Enlarged Prostate

7 mins read

The enlarged prostate is one of the most common age-related conditions for men. While not serious, it can lead to serious complications. BIGGER IS NOT BETTER!

An enlarged prostate is the growth of the prostate gland. The prostate gland is involved in the production of semen and reproductive function in men. The prostate wraps around urethra which is the tube that carries urine from the bladder out through the tip of the penis.

The prostate grows as a man matures. During puberty, the prostate doubles in size. At about age 25, the prostate gland grows again, and this can lead to an enlarged prostate as a man enters his 40s. An enlarged prostate is also known as benign prostatic hyperplasia (BPH). BPH is generally not caused by infection or cancer.
As the prostate grows larger, it may press on the urethra. This causes the urethra to narrow. Narrowing of the urethra can cause some men with prostate enlargement to have trouble with urination. Prostate enlargement is one of the most common health problems in men older than 60 years of age.

Causes
Benign Prostatic Hyperplasia is a medical terminology for a non-cancerous enlargement of the prostate gland. It is particularly common in older men.  An estimated 50% of men have histologic evidence of BPH by age 50 years and by 80 years, 75%. Doctors aren’t sure what causes it. It may be due to the changing balance of sex hormones as men grow older.

Signs and symptoms
Most men with an enlarged prostate don’t exhibit any symptoms. However, where enlarged prostate symptoms are present they may include the following:

  • Problems urinating: As the prostate grows, it creates an enlargement that puts pressure on the urethra. As the urethra narrows, the bladder has to contract more forcefully to push urine through the body. Problems associated with urinating include the following:
  • Problems achieving or maintaining an Erection: It has been argued that an enlarged prostate may cause problems of achieving or maintaining an erection.
  • Blood in the Urine or Semen: If you see some blood spots in your urine then you may have an enlarged prostate.
  • Pain in the Lower Back, Upper Thigh or Hips: Men with enlarged prostate condition may feel pain in the lower back, upper thigh or hips.
  • An inability to urinate at all.
  • Difficulty controlling urine flow.
  • Frequent urination.
  • A weak or intermittent flow of urine.
  • Pain or a burning sensation when urinating.

When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including-

  • Bladder stones
  • Blood in the urine
  • Incontinence
  • Acute Urinary Retention (an inability to urinate)

If you can’t pee at all: you should see your doctor immediately — a sudden and complete inability to urinate is a medical emergency.  In rare cases, bladder and/or kidney damage can develop from BPH.

Treatment options

  • Watchful waiting: This is the conservative and often best program of care. For many men, symptoms can lessen over time without treatment. On the other hand, medications should be started early for moderate symptoms. Also, if there are complications or if symptoms are severe, your doctor may recommend surgery. For most men, the decision to treat the symptoms of an enlarged prostate is based on the patient’s desire to improve his quality of life.
  • Self-Care: If you have an enlarged prostate, there are a number of things that you can do to lessen the symptoms or prevent them from worsening.
  • Try and cut down on alcohol and caffeine. These can encourage you to urinate and irritate the bladder.
  • Don’t drink a lot of fluid all at once, spread out fluids throughout the day. Avoid drinking fluids within 2 hours of bedtime.
  • Try not to take over-the-counter cold and sinus medications that contain decongestants or antihistamines. These medications can increase BPH symptoms.
  • Keep warm and exercise regularly: Cold weather and lack of physical activity may worsen symptoms.
  • Learn and practice Kegel exercises (pelvic strengthening exercises – the same that are used with pregnant women). They strengthen the muscles that support the bladder.
  • Reduce stress: Nervousness and tension can lead to more frequent urination.
  • Several studies have found that cranberry juice may be helpful in the prevention of urinary tract infections.
  • Medication: Alpha 1-blockers (doxazosin, prazosin, tamsulosin, terazosin, and alfuzosin) are a class of medications used to treat enlarged prostate. These medications relax the muscles of the bladder neck and prostate. This allows easier urination. Most people treated with alpha 1-blocker medication find that it helps their symptoms.
  • Finasteride and dutasteridelower levels of hormones produced by the prostate reduce the size of the prostate gland, increase urine flow rate, and decrease symptoms of BPH. It may take 3 to 6 months before you notice much improvement in your symptoms. However, finasteride and dutasteride have potential side effects related to their use. These effects include decreased sex drive and impotence.
  • More recent studies have indicated that the best results involve a combination of an alpha blocker and a drug to shrink the prostate.
  • Surgery: Prostate surgery may be recommended if you have the following conditions:
    • Incontinence
    • Recurrent blood in the urine
    • Inability to fully empty the bladder (urinary retention)
    • Recurrent urinary tract infections
    • Kidney failure
    • Bladder stones

Your doctor will determine the specific surgical procedure based on the severity of your symptoms and the size and shape of your prostate gland.

Alternative treatments

  • Saw Palmetto: Saw palmetto is a herbal cure that has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to prescription medication. Some studies have shown that it helps with symptoms, but others have found that this popular herb is no better than a placebo in relieving the symptoms of BPH. [1,5]
  • Stinging Nettle Extract: Made from the extract of the stinging nettle, studies in people suggest that stinging nettle, in combination with other herbs (especially saw palmetto), may be effective at relieving symptoms, such as reduced urinary flow, incomplete emptying of the bladder, and the constant urge to urinate. [2,6]
  • Pygeum: This herb is made from the oil of an African prune tree. Several studies show that pygeum can significantly reduce the amount of times the person wakes up in the night to urinate, and lessen any pain with urination in men who suffer from mild-to-moderate BPH symptoms. [3]

Prostate enlargement is a natural part of aging for men. As the gland grows, it can press on the urethra and cause urination and bladder problems. Prostate enlargement is not a serious condition, but it can cause complications such as urinary tract infections, bladder stones, bladder damage, kidney damage, which can be serious problems. Fortunately, there are a number of treatments for prostatitis, both prescription medicines and alternative remedies.

Read More:
Healing QA: Treatment For An Enlarged Prostate? 

References:

1. Grant P, Ramasamy S. An update on plant derived anti-androgens. Int J Endocrinol Metab. 2012 Spring;10(2):497-502. doi: 10.5812/ijem.3644. Epub 2012 Apr 20. PubMed PMID: 23843810; PubMed Central PMCID: PMC3693613.

2. Tacklind J, Macdonald R, Rutks I, Stanke JU, Wilt TJ. Serenoa repens forbenign prostatic hyperplasia. Cochrane Database Syst Rev. 2012 Dec12;12:CD001423. doi: 10.1002/14651858.CD001423.pub3. Review. PubMed PMID:23235581.

3. Ishani A, MacDonald R, Nelson D, Rutks I, Wilt TJ. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. Am J Med. 2000 Dec 1;109(8):654-64. Review. PubMedPMID: 11099686.
4. Klingler HC. New innovative therapies for benign prostatic hyperplasia: anyadvance? Curr Opin Urol. 2003 Jan;13(1):11-5. Review. PubMed PMID: 12490810.

5. Marks LS, Partin AW, Epstein JI, Tyler VE, Simon I, Macairan ML, Chan TL,Dorey FJ, Garris JB, Veltri RW, Santos PB, Stonebrook KA, deKernion JB. Effectsof a saw palmetto herbal blend in men with symptomatic benign prostatichyperplasia. J Urol. 2000 May;163(5):1451-6. PubMed PMID: 10751856.

6. Katz AE. Flavonoid and botanical approaches to prostate health. J AlternComplement Med. 2002 Dec;8(6):813-21. Review. PubMed PMID: 12614534.

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