Prostate enlargement

An enlarged prostate is a non-cancerous condition in which the narrowing of the urethra make the elimination of urine more difficult. It most habitually occurs within men over age 50.

Definition

A non-cancerous condition that affects many men long-gone 50 years of age, enlarged prostate makes eliminate urine more difficult by narrowing the urethra, a tube running from the bladder through the prostate gland. It can effectively be treated by surgery and, today, by certain drugs.

Description

The adjectives term for enlarged prostate is BPH, which stands for benign (non-cancerous) prostatic hyperplasia or hypertrophy. Hyperplasia resources that the prostate cells are dividing too hastily, increasing the total number of cells and consequently the size of the organ itself. Hypertrophy simply means expansion. BPH is often chunk of the aging process. The actual changes within the prostate may start as early as the 30s but pilfer place very little by little, so that significant enlargement and symptoms usually do not appear until after age 50. Past this age the probability of the prostate enlarging and cause urinary symptoms become progressively greater. More than 40% of men in their 70s have an enlarged prostate. Symptoms roughly appear between ages 55-75. About 10% of all men eventually will require treatment for BPH.

BPH have been view as a rare condition surrounded by blacks, but this may partly be due to the reality that black patients may have smaller amount access to medical care. The condition also seem to be uncommon surrounded by the Chinese and other Asian peoples, for reasons that are not clear.

Causes & symptoms

The wreak of BPH is a mystery, but age-related changes contained by the levels of hormones circulating in the blood may be a factor. Whatever the lead to, an enlarging prostate little by little narrows the urethra and obstruct the flow of urine. Even though the muscle in the bladder wall becomes stronger within an attempt to push urine through the smaller urethra, in time, the bladder fails to aimless completely at each urination. The urine that collects in the bladder can become infected and organize to stone formation. The kidneys themselves may be damaged by infection or by urine constantly "protection up."

When the enlarging prostate gland narrow the urethra, a man will have increasing trouble starting the urine stream. Because some urine remains astern in the bladder, he will own to urinate more often, probably two or three times at night (nocturia). The stipulation to urinate can become very urgent and, contained by time, urine may dribble out to stain a man's clothing--to his embarrassment. Other symptoms of BPH are a thinned and sometimes a split stream, and general painful or pain surrounded by the perineum (the area between the scrotum and anus). Some men may hold considerable enlargement of the prostate past even mild symptoms develop.

If a man must strain hard to force out the urine, small vein in the bladder wall and urethra may rupture, cause blood to appear in the urine. If the urinary stream become totally blocked, the urine collecting in the bladder may cause severe discomfort, a condition call acute urinary retention. Urine that stagnates in the bladder can easily become infected. A burning inkling during urination and fever are clues that infection may enjoy developed. Finally, if urine backs up long satisfactory it may increase pressure in the kidneys, though this rarely cause permanent kidney harmed.

Diagnosis

When a man's symptoms point to BPH, the first thing the physician will want to do is a digital rectal nouns, inserting a finger into the anus to feel whether--and how much--the prostate is enlarged. A smooth prostate surface suggests BPH, whereas a distinct lump in the gland might close-fisted prostate cancer. The next step is a blood assessment for a substance called prostate-specific antigen (PSA). Between 30-50% of men next to BPH have an elevated PSA height. This does not mean cancer by any finances, but other measures are needed to make sure that the prostate escalation is benign. An ultrasound exam of the prostate, which is entirely safe and deliver no radiation, can show whether it is enlarged and may show that cancer is present.

If digital or ultrasound examination of the prostate raise the suspicion of cancer, most urologists will recommend that a prostatic tissue biopsy be performed. This is usually done using a lance-like instrument specifically inserted into the rectum. It pierces the rectal wall and, guided by the physician's finger, obtains six to eight pieces of prostatic tissue that are sent to the laboratory for microscopic nouns.

A catheter placed through the urethra and into the bladder can show how much urine remains in the bladder after the patient urinates--a consider of how severe the obstruction is. Another and tremendously simple test for hindrance is to have the man urinate into a uroflowmeter that measures the rate of urine flow. A massively certain--though invasive--way of confirming obstruction from an enlarged prostate is to slip away a special viewing instrument called a cystoscope into the bladder, but this is not commonly necessary.

It is routine to check a urine taste for an increased number of white blood cells, which may denote there is infection of the bladder or kidneys. The same example may be cultured to show what type of bacterium is causing the infection, and which antibiotics will work best. The state of the kidneys may be checked in two ways: imaging by any ultrasound or injecting a dye (the intravenous urogram, or pyelogram); or a blood test for creatinine, which collects in the blood when the kidneys cannot.

Treatment

An extract of the saw palmetto (Serenoa repens or S. serrulata) have been shown to stop or diminish the hyperplasia of the prostate. The herb is believed to inhibit the enzyme that converts one type of testosterone to another (significant in both prostate enlargement and prostate cancer ), offering equal positive effects as the prescription drug Poscar (finasteride) without the unenthusiastic side effects. Symptoms of BPH will improve after taking the herb for one to two months, but continued use is recommended.

Zinc have also been found impressive in shrinking an enlarged prostate. A 15-30 mg zinc supplement, or inclusion of pumpkin or sunflower seed in the day after day diet can produce the desired effect. Prevention of prostate inflammation and swelling is thought to be aided by an increase in essential fatty acids . One source of these fatty acids is flaxseed oil, available within capsule or juice form at most health food stores.

The increase in circulation to the groin achieve by certain yoga poses and exercises can also reduce prostate problems. The knee squeeze and the seated sun poses should become a slice of the daily routine. The stomach lock exercise, perform in a supine position, involves taking a gaping breath and then breathing out slowly as the buttocks, groin, and stomach muscles are pulled in. Experts believe this exercise can both prevent prostate problems and treat flare ups; however, this exercise is foolish for those with hypertension, heart disease , hiatal hernia , or ulcer.

Imagery that involves picturing the prostate shrinking to normal size and sensing an even flow of urine, practiced twice a sunshine, can be helpful. A reflexology session to relax the entire body, beside special attention to the prostate and endocrine reflexes within the hands and foot, may help the body make well itself.

Allopathic treatment

A class of drugs called alpha-adrenergic blockers, which includes phenoxybenzamine and doxazosin, relax the muscle tissue surrounding the bladder outlet and pool liner the wall of the urethra to permit urine to flow more freely. These drugs promote obstructive symptoms, but do not keep the prostate from enlarge. Other drugs (finasteride is a good example) do shrink the prostate and may hitch the need for surgery. Symptoms may not, however, upgrade until the drug has be used for three months or longer. Antibiotic drugs are given promptly whenever infection is diagnosed. Some medications, including antihistamines and some decongestants, can formulate the symptoms of BPH suddenly worse and even cause acute urinary retention, and hence should be avoided.

When drugs have messed up to control symptoms of BPH but the physician does not believe that conventional surgery is yet needed, a procedure call transurethral needle ablation may be tried. Using local anesthesia, a hypodermic is inserted into the prostate and radio frequency energy is applied to verbs the tissue that is obstruct urine flow. Another new approach is microwave hyperthermia, using a device call the Prostatron to deliver microwave energy to the prostate through a catheter. This procedure is done at an outpatient surgery center.

For oodles years the standard operation for BPH has be transurethral resection (TUR) of the prostate. Under general or spinal anesthesia, a cystoscope is passed through the urethra and prostate tissue surrounding the urethra is removed using any a cutting instrument or a heated line loop. The small pieces of prostate tissue are washed out through the breadth. No incision is needed for TUR. There normally is some blood surrounded by the urine for a few days following the procedure. In a few men--less than 5% of all those have TUR--urine will continue to escape unconsciously. Other uncommon complications include a impermanent rise in blood pressure beside mental confusion, which is treated by giving salt solution. Impotence--the inability to finish lasting penile erections--does come about, but probably in a lesser amount of than 10% of patients. A narrowing or stricture rarely develops contained by the urethra, but this can be treated fairly confidently.

Expected results

In several studies, 160 mg dose of saw palmetto given twice daily for 45 days achieve positive results in approximately 80% of the patients studied. That percentage increased when results be obtained after 90 days. When BPH is treated by conventional TUR, here is a risk of complications but, in the great majority of men, urinary symptoms will be relieved and their talent of life will be much enhanced. In the adjectives, it is possible that the less invasive forms of surgical treatment will be increasingly used to complete results as good as those of the standard operation.

Prevention

Whether or not BPH is cause by hormonal changes contained by aging men, there is no agreed way of preventing it. Once it does develop and symptoms are present that interfere seriously beside the patient's enthusiasm, timely medical or surgical treatment will reliably prevent symptoms from getting worse. Also, if the condition is treated before the prostate have become grossly enlarged, the risk of complications is minimal. One of the potentially most serious complications of BPH, urinary infection (and possible infection of the kidneys) can be prevented by using a catheter to drain excess urine out of the bladder so that it does not collect, stagnate, and become infected.

Key Terms

Catheter

A rubber or plastic tube placed through the urethra into the bladder to remove excess urine when the flow of urine is cut off, or to prevent urinary infection.

Creatinine

One of the "throw away" substances normally excreted by the kidneys into the urine. When urine flow is slowed, creatinine may collect in the blood and bring toxic effects.

Hyperplasia

A condition where cell, such as those making up the prostate gland, divide abnormally hastily and cause the organ to become enlarged.

Hypertrophy

A logical term for expansion, as in BPH (benign prostatic hypertrophy).

Urethra

In males, the tube that conducts urine from the bladder through the penis to the outside of the body. When narrowed by an enlarge prostate, symptoms of BPH develop.

Urinary retention

The result of progressive obstruction of the urethra by an enlarge prostate, causing urine to remain in the bladder even after urination.