Monday, December 4, 2023

What Size Is A Large Prostate

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Possible Cancer Protection From Prostate Drugs

Does Your Prostate Size Matter? | Mark Moyad, MD MPH & Mark Scholz, MD at the PCRI Conference 2019

Early research suggested that 5-alpha-reductase inhibitors , a class of drugs used to treat prostate enlargement, might increase the risk of developing more aggressive prostate cancer. However, newer studies have found that not only do the drugs appear to pose no extra risk, they may even protect against prostate cancer.

For instance, research from the Prostate Cancer Prevention Trial study in 2013 showed that taking the 5-ARI finasteride for seven years could lower the chance of getting low-grade prostate cancer by 25% among men ages 55 and older. A follow-up study of almost 9,500 men, published in the Nov. 1, 2018, issue of the Journal of the National Cancer Institute, also showed that finasteride lowered the risk by a similar amount , and found the protective effect lasted for at least 16 years.

Is Treatment Always Necessary

No. In most cases, an enlarged prostate does not do any damage or cause complications. Whether treatment is needed usually depends on how much bother the symptoms cause. For example, you may be glad for some treatment if you are woken six times a night, every night, with an urgent need to go to the toilet. On the other hand, slight hesitancy when you go to the toilet and getting up once a night to pass urine may cause little problem and not need treatment.

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.

Tsimane .

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When Should You Call A Doctor For Bph

Urinary symptoms related to enlarging prostate initially affect the quality of life, and if no complications exist, as mentioned above , the decision to treat is optional and is left to the patient. This means that if you don’t feel bothered enough to take a medicine or undergo a procedure for it, you’ll need to follow up with your doctor to ensure the symptoms are stable, and the bladder empties well. This can be assessed by prostate symptom questionnaires and a measure of the strength of the urinary stream and residual urine in the bladder. If complications develop, however, or if the bladder starts holding increasing amounts of residual urine after urination, treatment should be started.

If you experience bladder pain or burning with urination, blood in the urine associated with fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospital’s emergency department.

For acute symptoms such as acute urinary retention , you should immediately go to the closest emergency medical facility for bladder drainage, usually with a catheter, which is a tube inserted into the bladder.

Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.

What Is An Enlarged Prostate

Enlarged Prostate

An enlarged prostate exists when a physician determines that the size of the prostate has exceeded what is considered a normal range. Because the prostate may undergo a period of growth during the forties and fifties, it is not uncommon for a male to have an enlarged prostate. In many cases, the growth is limited and does not cause any real problems. However, an accelerated growth of the prostate can lead to a number of health issues and may also be an indicator of a more serious health risk.

Enlarged prostates usually do not develop earlier in life. After the mid-twenties, the average size of the prostate is roughly that of a walnut. However, changes in the balance between testosterone and estrogen in the male body may trigger a period of modest growth in men as they approach middle age. For many men, the slight growth does not produce any significant side effects or problems. However, it is important for men to have annual prostate exams after the age of forty in order to make sure this growth does not exceed certain limits.

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Natural Supplements For An Enlarged Prostate

At Bens Natural Health, we have formulated natural supplements to improve prostate health and reduce prostate size. When it comes to managing your BPH, we firmly believe that natural is the way to go. Not only will natural remedies help to heal your prostate, relieving you of uncomfortable symptoms, but they will do so without any adverse side effects.

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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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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How Is Bph Treated

#23298 Prostate size and flowrate can predict absence of outflow obstruction.
  • Watchful waiting means you do not receive treatment right away. Your signs and symptoms will be monitored over time to see if they get worse. You may be asked to keep a record of how much liquid you drink and how often you urinate. The record will include when you urinate, how easy or difficult it was, and any changes in urination. You will bring the record to follow-up visits. Your healthcare provider may also recommend ways to improve your symptoms during watchful waiting.
  • Medicine may be used to relax the muscles in your prostate and bladder. This may help you urinate more easily. You may also need medicine that blocks the production of a hormone that causes the prostate to get larger. It may help to slow the growth of the prostate or shrink it. Your healthcare provider may also make changes to your current medicines if they are making your symptoms worse.
  • A procedure may be used to place a stent into your urethra to hold it open. A stent is a short, tiny mesh tube. A prostatic urethral lift, or UroLift, may be used to hold the prostate away from the urethra. This makes the urethra wider so urine can pass through more easily.
  • Surgery may be used to relieve your symptoms if other treatments do not work. Extra tissue that is causing your symptoms may be destroyed. All or part of your prostate may be removed during another type of surgery.

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What Exams Tests And Procedures Diagnose Bph

A physical exam is required to see if other medical problems may be causing your BPH symptoms. The healthcare provider will order a digital rectal exam to examine the prostate gland. The healthcare provider may feel the prostate by inserting a gloved, lubricated finger into the rectum. The rectal exam allows your doctor to roughly estimate the size and consistency of the prostate. Most importantly, it allows the doctor to feel for lumps or hard areas that could indicate the presence of prostate cancer. Your doctor may check your urine for blood or signs of infection. Your blood may be tested for kidney problems , for PSA levels , a screening test for enlarged prostate, prostate cancer, prostatitis, and urinary tract infections

Some men are referred to a specialist for further tests. Urologists specialize in diseases of the male and female urinary tracts and of the male genital tract. Before you are treated for BPH. It is important for the doctor to rule out other possible causes of an enlarged prostate, such as prostate cancer, which is benign or non-cancerous.

What Is The Normal Size Of The Prostate

The prostate is an organ located below the bladder and in front of the rectum which is only present in the male body, fulfilling a key role in the formation of seminal fluid. The prostate secretes an alkaline fluid, white in appearance, that makes up to 30% of the volume of semen.

Over the years this gland can slightly increase in size, resulting in a condition known as prostatitis or inflammation of the prostate. For this reason many men wonder what the normal size of the prostate is and at what point it is considered enlarged. Read this OneHowTo article if you want more information about the normal size of the prostate.

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Tests Used To Check The Prostate

This first step lets your doctor hear and understand the “story” of your prostate concerns. You’ll be asked whether you have symptoms, how long you’ve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.

What Are The Signs And Symptoms Of Bph

Comparison of a Normal and an Enlarged Prostate ...
  • Urinating 8 or more times each day
  • A feeling of not fully emptying your bladder when you urinate
  • An urgent need to urinate that you could not put off, or urinating again within 2 hours
  • Being woken from sleep because you needed to urinate
  • Trouble starting your urine flow, or a need to push or strain to get it to start
  • Urine that stops and starts several times when you urinate
  • A weak urine stream, or dribbling after you urinate

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Bladder Dysfunction And Retention

Sudden increase in prostate size, such as may occur during hemorrhage or infarction, may cause acute retention of urine, but these conditions are unusual. It is a common observation that patients on urologic waiting lists for outflow tract obstruction rarely present in acute retention by contrast men admitted with this condition have usually not seen their general practitioner previously, and the precipitating factor seems often to relate to acute fluid loading and subsequent overstretching of the unrelieved bladderas happens, for example, during a long coach trip.

Chronic retention of urine is broadly divided into two forms: the relatively common low-pressure floppy bladder, which may become complicated by infection but which has normal upper tracts and the unusual high-pressure tense bladder, which frequently is seen in patients with few if any lower tract symptoms but which usually is associated with bilateral upper tract dilatation and obstructive uropathy.42

High-pressure chronic retention is specifically associated with sterile urine, late onset enuresis , and renal impairment in its later stages. However, elevated creatinine levels may occur for many reasons in the elderly, and this has led to a misdiagnosis of HPCR in many patients with other forms of retention, the true incidence of the condition only being approximately 1 in 20 men with significant retention of urine.42

Bob Djavan, Mojtaba Teimoori, in, 2018

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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Southern Cross Medical Library

The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.

Risks Factors Of An Enlarged Prostate

3 Easy Ways To Shrink An Enlarged Prostate Naturally

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.

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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:

  • Open prostatectomy – The surgeon makes an incision and removes some of the enlarged prostate. This is done rarely today because less invasive surgeries through the urethra work well with fewer side effects.
  • Transurethral resection of the prostate – Going in through the urethra, with the aid of a small camera, the surgeon removes tissue to open up the channel, which can help the urine flow and take some of the pressure off the bladder. Tissue is removed with bipolar energy that shaves off pieces of the prostate. While this method is less invasive than open prostatectomy, it still can have side affects, such as bleeding, infection, need for repeat resection, erectile dysfunction, and scarring.
  • Transurethral laser ablation of the prostate – This is where the urine channel is opened up using a high-powered holmium laser to vaporize the prostate tissue. Like TURP, the procedure can help urine flow and symptoms from enlarged prostate. The use of the laser may decrease the need for a catheter or reduce bleeding after the procedure. A high-powered laser that uses “Moses effect” pulses has the potential to remove the tissue more efficiently, so the procedure time can be shortened.
  • About Half Of Men Older Than 50 Have An Enlarged Prostate Here Are Some Of The Basic Facts You Need To Know About This Common Condition

    As men age, many experience prostate gland enlargement. This condition is known as benign prostatic hyperplasia .

    The prostate gland surrounds the urethra, the hollow tube that carries urine out of the body. When the prostate gets bigger, it can squeeze or partially block the urethra, which leads to problems urinating.

    BPH is quite common in older men. In fact, the condition impacts about 50% of men between the ages of 51 and 60. For men 80 and older, the prevalence of BPH is approximately 90%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

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