardiovascular – S1, S2 normal
  • P/A – Soft and nontender
  • Central nervous system– Conscious and oriented.


The patient was admitted with the above complaints. All investigations were done. Uroflowmetry was also done showing very poor flow rates. The patient was treated conservatively with:

  • Injection Magnex – 1.5 g in 100 ml NS twice a day
  • Injection Bristokacin – 500 mg intravenous once a day
  • Tablet Neksium – 40 mg once a day
  • Tablet Rapilif (Silodosin) – 8 mg 1 HS
  • Naturolax powder – 2 tsf for 30 days
  • Sitz bath.


The patient was discharged. The hospital stay was uneventful and the patient was stable at the time of discharge.

On discharge, the patient took the following medicines:

  • Rapilif - from July 14, 2013 – 4 mg
  • On August 1, 2013 medication was stopped
  • Now the patient started with yoga practices, after July 2013.


Case 2

A 79-year-old male was admitted in hospital for 6 days with burning of micturition.

P/R examination revealed an enlarged prostate.

The following medications were prescribed:

  • Inj Magnam 1.5 g BD
  • I.V. Pan40
  • Inj Parfalgan sos
  • Inj Aknil sos
  • Tablet Domstal
  • Citrosoda Satchet
  • Capsule Beven
  • Urimax 0.4 mg HS
  • Tablet Goutnil 0.5 mg 1 tds


The following medications were advised on discharge:

  • Injection Magnam 1.5 g BD for 3 days
  • Tablet Urimax 0.4 mg HS
  • Tablet Goutnil 0.5 mg 1 tds
  • Tablet Dutas 0.5 mg 1 od.



  Discussion Top


Both the cases were investigated in the hospital and were asked to undergo a surgery. They were practicing yoga regularly, but now they added some specific yogic kriyas. After some days, they were reinvestigated and now there was no need for a surgery. Two reports are evidently self-explanatory about the effect of yoga on prostate gland problem.

In Case 1, the patient has received tablet Rapilif (Silodosin) 8 mg from May 2013 to July 14 and later on 4 mg till July 31, and from August 1, it was totally stopped and then the patient started practicing a special yoga module for prostate. The serum PSA level came down to normal from 25.24 to 0.82 ng/ml [Table 2] with medical line of treatment. USG was done on May 23, 2013; June 6, 2013; and July 15, 2013. All these investigations showed prostate size as 144 cc in spite of taking Rapilif which, from medical literature, is supposed to reduce the size drastically (Rains, & Ritchie, 1979; Wein, 2007), but it has actually made no difference in size. However, after starting yoga module on August 1 and when USG was repeated on August 15, it has reduced from 144 to just 37 cc [Table 3]. Also, the uroflowmetry done after yoga intervention showed improvement [Table 4].
Table 2: Values of pre and post biochemical parameters for Case 1

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Table 3: Values of pre and post USG Abdomen for Case 1

Click here to view
Table 4: Values of pre and post Uroflowmetry parameters for Case 1

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In Case 2, as per the investigations [Table 5] & [Table 6] and diagnosis by the doctor, patient took the required treatment. After April 10, 2012, the patient stopped all treatment and started practicing a special yoga module. After practicing special yoga module for 15 days, USG showed drastic reduction in the size of prostate from 91 to 23.6 cc [Table 7] and serum PSA has reduced from 128.5 to 16.35 ng [Table 8]. This definitely proves that yoga appears to have a definite role in reducing prostate size. Act of Micturition depends upon the good coordination between the bladder muscle and sphincter muscle tone. When bladder muscles contracts and sphincter muscles relaxes the act of micturition can be completed. Yogic practices strengthen the pelvic muscles and sphincter muscle tone (Digambarji, & Gharote, 1978; Digambarji, & Kokaje, 1971; Kuvalayananda, 1933). This improves the contractibility of bladder muscles to enhance the act of micturition, which is completed by the relaxation of sphincter muscles to open the passage for urine to flow out. Yogic kriyas and asanas improve the blood flow to the prostate gland so as to reduce the inflammation (Kuvalayananda, & Vinekar, 1963; Tiwari, 2015). Rise in serum, PSA due to inflammation, can also be reduced resulting in its reduced level. Authors, however, are not referring to a rise in Serum PSA due to cancer (Carcinoma).
Table 5: Values of uroflowmetry parameters prior to yoga intervention for Case 2

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Table 6: Values of urine examination prior to yoga intervention for Case 2

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Table 7: Values of pre and post USG Abdomen for Case 2

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Table 8: Values of pre and post biochemical parameters for Case 2

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Both the patients are healthy and now in 2016, their daily working schedule is more hectic and busy perhaps compared to most men in the age group of 50–60 years.

This study, if undertaken on a large scale, can help standardize the yogic treatment for prostate disease, which has become a main hurdle in the life of senior citizens. As life expectancy, in general, has increased, the population of senior citizens is also on the rise. This population is facing not only physical but also social and psychological problems. By implementing this yoga module, we can make the life of senior citizens significantly happier.

Acknowledgment

The authors are grateful to Swami Maheshananda, chairman, Kaivalyadhama SMYM Samiti, Lonavla, Shri O. P. Tiwari, secretary, Kaivalyadhama SMYM Samiti, Lonavla, and Shri Subodh Tiwari for their constant encouragement to quality research endeavors. They are also thankful to the SRD staff for their valuable inputs in this communication.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Digambarji, S., & Gharote, M. L. (1978). Gheranda Samhita. Lonavla: Kaivalyadhama SMYM Samiti.  Back to cited text no. 1
    
2.
Digambarji, S., & Kokaje, R. S. (1971). Hathapradipika. Lonavla: Kaivalyadhama SMYM Samiti.  Back to cited text no. 2
    
3.
Kuvalayananda, S. (1933). Asanas. Lonavla: Kaivalyadhama SMYM Samiti.  Back to cited text no. 3
    
4.
Kuvalayananda, S., & Vinekar, S. L. (1963). Yogic Therapy. Lonavla: Kaivalyadhama SMYM Samiti.  Back to cited text no. 4
    
5.
Rains, A. J., & Ritchie, H. D. (1979). Bailey & Love's Short Practice of Surgery. London: ELBS & H.K. LEWIS & Co., Ltd.  Back to cited text no. 5
    
6.
Tiwari, O. P. (2015). Asana: Why & How? Lonavla: Kaivalyadhama SMYM Samiti.  Back to cited text no. 6
    
7.
Wein, A. J. (2007). Campbell-Walsh Urology. (9th ed., Vol. 3). Pennsylvania: Saunders Elsevier.  Back to cited text no. 7
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

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