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What is the prostate gland?
The prostate is a small organ about the size of a walnut. It lies below the bladder (where urine is stored) and surrounds the urethra (the tube that carries urine from the bladder). The prostate makes a fluid that helps to nourish sperm as part of the semen (ejaculatory fluid). Prostate problems are common in men 50 and older. Most can be treated successfully without harming sexual function. A urologist is a specialist in diseases of the urinary system, including diagnosing and treating problems of the prostate gland.
How does the doctor detect prostate enlargement?
A doctor usually can detect an enlarged prostate by rectal exam. The doctor also may examine the urethra, prostate, and bladder using a cytoscope, an instrument that is inserted through the penis.
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia is nonmalignant (noncancerous) enlargement of the prostate gland, a common occurrence in older men. It is also known as benign prostatic hyperplasia and abbreviated as BPH.
When does benign prostatic hyperplasia start?
BPH generally begins in a man's 30s, evolves slowly, and most commonly only causes symptoms after 50.
What happens in BPH? What are symptoms of BPH?
In BPH, the prostate gland grows in size. It may compress the urethra which courses through the center of the prostate. This can impede the flow of urine from the bladder through the urethra to the outside. It can cause urine to back up in the bladder (retention) leading to the need to urinate frequently during the day and night. Other common symptoms include a slow flow of urine, the
Treatment of BPH is usually reserved for men with significant symptoms. Half of all men over 50 develop symptoms of BPH. but only 10% need medical or surgical intervention. It is not a precursor (a forerunner) to prostate cancer. Is BPH always treated? No. Watchful waiting with medical monitoring once a year is appropriate for most men with BPH. How is BPH treated? There are several different ways to treat BPH: . which may be a medical emergency and can lead injury to the kidneys. How common is BPH? Are there any risk factors? BPH is extremely common. Is BPH a type of cancer? No! BPH is completely benign.need to urinate urgently and difficulty starting the urinary stream. More serious problems include urinary tract infections and complete blockage of the urethra.
o y Surgery or office procedures may also be used to treat BPH. which helps to relieve urinary obstruction caused by an enlarged prostate in BPH. alfuzosin (Uroxatral). such as a complete inability to urinate. After the patient is given anesthesia. For this reason. most commonly in men who have not responded satisfactorily to medication or those who have more severe problems. and the bladder neck. They have no treatment but get regular checkups and wait to see whether or not the condition gets worse. or lightheadedness. Side effects can include headaches. problems getting an erection. the doctor inserts a special instrument into the urethra through the penis. The available drugs include o alpha blockers relax the smooth muscles of the prostate.y Watchful waiting is often chosen by men who are not bothered by symptoms of BPH. Examples of 5-alpha reductase inhibitors include Finasteride (Proscar) and dutasteride (Avodart). the doctor then shaves away part of the inner prostate to relieve the outflow of urine from the bladder. and problems with ejaculation. These drugs generally will lead to improvement in symptoms within several weeks and have no effect on prostate size. and older medications such as terazosin (Hytrin) or doxazosin (Cardura). Commonly used alpha blockers in BPH include tamsulosin (Flomax). With the instrument. some of which can be performed in the doctor's office with minimal anesthesia. y Medical treatment of BPH is usually reserved for men who have significant symptoms. These procedures . Side effects of finasteride may include declining interest in sex. fatigue. o Transurethral resection of the prostate (TURP) has been used for the longest period of time. The prostate enlargement in BPH is directly dependent on DHT. and 5-alpha reductase inhibitors block the conversion of the male hormone testosterone into its active form in the prostate (DHT). improvement in urinary symptoms most commonly takes this long to occur. o Laser procedures: A number of laser procedures are available. so these drugs lead to an approximate 25% reduction in prostate size over six to 12 months.
also involve the removal of obstructing prostate tissue. and the exact cause is not well understood. Doctors prescribe antibiotics for acute prostatitis and recommend that the patient drink more liquids. . It is usually not associated with true bacterial infection but causes similar symptoms of pain and discomfort. Antibiotics may be used in some cases as well as antiinflammatory medications such as ibuprofen. Can prostate problems be prevented? The best protection against prostate problems is to have regular medical checkups that include a careful prostate exam. Are there other noncancerous prostate problems? Yes. chills. This problem also can make it hard or painful to urinate. o Microwave therapy: This procedure is generally performed in the office and involves the use of microwave energy delivered to the prostate to kill some of the cells leading eventually to shrinkage of the prostate. It can occur in men at any age. aside from BPH. Symptoms include fever. there are a number of prostate problems that also have nothing at all to do with cancer. Men should carefully weigh the risks and benefits of each of these options. or y dribbling of urine. and pain in the lower back and between the legs. Prostate surgery has traditionally been seen as offering the most benefits for BPH but unfortunately carries the most risks. Chronic prostatitis is a prostate inflammation that tends to recur over time. Treatment is usually successful. In many cases. y difficulty in urinating. Chronic prostatitis is difficult to treat. They are generally associated with less bleeding and quicker recovery than TURP but may not be as effective over the long term in some men. Acute prostatitis is a bacterial infection of the prostate. without fevers or chills. See a doctor promptly if symptoms occur such as y a frequent urge to urinate. symptoms will resolve on their own. Among these benign disorders of the prostate are acute prostatitis and chronic prostatitis.
BPH can impede the flow of urine. Symptoms of prostate cancer may include y y y Problems passing urine. The treatment of BPH is usually reserved for men with significant symptoms. chemotherapy or control of hormones that affect the cancer. Medical and surgical approaches are available to treat BPH. In all cases. Benign Prostatic Hyperplasia At A Glance y y y y y y y The prostate gland makes a fluid that becomes part of the semen. However. Benign prostatic hyperplasia (BPH) involves enlargement of the prostate gland. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. BPH surgery does not protect against prostate cancer because only part of the prostate is removed. difficulty urinating and dribbling of urine. PSA can also be high with other prostate conditions. Treatment may include surgery. Symptoms include frequent urge to urinate. The prostate is the gland below a man's bladder that produces fluid for semen. Prostate cancer is the second most common cause of death from cancer in men of all ages. The prostate enlargement in BPH is not malignant. the sooner a doctor finds a problem. It is rare in men younger than 40. Since the PSA test became common. or dribbling Low back pain Pain with ejaculation Prostate cancer treatment often depends on the stage of the cancer.Regular checkups are important even for men who have had surgery for BPH. the better the chances that treatment will work. . such as pain. difficulty starting or stopping the stream. radiation therapy. Levels of a substance called prostate specific antigen (PSA) is often high in men with prostate cancer. most prostate cancers are found before they cause symptoms.
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