Using Medication To Reduce Symptoms
What Is The Gleason Score
So, how do you know where your biopsy stands? Your biopsy samples will be assigned whats called a Gleason score, the most commonly used way to grade prostate cancer, which will help your doctor make treatment decisions.
It works like this:
Your doctor compares each of the tissue samples taken during your biopsy to normal, healthy prostate tissue.
He or she gives each sample a score, or grade, ranging from 3 to 5.
The more abnormal your cells, the higher your grade. A 5 represents the most aggressive cancer.
Once each sample has been graded, your doctor then takes the two most common scores from all the samples and add them together. These two numbers are then weighted for prevalence. This is your Gleason Score, which can range from 6 to 10, with 10 being the most aggressive cancer.
To make it super clear, lets walk you through an example.
Lets say a man has a biopsy in which 12 tissue samples are removed from his prostate.
After careful study in a lab, each tissue receives a score. Eight of the tissue samples score a 3, while the other four samples each receive a 4.
His doctor then writes the two most common scores, 3 and 4, as the final score: 3+4=7. He writes 3 first because more of the slides were graded as a 3, thus giving these readings more significance.
Remedies For An Enlarged Prostate
Even if you have an enlarged prostate, that does not mean you must live with the symptoms for the rest of your life. Your doctor might advise one of several approaches to coping with BPH, including lifestyle changes, medication changes, and other treatments. The remedies and treatments available will depend on your own health situation and how disruptive the symptoms have become.
Get Sufficient Exercise
Exercise can improve with your overall fitness, as well as benefit your prostate health. Studies have shown a connection between increased physical activity and reduced risk of BPH, with exercise of any type having some degree of benefit.
Seated activities, such cycling, can put pressure on the perineum and groin. This can lead to numbness or pinched nerves. To avoid these issues, make sure you utilize a wide seat and engage in a variety of activity types.
You can also try Kegel exercises to strengthen your pelvic muscles and reduce urine dribbling. To do these exercises, squeeze the muscles that affect urine flow and then release, repeating several times to train the muscles.
When you head to the bathroom, make sure you slow down. When you relax your muscles and leave time to account for delayed urine and possible dribbling, you’re much more likely to completely empty your bladder. Urine that remains in the bladder because of an enlarged prostate can lead to urinary tract infections or painful bladder stones.
Reduce Caffeine and Alcohol Consumption
/6what Causes Prostate Enlargement
The prostate continues to grow as a man ages, which is why older men tend to have larger prostates than younger men.
Non-cancerous enlargement of the prostate is called benign prostatic hyperplasia .
BPH is very common. It can cause bothersome lower urinary tract symptoms such as the frequent urge to urinate, getting up at night to urinate, difficulty in urinating, and dribbling of urine at the end of urination.
Mediclinic Welcare Hospital Is The First In The Uae To Offer Itind Procedure For Enlarged Prostate
The iTind is a temporarily implanted device which delivers rapid and effective relief
Mediclinic Welcare Hospital has become the first hospital in the MENA region to offer iTind an advanced and minimally invasive procedure for the enlarged prostate.
Benign prostatic hyperplasia, or BPH, is a noncancerous enlargement of the prostate gland, and the most common benign tumor found in men. This causes the prostate to press against the urethra, causing chronic and sometimes troublesome lower urinary tract symptoms that can severely affect your quality of life. If a man has been diagnosed with an enlarged prostate due to BPH, it is important to be monitored by a urologist. If left untreated, BPH can affect erectile function and libido and can lead to urinary tract infections , stones in the bladder and kidney damage.
Dr. Salam Alhasani, Consultant Urologist at Mediclinic Welcare Hospital, is one of the first urologists not only in the UAE but in the entire MENA region, to offer iTind for the treatment of an enlarged prostate to his patients. Three of his carefully selected patients have already had procedures completed.
One of the patients that were eligible for the procedure was Abbas Khelkhali.
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Treating An Enlarged Prostate
Benign prostatic hyperplasia is a highly treatable condition. Treatments include medications, lifestyle changes and surgery. An alternative, nonsurgical treatment for BPH that is fast gaining popularity is prostate artery embolization . This relatively new procedure doesn’t involve surgery, therefore reducing your recovery time.
PAE is an outpatient procedure, meaning you can go home shortly after it has been performed. A hospital stay isn’t required. The technique blocks off arteries that feed the prostate, which causes it to shrink.
PAE works by inserting a small catheter into these arteries and then injecting thousands of microscopic plastic beads that safely restrict blood flow to the gland. As the prostate shrinks, it takes pressure off the bladder, which allows urine to flow normally. Even though the prostate gets smaller, there is no negative impact on sexual function.
PAE takes about two hours to perform and is not painful. Therefore, a general anesthetic is not needed. Recovery takes a few days of rest at home.
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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What Are The Treatment Options For Prostate Enlargement
Enlarged Prostate Management Options
Each treatment option for an enlarged prostate has various benefits, risks and consequences. In collaboration with health.org.uk, we’ve put together a summary decision aid that encourages patients and doctors to discuss and assess what’s available.
No treatment is likely to clear all symptoms totally, although symptoms can usually be greatly improved with treatment. The treatments considered usually depend on how severe and bothersome your symptoms are.
What Are The Warning Signs Of Benign Prostatic Hyperplasia
Your prostate surrounds your urethra. When BPH causes your prostate to grow, it can cause blockage in your urethra. As a result, early symptoms of BPH include:
- Slowness or dribbling when you pee.
- Difficulty starting to pee.
- Kidney damage due to pee backflow from your bladder up to your kidney. The pee backflow increases pressure on your kidney.
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Using Pads Or A Sheath
Absorbent pads and pants can be worn inside your underwear, or may replace your underwear altogether. These will soak up any leaks.
Urinary sheaths can also help with dribbling. They look like condoms with a tube coming out of the end. The tube connects to a bag that you can strap to your leg under your clothing.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is a condition in which your prostate grows in size.
Your prostate is a gland that rests below your bladder and in front of your rectum. Its about the size of a walnut, and it surrounds part of your urethra.
Your urethra is a tube that carries urine and sperm out of your body.
BPH isnt cancerous. However, symptoms of BPH may indicate more serious conditions, including prostate cancer.
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When To Contact A Medical Professional
Contact your provider right away if you have:
- Less urine than usual
- Back, side, or abdominal pain
- Blood or pus in your urine
Also contact your provider if:
- Your bladder does not feel completely empty after you urinate.
- You take medicines that may cause urinary problems, such as diuretics, antihistamines, antidepressants, or sedatives. DO NOT stop or change your medicines without talking to your provider.
- You have tried self-care steps for 2 months and symptoms have not improved.
Assessing The Symptoms Of An Enlarged Prostate
To help your doctor understand how bothersome enlarged prostate symptoms are for you, the American Urological Association has developed a BPH Symptom Index. This is a brief questionnaire that asks about specific symptoms and how frequently they occur. Each answer is assigned a number — and your total is ranked on a scale ranging from mild to severe.
A score of 0 to 7 is considered a mild symptom score 8 or over is considered moderate to severe.
The AUA recommends the following treatment for an enlarged prostate based on the severity of symptoms:
- Mild symptoms that don’t bother you : If you are not bothered by your symptoms, and they don’t affect your daily life, watchful waiting is the best option for you. You should get regular checkups to make sure that you are not developing complications.
- Moderate to severe symptoms : If you are not bothered by your symptoms, you may choose watchful waiting. However, if your symptoms do start to interfere, you may choose medication, a minimally invasive procedure, or surgery.
- Moderate to severe symptoms with complications: If symptoms are bothersome and you have developed complications such as inability to urinate, you may need a catheter, surgery, or other treatment.
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Medication And Surgical Treatments
You can also take dutasteride or finasteride , a different kind of medication for reducing BPH symptoms. These block the hormones that cause the prostate to grow.
Combining several types of medications may also be recommended. Your doctor might also recommend surgery to remove the extra prostate tissue. One common surgical procedure for BPH is known as transurethral resection of the prostate .
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
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How Is Benign Prostatic Hyperplasia Diagnosed
Your healthcare provider will review your medical history, ask you questions and perform a physical examination. Part of the physical exam involves a digital rectal exam.
During a digital rectal exam, your healthcare provider will carefully insert their gloved digit into your rectum. Theyll feel the edges and surface of your prostate, estimate the size of your prostate and detect any hard areas that could be cancer.
Your healthcare provider may also order:
- A survey to evaluate the severity of your symptoms.
- A urine flow test to measure the speed of your pee stream.
- A study to detect how much pee remains in your bladder after youve finished peeing.
- A cystoscopy to look into your bladder.
Treating Benign Prostate Enlargement
Treatment for an enlarged prostate is determined by the severity of your symptoms.
If you have mild to moderate symptoms, you won’t receive any immediate medical treatment, but you’ll have regular check-ups to carefully monitor your prostate.
As well as lifestyle changes, medication is usually recommended to treat moderate to severe symptoms of benign prostate enlargement. Finasteride and dutasteride are medications that are commonly used. They block the effects of a hormone called dihydrotestosterone on the prostate gland, which can reduce the size of the prostate and improve associated symptoms.
Alpha blockers may also be prescribed. They help to relax your bladder muscles, making it easier to pass urine. Tamsulosin and alfuzosin are two alpha blockers commonly used to treat benign prostate enlargement.
Surgery is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication.
Read more about treating benign prostate enlargement
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Does Having Benign Prostatic Hyperplasia Increase The Risk Of Prostate Cancer
Research shows that having BPH doesnt increase your risk of developing prostate cancer. However, BPH and prostate cancer have similar symptoms. If you have BPH, you may have undetected prostate cancer at the same time.
To help detect prostate cancer in its early stages, every person with a prostate should get a prostate screening every year between the ages of 55 and 69. You have an increased risk of getting prostate cancer if youre Black or have a family history of prostate cancer. If you have an increased risk of prostate cancer, you should start getting prostate screenings at age 40.
How Can I Reduce My Risk Of Developing Benign Prostatic Hyperplasia
The best ways to reduce your risk of developing BPH are to make lifestyle changes that improve your prostate and heart health and take supplements.
Exercising at least 30 minutes each day may help prevent BPH or slow prostate growth. Maintaining normal cholesterol, blood pressure and blood sugar levels is also important.
The following herbal supplements may also help reduce your risk of developing BPH:
- Beta-sitosterol. Beta-sitosterol is a micronutrient in plants that may help keep your heart healthy.
- Pygeum africanum. Pygeum africanum is an herbal extract from African cherry tree bark that may help shrink your prostate.
- Flaxseed. Flax is a good source of dietary fiber and omega-3 fatty acids that may help lower your cholesterol.
- Pumpkin seed oil. Pumpkin seed oil comes from pumpkin seeds. It may help shrink your prostate.
Talk to your healthcare provider before taking any new supplements. They may adversely react to other supplements or medications youre currently taking.
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What Are The Possible Complications
Urinary symptoms do not worsen in everyone. Serious complications are unlikely to occur in most men with an enlarged prostate. Complications that sometimes occur include:
- In some cases, a total blockage of urine occurs so you will no longer be able to pass urine. This is called urinary retention. It can be very uncomfortable and you will need to have a small tube inserted to drain the bladder. It occurs in less than 1 in 100 men with an enlarged prostate each year. See the separate leaflet called Urinary Retention.
- In some cases, only some of the urine in the bladder is emptied when you pass urine. Some urine remains in the bladder at all times. This ongoing condition is called chronic retention. This may cause repeated urine infections, or incontinence .
Note: the risk of prostate cancer is not increased. Men with a benign prostate enlargement are no more or less likely to develop prostate cancer than those without benign prostate enlargement.
How Is Bph Treated
In some cases, in particular where symptoms are mild, BPH requires no treatment. At the opposite extreme, some men require immediate intervention if they cannot urinate at all or if kidney/bladder damage has occurred. When treatment is necessary, many men will simply require daily medication. If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend minimally invasive endoscopic surgery . Or, in some cases, traditional surgery may be recommended.
- Drug treatment: The FDA has approved several drugs to relieve common symptoms associated with an enlarged prostate, including drugs that inhibit the production of the hormone DHT and drugs that relax the smooth muscle of the prostate and bladder neck to improve urine flow.
For surgery, there are many procedures to choose from, and the choice depends largely on your specific prostate anatomy, and surgeon preference and training. These procedures all have a common goal of widening the urethral channel as it passes through the prostate. Procedures include the following:
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