Your Growing Prostate

One of the most important glands in a man's body starts out the size ofa 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 justbeneath the bladder -- and its growth is an inevitable consequence ofaging.

Benign growth -- not cancer

The result of this normal process of growth, which most peoplespeak of as an "enlarged prostate," is a benign progression in thebody. In fact, medically, it is referred to as benign prostatichyperplasia (BPH). It is not a cancer nor does it lead to prostatecancer.

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

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

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

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

Men who experience these symptoms should check with theirdoctors to determine whether they have BPH or a more serious problem --a bladder infection, inflammation of the prostate or even kidneydisease. Most importantly, patients with BPH symptoms should undergothe prostate-specific antigen blood test, which, along with the digitalrectal exam, screens for prostate cancer. Treatments varyFor patients with mild cases of BPH, or those in the earlystages, physicians will usually recommend a "watchful waiting"approach. Some men with BPH do not experience any interference withbladder function and may live out their lives without treatment.Doctors will, however, recommend regular checkups. Initially, BPH patients may be able to reduce symptoms bymaking lifestyle changes such as limiting beverages in the evening;limiting caffeine, alcohol or diuretics; and limiting decongestants orantihistamines. Staying active and warm can also help, because inactivity andcolder temperatures can cause urine retention. Quickly responding tothe urge to urinate is also important, because waiting too long mayoverstretch and damage the bladder muscle. Alpha-blockers, drugs that relax muscles, may be prescribed toease constriction around the neck of the bladder, which can be pinchedwhen the prostate grows. For BPH patients, these alpha- blockers may beprescribed: 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 theyprevent testosterone from being converted to the hormone DHT(dihydrotes-testosterone), and can help shrink the prostate. Research by the National Institute of Diabetes and Digestiveand Kidney Diseases has found that using a two-drug combination offinasteridewith doxazosin can be more effective than using either drugalone to relieve symptoms and prevent BPH from progressing. Conventional surgery may also be recommended to treat BPH. Oneprocedure, transurethral resection of the prostate, involves scrapingor removing part of the prostate that may be blocking the urethra. Another procedure, green light laser prostectomy, also enablessurgeons to remove enlarged prostate tissue, but they vaporize it usinga laser. Minimally-invasive procedures can also be quite effective inshrinking prostate tissue. These options for BPH patients includeinterstitial laser coagulation, trans urethral microwave thermotherapyand 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.Provided by ProQuest Information and Learning. Powered by YellowBrix.
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