Your Growing Prostate

One of the most important glands in a man's body starts out the size of
a pea during childhood, grows as large as a walnut by the teen years,
and gets as big as a plum or even an orange during old age.

The gland is the prostate -- an internal organ located just
beneath the bladder -- and its growth is an inevitable consequence of
aging.

Benign growth -- not cancer 

The result of this normal process of growth, which most people
speak of as an "enlarged prostate," is a benign progression in the
body. In fact, medically, it is referred to as benign prostatic
hyperplasia (BPH). It is not a cancer nor does it lead to prostate
cancer.

As many as half of men in their 50s, and up to 90 percent of
those in their 80s and 90s, have BPH. Rarely is it found in men age 40
or younger.

Though BPH is not cancerous, it can still be troublesome. The
prostate not only sits close to the bladder, it also surrounds the
urethra, the canal through which urine passes out of the body. When the
prostate expands, it can irritate the bladder wall and tighten the
opening of the urethra.

This interference with the work of the bladder and the
urethra cause many of the problems and the condition is referred to as
benign prostatic hypertrophy (also BPH).

Symptoms may be classified as obstructions -- including a weak
or slow urine stream, difficulty starting and/or continuing urination,
or the inability to urinate altogether. Irritative symptoms of BPH can
show up as a frequent need to urinate (especially at night); a sudden
urge to urinate; urinary incontinence; and a severe urgency to urinate.

Men who experience these symptoms should check with their
doctors to determine whether they have BPH or a more serious problem --
a bladder infection, inflammation of the prostate or even kidney
disease.

Most importantly, patients with BPH symptoms should undergo
the prostate-specific antigen blood test, which, along with the digital
rectal exam, screens for prostate cancer.

Treatments vary 

For patients with mild cases of BPH, or those in the early
stages, physicians will usually recommend a "watchful waiting"
approach.

Some men with BPH do not experience any interference with
bladder function and may live out their lives without treatment.
Doctors will, however, recommend regular checkups.

Initially, BPH patients may be able to reduce symptoms by
making lifestyle changes such as limiting beverages in the evening;
limiting caffeine, alcohol or diuretics; and limiting decongestants or
antihistamines.

Staying active and warm can also help, because inactivity and
colder temperatures can cause urine retention. Quickly responding to
the urge to urinate is also important, because waiting too long may
overstretch and damage the bladder muscle.

Alpha-blockers, drugs that relax muscles, may be prescribed to
ease constriction around the neck of the bladder, which can be pinched
when the prostate grows. For BPH patients, these alpha- blockers may be
prescribed: tamsulosin (Flomax), alfuzosin (Uroxatral), terazosin
(Hytrin) or doxazosin (Cardura).

Another class of drugs, DHT blockers such as finasteride
(Proscar) and dutasteride (Avodart), may also be helpful because they
prevent testosterone from being converted to the hormone DHT
(dihydrotes-testosterone), and can help shrink the prostate.

Research by the National Institute of Diabetes and Digestive
and Kidney Diseases has found that using a two-drug combination of
finasteridewith doxazosin can be more effective than using either drug
alone to relieve symptoms and prevent BPH from progressing.

Conventional surgery may also be recommended to treat BPH. One
procedure, transurethral resection of the prostate, involves scraping
or removing part of the prostate that may be blocking the urethra.

Another procedure, green light laser prostectomy, also enables
surgeons to remove enlarged prostate tissue, but they vaporize it using
a laser.

Minimally-invasive procedures can also be quite effective in
shrinking prostate tissue. These options for BPH patients include
interstitial laser coagulation, trans urethral microwave thermotherapy
and trans urethral needle ablation using radio frequency. Usually,
these can be done as outpatient procedures under local anesthesia.

Originally published by Sourjya P. Misra, M.D.

Source: Oakland Tribune.
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