Enlarged Prostate
The male reproductive gland known as the prostate creates the medium in which sperm travels during ejaculation. This fluid is essential in the reproductive process. An enlarged prostate can cause men to have a difficult time passing urine because of the location of the gland. During urination the urethra carries the urine from the bladder. The prostate surrounds the urethra and can cause difficulties in men with the condition.
As men age they run the risk of having an enlarged prostate. This can cause serious discomfort as the gland grows and presses down on the urethra. This can result in bladder problems as well as problems passing urine. To the relief of the man suffering from an enlarged prostate the condition is known to be troublesome, but benign. This condition is known as BPH or benign prostatic hypertrophy. BPH is not cancerous nor does it raise your risk for prostate cancer.
Causes of Enlarged Prostate
While the cause of BPH is still unknown, risk factors that correlate with an enlarged prostate are simply aging and having testicles. It has been observed that having your testicles removed at a young age will eliminate any risk of developing the condition. However, if the testicles are removed after the onset of BPH, the size of the gland will reduce and so will the accompanying symptoms.
Facts
The facts about enlarged prostates are not as widely known as they should be. For instance, the chances for developing an enlarged prostate increases with age. In fact, it is reported that if a mans lifespan is long enough he will most certainly develop BPH. Men over the age of 40 are less likely to suffer from an enlarged prostate than a man over the age of 80. Once a man has reached the age of 80 his likelihood of developing an enlarged prostate is more than 90%. Other than age, no other risk factors, other than having testicles have been found to cause BPH.
Symptoms of Enlarged Prostate
The symptoms of BPH only present themselves in less than half of men who have the condition. Symptoms include dribbling at the end of urination, the inability to pass urine, not being able to completely empty the bladder, incontinence and the urge to urinate two or more times during the night. Other symptoms of BPH are pain while urinating, blood in the urine and a delayed start of the urinary stream. Most men report having to strain while trying to pass urine as well as strong sudden urges to urinate accompanied by a weak stream.
Tests
If BPH is suspected, a complete medical history will be done by your doctor. Along with the medical history there are other tests a he or she may want to perform in order to confirm the diagnosis. A digital rectal exam may be ordered as well as a test to rate the speed of urination. To check for the inability to completely empty the bladder a post-void residual urine test can be used to measure the amount or urine left in the bladder after urination. A urinalysis will be preformed to check for infection and blood in the urine. A blood test may also be ordered to test for prostate cancer. In addition to the tests your doctor may want a form filled out that will record your current symptoms and test results. This will help keep track of the rate of which an enlarged prostate is growing. The form will document the severity of the symptoms and the impact they have on an individual’s daily life.
Treatment of Enlarged Prostate
Treatment is available for an enlarged prostate. The treatments are given in correlation to the severity of the symptoms, the effect on daily life and any other current medical conditions. The treatment options include lifestyle changes, medication or surgery.
Men over the age of 60 are more likely to have symptoms of BPH. Yet, most men will not notice any symptoms of an enlarged prostate until much later. Having yearly exams to check for and record the progression of BPH are highly recommended. Along with professional medical treatment and prevention, there are steps men can take for self care of the symptoms. If minor symptoms are experienced be sure to pass urine each time the urge presents and even if it doesn’t. Avoiding things like caffeine and alcohol can help mange minor symptoms. Also, drinking small amounts of fluid thought the day and avoiding fluids two hours before bedtime will help. Taking over the counter antihistamines and decongestants can increase the symptoms of BPH. Regular exercise and performing pelvic strengthening exercises called kegals can help. As does keeping warm and avoiding stress.
Medications
Medications that are prescribed to help patients with an enlarged prostate are called Alpha 1-blockers. These include doxazosin, prazosin, tamsulosin, terazosin, and afluzosin. These medications are also known for the treatment of high blood pressure and tend to relax the muscles of the bladder, neck and prostate. Finasteride and dutasteride are lower levels of hormones produced by the prostate. They will reduce the size of the gland and increase urine flow. However, it can take 3-6 months on the medication until the patient notices any relief.
Side effects of these hormones are impotence or decreased sex drive. Antibiotics have been found to relieve BPH symptoms in some cases. Herbal treatments have also been sought out for the treatment of BPH. The herb saw palmetto has been used to ease symptoms by millions of men. There is no scientific evidence that the herbal treatments help ease BPH.
Surgery
Surgery is an option for men who suffer from incontinence, the reoccurring symptoms of bloody urine and the reoccurring urinary tract infections. Other symptoms that need immediate treatment are kidney failure and bladder stones. The surgery option is based on the symptoms and the prostate itself. Transurethral resection of the prostate (TURP) is the most common surgery for BPH. This is done by inserting a scope into the penis and removing prostate a piece at a time. Transurethral incision of the prostate (TUIP) is similar to TURP, but is recommended for men with smaller prostates. This is an out patient procedure that uses a scope inserted into the penis. Then, a small incision is made in the gland in order to enlarge the urethra’s opening. A prostatectomy is performed under general anesthesia and is considered a lengthy procedure. An incision is made either in the abdomen or behind the scrotum. Then, the interior of the prostate gland is removed leaving behind the outer part. This procedure will require a five to ten day hospital stay.
If surgery seems to invasive, then less invasive procedures are available. It has been found that using heat procedures have the potential to destroy the prostate gland tissues. The different forms of heat used during these procedures are radio frequency energy, microwave energy, electrical currents, hot water and lasers. These heat treatments have not been proven to be better than the traditional surgical procedures in scientific study. If the less evasive procedure has been chosen it is common to need to repeat the treatment after five to ten years of the original treatment. The less invasive procedures are recommended mostly for younger men, but are chosen by some elderly patients as well. Older men with other severe medical conditions such as diabetics or who are taking blood thinners are usually advised to consider the less invasive heat treatments first.
One of the newer techniques used for the treatment of an enlarged prostate is a robot guided prostatectomy. This treatment is not widely available and because of this it can be hard to find a surgeon with the proper experience to do the technique. As with most new medical treatments there are no long term studies of this procedure.
There are support groups for men who suffer from enlarged prostates these groups are also there to support the families of men with BPH. These support groups are good ways for patients to talk about any fears or experiences they have associated with this condition. It can also be a good place to receive encouragement and advice from others who have tried the procedures the patent is considering.
There are some possible complications to men with enlarged prostates. The sudden inability to pass urine, urinary tract infections, urinary stones, kidney damage and blood present in the urine are some possible side effects of BPH. Unfortunately, BPH may return even after under going surgery.
It is a good idea to contact a medical professional right away if you experience any of the following symptoms. A reduction in the amount of urine passed, fever or chills and pain in the back, side or abdomen. If you notice blood or pus in your urine call the doctor immediately. Make sure to tell your doctor about any inability to fully empty the bladder or if there are any medications being taken that could cause urinary issues. These include diuretics, antihistamines, antidepressants, or sedatives. If you suspect that these medications are causing or worsening BPH seek medical advice before reducing dosage or stopping the medication.