The prostate is a small, solid gland located at the base of the urinary bladder. It is found only in males and is normally about the size of a walnut. The prostate is wrapped around the urethra, the tube that through which urine and semen moves out of the body.
It is very common for the prostate to enlarge as one grows older. When this happens the urethra is narrowed and urination becomes difficult. Two main conditions can casue an enlarged prostate, namely Benign Prostatic Hyperplasia (BPH) and Prostate cancer. As the name goes, the former is a benign health problem although the symptoms can be difficult to live with. The latter is malignant and luckily less common than BPH.
What are the symptoms of an enlarged prostate?
Whatever the cause, the symptoms of prostate enlargement overlap especially at the initial stages. These are sometimes called lower urinary tract symptoms (LUTS) by the doctor, and they are as follows:
- Irresistible urge to urinate
- Wetting oneself involuntarily with any attempt to suppress the urge
- Hesitancy of urine to flow out
- Having to strain to pass urine
- Having a weak stream of urine
- Intermittent stoppage of urine flow
- Continued leakage of urine after urinating
- Feeling of incomplete bladder emptying
- Having to urinate more often than usual
- Having to get up at night more than once to urinate in the absence of alcohol intake or use of a type of antihypertensive drugs called a diuretic.
If the enlargement is due to a prostate cancer, there could also be bone pains especially in the lower back and thighs when the cancer spreads to these areas.
What treatments are available?
There are several treatments for an enlarged prostate, including herbal products, medicines, and surgery. The treatments depend on the cause of the enlargement and how distressing the symptoms are. If the symptoms are not too worrisome, the doctor may suggest close monitoring without any treatment until it is required.
The doctor has to find out exactly what is causing the prostate to enlarge by asking a lot of relevant questions, doing a proper physical examination and carrying out appropriate tests. An important part of the examination is a digital rectal examination (DRE) which involves the doctor inserting a gloved finger into the rectum and feeling the prostate from behind. The tests are carried out on blood and prostatic tissue samples. The tissues are obtained from biopsy using a special needle passed through the rectum.
When the doctor has tied all his findings together, he can now decide on the diagnosis and the appropriate treatment for it.
Things you can do for yourself
The doctor might suggest some changes to your lifestyle to help relieve your symptoms.
These tips haven’t been proven to be effective, but they might help.
• Avoid drinking large amounts of liquid at any one time.
• Avoid drinks altogether before going to bed.
• Reduce the amount of alcohol intake (alcohol can cause more urine to be produced).
• Cut back on coffee, tea, cola, or any other drinks that contain caffeine (caffeine can stimulate the bladder).
• Show your doctor any medicines you are taking. Some drugs can make your problems with urinating worse.
How do I decide which treatment is right for me?
Your doctor is going to discuss all the treatment options in details to help you make the right decision.
- If your symptoms aren’t bad enough to affect your life, then you may prefer to wait and see what happens.
- You may need to take tablets for a while before you get any results, and after a few years you may need surgery anyway. So if you don’t mind taking them, you may want to give them a try.
- If you however want a quick and permanent solution, then surgery is the best bet.
What will happen to me if I choose not to have treatment?
If BPH is the cause of the prostate enlargement, then the symptoms don’t usually get worse quickly. The deterioration is gradual, so there is usually no need to rush into treatment. This is however not always so. Many men find that their symptoms gradually get worse as they get older. But this is not always the case. Some men find that their symptoms change slowly, and others find that they don’t change at all. Some men even find that their symptoms get better on their own.
Some men can get serious complications from BPH. It can make one suddenly unable to urinate at all even with a full bladder. This is called acute urinary retention, and it needs to be treated urgently.
The outlook is even poorer is the cause of the enlargement is a prostate cancer. It needs a faster intervention so that the cancer can be contained before it spreads. If left untreated, complications such as easy fracture of bones, faecal incontinence and weight loss may arise.
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