What Is The Prostate
The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a mans fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.
Risks Factors Of An Enlarged Prostate
Risk factors for benign prostatic hyperplasia include:
- AgeAs men age, they are more likely to develop BPH. More than half of men over 80 have symptoms from the condition.
- Family history If your father or brother have prostate conditions including BPH, you are more likely to develop the prostate conditions.
- Chronic conditions Chronic conditions such as diabetes and heart disease can increase your risk of developing BPH.
- Obesity Being overweight makes you more likely to develop BPH as you age.
Medications For Prostate Enlargement
Typical medications used to treat prostate issues are Finasteride , dutasteride , and tamsulosin . Finasteride and dutasteride are 5-alpha reductase inhibitors that reduce the amount of the 5-alpha reductase enzyme in the blood. This enzyme converts testosterone in the blood into estrogen. High levels of estrogen exacerbate prostate growth and can result in BPH.;
Men with high estrogen levels also tend to develop breast enlargement . Any man who spends a lot of time at the gym has probably noticed older men with enlarged breasts due to a high estrogen level. Enlarged male breasts are an outward indicator, but BPH is most likely also present inwardly.;
Tamsulosin is an alpha-blocker that works by relaxing the prostate and bladder muscles so that urine flows easier.;
Each of these drugs has a profile of severe sexual side effects. Alpha-blockers can lead to difficulty ejaculating, and 5-alpha reductase inhibitors can destroy libido as well as alter the sensation of orgasm or interfere with erections. For example, in several studies, Finasteride has been shown to increase the risk for men with BPH to develop erectile dysfunction.;
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Treatments Options For High
The prostate is a walnut-sized organ that is part of the male reproductive system. It sits in front the bladder and above the rectum. The prostate is responsible for the production and supply of fluid that helps nourish sperm in the ejaculate. The urethra, where urine travels from the bladder to the penis, runs through the prostate.
As a result of family history, lifestyle, diet, and natural hormonal changes, the prostate begins to grow in size as men age, starting in their mid-30s. When the prostate becomes more enlarged over time, it might press against the urethra and block urine flow . This condition is called benign prostatic hyperplasia, or BPH.
Enlarged prostates differ in size. The size can be estimated on digital rectal exam or prostate imaging like an ultrasound. People with very enlarged prostates have several treatment options. However, size is not the only factor used to choose a treatment.
When doctors evaluate the prostate, symptoms are just as important as size. In addition, size and symptoms don’t always correspond. For example, one person might have a mildly enlarged prostate with noticeable symptoms, while another person could have a very large prostate with no symptoms.
All of this information is the basis of a personalized treatment plan. Here are the options for patients with very enlarged prostates, with or without symptoms.
Diagnosing An Enlarged Prostate
As with all incontinence conditions, a thorough diagnosis must be developed before action can be taken.; You may have heard of some of these exams. And if you havent, now is a good time to familiarize yourself with them. Not only is knowledge power, but it also eliminates surprises.
Because those with BPH can experience symptoms from mild to severe, the treatment options featured here are organized from least invasive to more intense.
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Symptoms Of An Enlarged Prostate
As mentioned above, the most common symptoms of an enlarged prostate are urination problems. Its because the prostate portion surrounding the urethra narrows the normal passage of urine. These problems become worse as the patient gets older.
The progression prolongs which some patients may not even realize. They learn to live with the symptoms and sometimes wont even report them. However, it is crucial to recognize the symptoms of an enlarged prostate and consult your doctor.
Heres a list of the most important symptoms .
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Personal And Family Medical History
Taking a personal and family medical history is one of the first things a health care provider may do to help diagnose benign prostatic hyperplasia. A health care provider may ask a man
- what symptoms are present
- when the symptoms began and how often they occur
- whether he has a history of recurrent UTIs
- what medications he takes, both prescription and over the counter
- how much liquid he typically drinks each day
- whether he consumes caffeine and alcohol
- about his general medical history, including any significant illnesses or surgeries
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have;treatment.
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Prostate Volume And Bph Prevalence: Comparison To Industrial Populations
Compared to TRUS from multiple industrial populations including 1,240 Caucasian German men , 3,924 Caucasian Dutch men , 472 Caucasian Scottish men , and 631 Caucasian U.S. men , the Tsimane have significantly smaller prostate volumes controlling for age and height, and a shallower rate of change with age controlling for height .
The overall age standardized prevalence of BPH among men age 40 80 was 28.4% compared to 60.8% of U.S. men of the same age . For Tsimane men aged 60 80, an age standardized 31.7% presented with BPH, compared with 76.0% of U.S. men aged 60 80 . Only 0.56% of this sample achieved prostate volumes greater than 40 cc compared to approximately 20% of U.S. males .
Tsimane Prevalence of BPH by Age and U.S. Prevalence of Histologic BPH from Berry et al.
Natural Remedies For Enlarged Prostate
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The prostate grows
The prostate is a walnut-shaped gland that wraps around the urethra, the tube that urine flows out of. The prostate is part of the male reproductive system. One of its main jobs, along with other organs, is to add fluid to semen. This is the fluid that carries sperm.
The prostate gland starts out small and has two main phases of growth. It doubles in size during the teenage years, then continues to grow again after age 25 throughout the rest of a mans life.
An excessively enlarged prostate results in a disease known as benign prostatic hyperplasia . Eventually, an enlarged prostate can clamp down on the urethra and restrict the flow of urine from the bladder. This leads to problems such as:
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Blood And Lymphatic Vessels
The prostate receives blood through the inferior vesical artery, internal pudendal artery, and middle rectal arteries. These vessels enter the prostate on its outer posterior surface where it meets the bladder, and travel forward to the apex of the prostate. Both the inferior vesical and the middle rectal arteries often arise together directly from the internal iliac arteries. On entering the bladder, the inferior vesical artery splits into a urethral branch, supplying the urethral prostate; and a capsular branch, which travels around the capsule and has smaller branches which perforate into the prostate.
The veins of the prostate form a network the prostatic venous plexus, primarily around its front and outer surface. This network also receives blood from the deep dorsal vein of the penis, and is connected via branches to the vesical plexus and internal pudendal veins. Veins drain into the vesical and then internal iliac veins.
The lymphatic drainage of the prostate depends on the positioning of the area. Vessels surrounding the vas deferens, some of the vessels in the seminal vesicle, and a vessel from the posterior surface of the prostate drain into the external iliac lymph nodes. Some of the seminal vesicle vessels, prostatic vessels, and vessels from the anterior prostate drain into internal iliac lymph nodes. Vessels of the prostate itself also drain into the obturator and sacral lymph nodes.
Microscopic glands of the prostate
Does Bph Increase Your Risk Of Developing Prostate Cancer
The American Cancer Society recommends that men make an informed decision with their health care provider whether to be screened for prostate cancer. For men at average risk, this discussion should start at age 50. They also say that for men who are at high risk, such as African-American men and men with a family history of prostate cancer, screening should be considered at age 45. Men at an even higher risk, such as having more than one relative with a history of prostate cancer at an early age, should consider earlier testing.
The American Urological Association recommends against routine screening for men age 40 – 54 who have an average risk of prostate cancer. Those with a higher risk are encouraged to discuss prostate cancer screening tests with their doctor. The association recommends that men ages 55 – 69 should weigh the risks and benefits of screening and treatment. For those who choose screening, the AUA suggests that they may be screened every two years rather than annually. Tests used to screen for prostate cancer include a blood test for a substance called prostate-specific antigen and the digital rectal exam . The AUA does not recommend PSA screening in men over age 70 or any man with less than a 10-15-year life expectancy.
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Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
Enlarged Prostate Treatments In The Pipeline
Researchers continue to investigate new therapies for enlarged prostates. “Another category of drugs is under development,” says Slawin. “We’ve come a long way in treating BPH. It’s no longer the life-threatening disease it once was. Now, in treatment, we’re working on quality of life issuesÃ¢â¬Â¦ reducing side effects of treatment.”
Also being studied is a procedure called water-induced thermotherapy , an experimental procedure that involves destroying excess prostate tissue utilizing heated water and an air-filled balloon, which protects normal prostate tissue. The procedure is performed with only local anesthesia. Results may not be fully apparent for three to four months. However, preliminary studies examining WIT have shown positive results, with a near doubling in urine flow. However, the American Urological Association has not thus far endorsed WIT as a viable treatment option for symptoms of BPH.
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Minimally Invasive Treatments For An Enlarged Prostate
When medications don’t help your enlarged prostate, several procedures can relieve symptoms — without surgery. They are performed in a doctor’s office. “These procedures use various types of heat energy to shrink a portion of the prostate,” explains Westney. “They are very effective.”
TUMT : This therapy for mild to moderate blockage reduces urinary frequency, urgency, straining, and intermittent flow — but does not correct any bladder-emptying problems. In this procedure, computer-regulated microwaves are used to heat portions within the prostate to destroy select tissue. A cooling system protects the wall of the urethra during the procedure. TUMT is performed in a doctor’s office and requires only topical anesthesia and pain medications.
Possible side effects include painful urination for several weeks. Temporary urgency and frequency of urination is also possible. There may be less semen ejaculated. Many men must have this procedure repeated, either because symptoms return or do not improve.
TUNA : This procedure also destroys prostate tissue to improve urine flow and relieve symptoms. It involves heating the tissue with high-frequency radiowaves transmitted by needles inserted directly into the prostate . The procedure does not require a hospital stay. Possible side effects include painful, urgent, or frequent urination for a few weeks.
Treatment For An Enlarged Prostate
Treatment for BPH varies depending on the severity of your condition.
Medication options include:
- Alpha blockers help men urinate easier.
- 5-alpha reductase inhibitors5-alpha reductase inhibitors help shrink the prostate.
- Combination drug therapyTaking an alpha blocker and 5-alpha reductase inhibitor together.
- Tadalafil Typically used to treat erectile dysfunction, they can also treat BPH.
Surgical options include:
- ProstatectomyA prostatectomy is a commonly performed procedure that removes part of the prostate. Surgical correction of an enlarged prostate has the largest number of complications, so it should only be considered when other options have failed.
- Transurethral prostatectomy A transurethral prostatectomy is the most commonly used treatment for BPH. During a TURP procedure, the core of the prostate is removed to shrink the prostate. Most men experience symptom relief from this procedure.
- Transurethral incision of the prostate During a transurethral incision of the prostate, your urologist will relieve pressure on the urethra by making small incisions on the prostate gland. Not everyone is a candidate for this procedure.
- Open prostatectomyIf the prostate is very large, your doctor may recommend an open prostatectomy. During an open prostatectomy, large prostatic nodules are removed through the bladder. Complications from an open prostatectomy are common, so this is used as a last resort.
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What Causes Prostate Enlargement
Multiple factors cause prostate enlargement. Documented causes include specific medications, some of which are commonly used for prostate problems, as well dietary issues, disease processes, and hormonal imbalances.;
Nutritional and dietary issues are known to be common causes of BPH. A diet heavily laden with animal fat is one of the most significant causes. Foods known to have high levels of animal fat include red meat and dairy products.
Aside from BPH, a diet high in animal fats is also known for causing cardiac problems and diabetes. Increasing epidemiological evidence suggests that these foods significantly increase the risk of developing BPH.;
How High Is Psa With Bph
PSABPHBPHPSABPHEnlargement of the prostate gland can cause symptoms, for example:
- Dribbling urine.
- Pain or buring during urination.
- Frequent urination.
- Blood in the semen or urine.
- Frequent pain or stiffness in the lower back, hips, pelvic or rectal area, or the upper thighs.
- Urinary incontinence
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Symptoms Of Benign Prostate Enlargement
The;prostate is a small gland, located in the pelvis, between the penis and bladder.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
This can;affect how you pee and may cause: ;
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
In some men, the symptoms are mild and do not need treatment. In others, they can be very troublesome.