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.
Surgical Treatment For Enlarged Prostate
Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
Open prostatectomy .The surgeon makes an incision and removes the enlarged tissue from the prostate.
Laser surgery –Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
Transurethral incision of the prostate .This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostate’s pressure on the urethra, making urination easier.
Prognosis For Prostate Cancer
It is not possible for a doctor to predict the exact course of a disease, as it will depend on each persons individual circumstances. However, your doctor may give you a prognosis, the likely outcome of the disease, based on the type of prostate cancer you have, the test results, the rate of tumour growth, as well as your age, fitness and medical history.
Prostate cancer often grows slowly and even more aggressive types tend to grow more slowly than other types of cancer. If diagnosed early, prostate cancer has one of the highest five year survival rates.
When To See A Doctor
If you don’t see a reduction in symptoms or if your symptoms worsen, you may need to undergo a different treatment plan.
The first higher-level treatment is to begin taking prescription drugs for an enlarged prostate. One class of medication is an alpha blocker. These medications, such as Flomax, Rapaflo, and Cardura, work by relaxing the affected muscles around the prostate to encourage urine flow.
Another type of medication is a 5-alpha reductase inhibitor. Examples of these medications include Proscar and Avodart, which are long-term medications that help to block the production of dihydrotestosterone and shrink the size of the prostate.
Surgery and Minimally Invasive Procedures
For moderate to severe BPH, you may need a medical procedure to relieve your symptoms. There are a variety of procedures, including laser therapy, microwave heat, or prostate tissue compression. Partial prostate removal and full removal are more invasive but may be necessary for extremely large prostate glands.
Conditions Prostate Massage Might Help
Although studies are limited, prostate massage may be helpful in some medical situations and with some health conditions.
A doctor might do a prostate massage to diagnose the condition. They can test the fluid that comes from your prostate ducts to see whatâs causing the problem.
Although the most common treatments for prostatitis are antibiotics and non-steroidal anti-inflammatory drugs , prostate massage is another option. It can help ease pressure and swelling by releasing fluids that build up in the prostate. Small studies have found that massaging the area several times a week — along with taking antibiotics — can give relief from pain and pressure.
Diagnosing a Medical Condition
Sometimes a doctor might do a prostate massage during a prostate exam. The purpose is to get some fluid to examine under a microscope to look for signs of an infection or other problem.
The main treatments for erectile dysfunction include medications, pumps, shots, and implants. Lifestyle changes that can help treat the condition include getting more exercise, eating a healthy diet, and doing pelvic floor exercises. Some men say they’ve had increased sexual pleasure and are able to ejaculate more easily with prostate massage, though there isnât scientific proof to back up those claims.
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Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesn’t do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications aren’t developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
What Is The Prognosis For People Who Have Prostate Cancer
Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.
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Turp / Greenlight Pvp Laser / Thermotherapy
Transurethral resection of the prostate has long been the mainstay of enlarged prostate surgery, but less invasive alternatives are now available, with the potential for equal results. With TURP, the obstructing portion of the enlarged prostate tissue is removed. Although effective, TURP requires hospitalization and catheterization for 48 hours or more and comes with risks associated with anesthesia bleeding during and after the operation and, in rare cases, fluid absorption that can be life-threatening.
Prostate LaserOne alternative that has emerged is laser enlarged prostate surgery. Like TURP, the so-called GreenLight PVP Laser Therapy aims to create a channel in the urethra through which men can urinate more freely but the surgery is considerably less invasive. Instead of cutting tissue out, the newer technique creates the channel by vaporizing the tissue using laser energy. Thus far, almost every study has shown that when done by experienced urologists, the laser enlarged prostate surgery produces results that are equal to those with TURP, but without the severe side effects and risks. It is an outpatient procedure with minimal to no bleeding, no risk of fluid absorption, and catheterization only overnight, if at all.
How Is Benign Prostatic Hyperplasia Treated
Patients who have mild symptoms may not require treatment other than continued observation to make sure their condition doesn’t get worse. This approach is sometimes called “watchful waiting” or surveillance. There are a number of treatment options available if your symptoms are severe.
Finasteride and dutasteride work by decreasing the production of the hormone dihydrotestosterone , which affects the growth of the prostate gland. These appear to be most beneficial for men with larger prostates.
Drugs that relax the muscle in the prostate are more commonly used. These include terazosin , doxazosin , tamsulosin , alfuzosin , and silodosin . The most common side effects are lightheadedness, weakness and retrograde ejaculation.
Medications are sometimes combined to help treat symptoms and improve the flow of urine. One such medication is dutasteride and tamsulosin .
Several different types of surgery can be used to remove the prostate tissue that blocks the flow of urine, including:
Minimally invasive treatments
Minimally invasive treatments include:
Last reviewed by a Cleveland Clinic medical professional on 03/10/2020.
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What Are Prostate Cancer Treatment Side Effects
Some prostate cancer treatments can affect the bladder, erectile nerves and sphincter muscle, which controls urination. Potential problems include:
- Incontinence: Some men experience urinary incontinence. You may leak urine when you cough or laugh, or you may feel an urgent need to use the bathroom even when your bladder isnt full. This problem can improve over the first six to 12 months without treatment.
- Erectile dysfunction : Surgery, radiation and other treatments can damage the erectile nerves and affect your ability to get or maintain an erection. Some men regain erectile function within a year or two . In the meantime, medications like sildenafil or tadalafil can help by increasing blood flow to the penis.
- Infertility: Treatments can affect your ability to produce or ejaculate sperm, resulting in male infertility. If you think you might want children in the future, you can preserve sperm in a sperm bank before you start treatments. After treatments, you may undergo sperm extraction. This procedure involves removing sperm directly from testicular tissue and implanting it into a womans uterus.
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What Are The Symptoms Of Benign Prostatic Hyperplasia
Since the prostate gland surrounds the urethra , it is easy to understand that enlargement of the prostate can lead to blockage of the tube. Therefore, you may develop:
- Slowness or dribbling of your urinary stream.
- Hesitancy or difficulty starting to urinate.
- Frequent urination.
- Feeling of urgency .
- Need to get up at night to urinate.
- Pain after ejaculation or while urinating.
- Urine that looks or smells “funny” .
The enlargement of the prostate can lead to blockage of the urethra.
As symptoms get worse, you may develop:
- Damage to your kidneys from back pressure caused by retaining large amounts of extra urine in the bladder.
If you have any of these symptoms, see your doctor right away:
- Pain in the area of the lower abdomen or genitals while urinating.
- Cant urinate at all.
- Pain, fever and/or chills while urinating.
- Blood in the urine.
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Other Points To Consider With Enlarged Prostate
Need for repeat procedures: With minimally invasive procedures for an enlarged prostate, there is a chance you will need to have a repeat procedure later on. Having the procedure when you’re young makes that a near certainty. However, that may be a risk you’re willing to take — to avoid surgery in the short term.
Side effects of treatments: Some BPH treatments cause erection problems, although that risk is low. Men who have normal erections before surgery will not likely have trouble afterward. Some treatments cause retrograde ejaculation . Fertility can also be affected, but is still possible with newer assisted reproductive techniques.
Multiple health problems: If you have other health problems, especially if you are on an anticoagulant and cannot stop taking this medication, your treatment options for enlarged prostate may be affected. For example, if you have had surgery for obstructive sleep apnea or pulmonary surgery in the past, having surgery with general anesthesia may be too risky. However, spinal anesthesia may be an option for you. Or you may wish to have a minimally invasive office procedure that doesn’t require anesthesia at all.
Talk to your doctor about your BPH symptom score, your concerns, and about the plan of treatment that works best for you.
What Is The Prostate Gland For
Approximately the size of a walnut, the healthy prostate produces the fluid that comprises semen. It is located under the bladder, in front of the anus. It is crossed by the canal of the urethra, which leaves urine throughout urination and carries the semen throughout ejaculation. This position describes the urinary problems related to prostate pathologies: benign prostatic hyperplasia %2C,or%20loss%20of%20bladder%20control.” rel=”nofollow”> BPH) or prostate adenoma, prostatitis and cancer. These pathologies vary in incidence according to age.
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Men: Cancer Screening Exams By Age
These exams are for men at average risk of cancer.
Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.
These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.
- Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year to check for prostate cancer
- Colonoscopy every 10 years or virtual colonoscopy every 5 years to check for colorectal cancer
Age 76 and older
If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.
Regardless of your age, practice awareness. This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.
Enlarged Prostate Many Options To Treat This Common Problem
ROCHESTER, Minn. More than half of men in their 60s experience symptoms caused by an enlarged prostate gland. Add another decade or two, and nearly all men experience symptoms that may include a weak urine stream, difficulty starting urination, stopping and starting while urinating, and an urgent need to urinate.
The July issue of Mayo Clinic Health Letter covers how the prostate gland changes with age and ways to find relief for what’s technically termed benign prostatic hyperplasia.
The prostate gland is just below the bladder and surrounds the urethra through which urine passes out of the body. After puberty, the prostate gland is about the size of a walnut. As men age, the prostate gland can increase in size, pressing on the urethra and interfering with urine flow.
Men with mildly enlarged prostate glands and mild symptoms may not need immediate treatment. Studies have shown that up to one-third of mild cases clear up without treatment.
When treatment is needed, the focus is on reducing troubling symptoms and restoring normal urinary tract function. Several medication options are available for men with mild-to-moderate symptoms. Therapies include:
Alpha blockers: These drugs relax the bladder neck muscles and muscle fibers in the prostate. They help increase urine flow and reduce the need to urinate as often. Medications in this category are terazosin, doxazosin, tamsulosin, alfuzosin and silodosin.
Surgery options include:
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When To Get A Prostate Cancer Screening
A prostate screening can help your doctor find prostate cancer early, but youll need to decide if the benefits of the exam outweigh the risks. Have a discussion with your doctor about prostate cancer screenings.
The U.S. Preventive Services Task Force now recommends that men ages 55 to 69 decide for themselves whether to undergo a prostate-specific antigen screening test, after talking it over with their doctor.
They recommend against screening for men at or above the age of 70.
The American Cancer Society strongly recommends that no one be screened without discussion of the uncertainties, risks, and potential benefits of prostate cancer screening.
They give these specific recommendations for the date at which these discussions with a healthcare provider should take place:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
You should also speak with your doctor about a prostate exam if youre experiencing symptoms of a prostate problem, such as frequent or painful urination or blood in your urine.
After this discussion, if you decide to get a prostate cancer screening, the ACS and the American Urologic Association recommend getting a prostate-specific antigen blood test.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is a condition in which the prostate, a walnut-sized body part made of glandular and muscular tissue, grows in size. The prostate surrounds part of the urethra, which is the tube that carries urine and sperm out of the body. The benign condition is also called benign prostatic enlargement .
The prostate is located directly beneath the bladder and in front of the rectum. The urethra passes through the prostate, so if the prostate becomes enlarged, it can keep urine or semen from passing through the urethra.
The main function of the prostate is to produce fluid for the semen, the milky fluid in which sperm swims. Sperm is produced in the testicles, which also make the main male hormone testosterone. During puberty, testosterone stimulates the growth and function of the prostate, and helps with the production of fluid for semen.
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The Prostate An Organ Linked To Virility
For most guys, the prostate is an organ associated with the worths of youth, potency, fertility, sexuality and satisfaction. Discussing it to your doctor is a false admission of the end of the golden era of seduction. Men have the impression that family doctors feel defenseless and do not spontaneously broach the topic throughout the assessment.This appears to discuss the passivity of the male public towards this genital gland. As a result, there is a lack of awareness of the guidelines that need to be put in place to safeguard it, and spontaneous and specific early detection develops too slowly.