Urologic Diseases
Enlarged Prostate

Summary:

The prostate is a part of the male reproductive system, which includes the penis, prostate, seminal vesicles, and testicles.  The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and weighs approximately 20 gm. The prostate gland is composed of muscular tissue, glandular tissue, and a rough fibrous surface. The prostate gland secretes a thick, whitish fluid that helps transport sperm.

Overview:
  • An enlarged prostate gland is a common medical condition that affects men.
  • Its symptoms appear after the age of 50.
  • Treatment of an enlarged prostate depends on the severity of symptoms.
  • Lifestyle changes help treat an enlarged prostate.

What is enlarged prostate? 
An enlarged prostate gland is a common medical condition that affects men as they get older.  An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder.  It can also cause bladder, urinary tract or kidney problems. About 8% of men between the ages of 31 and 40 get enlarged prostate. It also affects about 80% of men in their 80s. 

Other Names:
Benign prostatic hyperplasia (BPH) - Prostate Gland Enlargement 

Cause:
It isn't entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.

Risk Factors:
  • Aging
  • Family history
  • Diabetes and heart disease
  • Obesity

Symptoms:
The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Signs and symptoms of BPH usually appear after the age of 50, and they include:  
  • Difficulty starting urination
  • Frequent or urgent need to urinate
  • Inability to completely empty the bladder
  • Weak urine stream or a stream that stops and starts
  • Dribbling at the end of urination
  • In rare cases, if the condition is left untreated, it can cause urinary retention. This can make you unable to empty your bladder.

When to see a doctor?
  • Inability to urinate
  • A painful, frequent, urgent need to urinate, with a shiver, and a high body temperature 
  • Bloody urine
  • Severe discomfort or pain in the lower abdomen

Complications:
  • Frequent urinary tract infections (UTIs)
  • Severe urinary retention
  • Bladder stones
  • Bloody urine
  • Renal insufficiency
  • Bladder damage 

Diagnosis:
Your doctor will start by asking detailed questions about your symptoms and family history, and doing a physical exam. Exams are likely to include:
  • Digital rectal exam
  • Urine test
  • Blood test

Treatment:
Some people with mild prostatitis may not need treatment, while others may need:
  • Some medicines, such as: 
    • Alpha blockers: These medications relax bladder neck muscles and muscle fibers in the prostate, making urination easier.
    • 5-alpha reductase inhibitors: These medications shrink your prostate or result in a prostate growth. 
  • Some doctors prescribe medications to treat erectile dysfunction. 
  • Catheterization and surgery in some cases in patients with: 
    • Renal insufficiency
    • Urinary retention
    • Frequent urinary tract infections (UTIs).
    • Frequent bladder stones 
  • Patients who do not respond to treatment, or who do not wish to use other treatments, should change their lifestyle by doing the following:  
    • Patients with an enlarged prostate should avoid medications that can worsen their symptoms or cause urinary retention. These include: Some antihistamines (e.g., diphenhydramine (benadryl)) and decongestants (e.g., Pseudoephedrine, found in some cold medicines).
    • Limit beverages in the evening, especially before bedtime or when leaving the house.
    • Reduce drinking beverages that could increase the urge to urinate (e.g Caffeine). 
    • Urinate — and then urinate again a few moments later. This practice is known as double voiding.

FAQ:
  • Does prostate enlargement affect fertility?
    • An enlarged prostate can lead to problems with transporting sperm. An enlarged prostate can put pressure on the ejaculatory ducts, preventing the formation of semen.
  • Does prostate enlargement affect sex life?
    • An enlarged prostate itself does not cause erectile dysfunction; however, some of the medications to treat the condition may result in erectile dysfunction. But there are other medications available that do not cause this side effect. On the other hand, surgical removal of the prostate can cause erectile dysfunction in some men.

Myths & Truths
  • Myth: An enlarged prostate increases the risk of prostate cancer. 
    • Truth: Truth: There is no correlation between the two things. 

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Last Update : 26 September 2021 05:21 AM
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