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.
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.
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What Are The Symptoms Of Prostate Enlargement
Not every man with an enlarged prostate has symptoms. But when symptoms do occur, they are related to the prostate obstructing the flow of urine through the urethra. This can lead to problems such as:
- Difficulty in starting or stopping urination
- Dribbling of urine after urination has stopped
- A weak urine stream
- Pain in the area between the scrotum and the anus and
- A feeling that the bladder is not empty even after urinating.
Although these symptoms are usually due to an enlarged prostate, they may also be caused by other serious conditions . So men should always see a doctor if they notice changes in the how they urinate, or how often.
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What Causes Prostate Cancer
Identifying a single cause of prostate cancer is difficult in most instances. A host of environmental and lifestyle factors influence the development of prostate cancer on a case-by-case basis.Some men are more prone to developing prostate cancer than others. The known risk factors for prostate cancer are:
- Age. Age is by far the single factor with the most direct correlation to prostate cancer risk. In fact, 80% of prostate cancer patients are 65 and older.
- Family history. If you have a direct relative with prostate cancer, your risk increases. This is due to the proven link between genetics and prostate cancer.
- Ethnicity. The data indicates that African Americans have higher incidences of prostate cancer in the United States and throughout North America.
- Diet. As with all forms of cancer, diet plays a huge role in the likelihood of developing prostate cancer. A healthy, whole-foods based diet delivers the nutrients that your immune system needs to eliminate unhealthy cells that could turn cancerous while tamping down a major risk factor for all cancers.
Androgen/androgen Receptor And Growth Factors
Growth factors play a crucial role in the cross-talk between stromal and epithelial cells. These factors, mainly secreted by stromal cells, act in an autocrine/paracrine manner to maintain prostate cellular homeostasis. In addition, numerous experimental studies support the interdependence between growth factors and the intra-prostatic steroid hormone milieu. Alterations of these interactions can modify the balance between cell proliferation and death leading to the development of BPH.
Insulin like growth factor pathway
An important family of growth factors implicated in the development of BPH is insulin-like growth factors , their receptors and IGF binding-proteins that regulate the availability of the same factors. IGF-II and IGF receptor type I are expressed at higher levels in stromal cells of BPH compared with normal cells these changes are followed by a decrease in the levels of IGFBP-2 and by an increased in the levels of IGFBP-5. Other studies have reported that DHT concentrations and IGF-II activity are higher in the stromal cells of the periurethral tissue in BPH patients compared with normal stromal cells .
Fibroblast growth factor pathway
Transforming growth factor Ã1
How Do You Know If Something Is Wrong With Your Prostate
Others experience discomfort or burning while urinating, blood in the urine or sperm, back, hips, or pelvis pain, and painful ejaculation. Your doctor will inquire about your previous medical issues as well as the medical history of your family to determine whether these symptoms are caused by prostate cancer.
How Is Enlarged Prostate Diagnosed
The first step is a standard physical exam which often involves a urine analysis and a digital rectal exam, which involves a doctor inserting a finger into the rectum. The physician will assess the size and contour of the prostate and determine if any nodules are present, which may suggest the presence of prostate cancer.
The physician may also assess for tenderness, which can be found when the prostate is inflamed. Tests may be done in the office to assess strength of urine flow or to check for residual urine in the bladder.
Next, doctors may run one or several tests to make an accurate diagnosis. These can include a PSA blood test, urodynamic tests , cystoscopy and transrectal ultrasound .
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Drugs That Stop Androgens From Working
For most prostate cancer cells to grow, androgens have to attach to a protein in the prostate cancer cell called an androgen receptor. Anti-androgens are drugs that also connect to these receptors, keeping the androgens from causing tumor growth. Anti-androgens are also sometimes called androgen receptor antagonists.
Drugs of this type include:
They are taken daily as pills.
In the United States, anti-androgens are not often used by themselves:
- An anti-androgen may be added to treatment if orchiectomy or an LHRH agonist or antagonist is no longer working by itself.
- An anti-androgen is also sometimes given for a few weeks when an LHRH agonist is first started to prevent a tumor flare.
- An anti-androgen can also be combined with orchiectomy or an LHRH agonist as first-line hormone therapy. This is called combined androgen blockade . There is still some debate as to whether CAB is more effective in this setting than using orchiectomy or an LHRH agonist alone. If there is a benefit, it appears to be small.
- In some men, if an anti-androgen is no longer working, simply stopping the anti-androgen can cause the cancer to stop growing for a short time. This is called the anti-androgen withdrawal effect, although they are not sure why it happens.
Enzalutamide , apalutamide and darolutamide are newer types of anti-androgens.
These drugs are taken as pills each day.
Benign Prostate Hyperplasia: Role Of Prolactin
The role of PRL in andrology was recently revisited in a review of Maggi and coll., illustrating implications for low PRL concerning reproduction, sexuality, metabolism, and psychological health .
Prolactin is best known for its action on the female mammary gland however, circulating hormone is also detected in males and its receptors are expressed in prostate, hence, prostate is a target of this hormone.
In the study of Wennbo and coll. three lines of PRL transgenic mice were generated having serum levels of PRL of approximately 15, 100, and 250 ng/mL, respectively. These mice developed dramatic enlargement of the prostate gland, approximately 20 times the normal prostate weight .
Although, the physiological role of PRL on prostate and on development on BPH has been studied mainly in animal model, its role is yet unclear. PRL can directly stimulate proliferation and inhibit apoptosis of prostate epithelial cells in a Stat5-mediated manner.
Prolactin action on rodent prostate was not well investigated until the generation of metallothionein PRL transgenic mice, that expressed PRL at systemic level. In this mice model, prostate enlarges significantly, but they have also elevated serum T levels that could mask the real PRL effect on the gland . In Mt PRL mice, after few weeks of PRL overexpression, prostate shows classical features of BPH, such as stromal hyperplasia and focal area of dysplasia , and these changes are independent of androgens levels .
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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.
How Is Enlarged Prostate Treated
Treatments for enlarged prostate include:
Lifestyle changes: These can include reducing liquid intake, bladder training , abstaining from alcohol and caffeinated beverages and regularly exercising the pelvic muscles.
Medication: A class of medication called Alpha Blockers works to relax muscle fibers in the prostate and bladder. This relaxation allows for increased urine flow and less frequent urination. A second class of medication, called Alpha Reductase Inhibitors, works to block the hormones that cause the prostate to swell. Many patients will take a combination of these two types of medication.
Minimally invasive procedures: Our specialists are trained in two minimally invasive procedures that can help remove or reduce the obstructing prostate tissue:
Surgery: For severe cases of a very enlarged prostate, surgical removal of the prostatecalled transurethral resection of the prostate may be the recommended course of action. Patients will decide with their doctor if aggressive treatment is warranted, depending on the size of the prostate and severity of symptoms.
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What The Caregiver Can Do
- Encourage or help the patient with appropriate skin care after using the bathroom. Use warm water and pat the area dry.
- Help the patient keep a diary that records specific foods or drinks that may affect how frequently the patient goes to the bathroom.
- Help the patient maintain a bladder or bowel plan.
- Encourage the patient to go to the bathroom at consistent time frames during the day, like after a meal.
- Encourage regular daily exercise, as permitted by the health care team.
Enlarged Prostate Cause Hemorrhoids
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Large Prostate With Significant Symptoms
For patients who have moderate or severe symptoms that have failed medical therapy from very enlarged prostates, the optimal treatment is often surgery. For very enlarged prostates, there are four main surgical options:
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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Too Much Estrogen Eat These
So, an Enlarged Prostate and Estrogen is the main focus here. Lower Estrogen and you Lower Prostate enlargement. Its that simple. Cortisol creates Estrogen so we can consume the right Supplements and Foods to Shrink the Prostate which lowers Cortisol and Estrogen. Fight off Estrogen Overload by increasing Cruciferous vegetables specifically Broccoli, Spinach, Brussel sprouts and Cauliflower. Collard Greens and Spinach also Helpful. Minimally a few times per week or more.
Your body converts these plants into other compounds allowing a lowering or Diminishing of estrogen activity. There are also Supplements like indole-3-carbinol and Diindolylmethane Or . Although, these ingredients act Very Well However more Effective absorption comes from the Vegetables.
Be sure to get enough vitamin B12, Choline, Betaine and Folate.
If You want Excess Estrogen to be Flushed Out of You then Eggs, Fish, shellfish, Quinoa, Spinach, and Beets are Outstanding Nutritional Sources.
Onions, garlic and scallions are rich in high-sulfur amino acids as well as quercetin. These help your liver flush out excess estrogen. Oregano, thyme, rosemary, sage, and turmeric are also thought to be helpful for this.
Eat plenty of omega-3 fatty acids. These are found in great quantity in fatty fish. Eat fish such as tuna, salmon, herring or sardines at least twice weekly.
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Hormones And Your Prostate Gland
The prostate gland is an essential part of the human male reproductive system. The gland is what produces the seminal fluid which both protects and nourishes the sperm on their way through the ducts of the reproductive system. The prostate is usually only about the size of a walnut and occurs near the bladder and before the penis. Many men have trouble with their prostate glands, particularly when they grow older.
Prostate cancer is actually the most commonly occurring cancer among men with more than 174,000 new cases diagnosed each year in the United States alone. If caught early enough the disease can be well managed, but if not detected in time, the cancer can grow and spread to the bones, eventually leading to death.
This cancer is more common in older men and men who are obese.
Scientists also believe that genetics may play a role in influencing your risk of getting prostate cancer. Screening and early detection is crucial for detection of prostate cancer in men to increase their odds of survival.
Enlarged prostate what are the causes?
Besides prostate cancer, other problems often occur with the gland in men as they age. The condition of benign prostatic hyperplasia occurs in some men. This is when the prostate gland enlarges and occurs most often in men who are older than 40, and even more often in men who are 80 or older.
The condition is not known to be linked to prostate cancer.
Hormones and aging is there a link?
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The Most Common Prostate Problem Among Men Over Age 50 This Condition Can Cause Embarrassing Urination Issues
While BPH does not increase your risk of getting prostate cancer or having sexual problems, it can affect quality of life, specifically by causing annoying and embarrassing urination problems.
Since prostate enlargement happens gradually, men often think more frequent trips to the bathroom are a natural part of aging, says Dr. Howard LeWine, chief medical editor at Harvard Health Publishing and an assistant professor of medicine at Harvard-affiliated Brigham and Womens Hospital. But a little medication can help relieve symptoms, meaning less urinary urgency and fewer nighttime awakenings to use the bathroom.
What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.