Enlarged Prostate

The prostate gland is responsible for producing the fluid which carries sperm during ejaculation. It can be found around the urethra which passes the urine out of the body. When the gland grows bigger, it is referred to as an enlarged prostate. The enlargement is caused mainly due to benign prostatic hyperplasia (BPH). It occurs with advancing age, but the process usually begins in the 30s. The symptoms are not seen till the man reaches around 50 years of age because it develops very slowly. More information regarding this condition will be discussed in this article.

What Causes Enlarged Prostate?

The actual cause of enlarged prostate is not known. It is believed that aging and changes in the cells of testicles can cause growth of prostate. The chances of enlarged prostate increase with increasing age and almost all men will suffer from this condition. Over the age of 40, a little enlargement of prostate is seen. However, over the age of 80, more than 90% of men will suffer from this condition because the testicles will not function normally at that time.

If the testicles are removed at a young age, they will not suffer from BPH. And the prostate will shrink if the testicles are removed after developing BPH.

What Are the Symptoms of Enlarged Prostate?

Common symptoms seen in prostate enlargement are:

  • Weakening of urine stream  
  • Dribbling of urine at the end
  • Strain while urination
  • Difficulty in starting urination
  • Starting and stopping while urinating
  • Frequently urinating or urgency in urination
  • Increased urination at night
  • Incomplete emptying of bladder
  • Development of bladder stones
  • Reduced kidney function
  • Sometimes the symptoms may not become noticeable or bothersome either.

When to See a Doctor

One should approach the doctor if there are any urinary problems. The doctor will determine if it is related to prostate enlargement. Immediate medical attention should be sought if urine is not passed at all. If the urinary symptoms are not very bothersome, treatment might not be required. However, it should be checked to rule out conditions like prostate cancer.

What Are the Complications of Enlarged Prostate?

When the prostate enlargement interferes with emptying bladder, it can become a problem. Surgery might be required if such a situation occurs. Some of the complications are as below:

  • Acute Urinary Retention

In this condition, there is an inability to urinate which is painful. A catheter might be inserted in the bladder through the urethra or lower abdomen. In some cases, surgery may be required to relieve the urinary retention. This can also occur when OTC decongestants are taken for allergies or cold.

  • Bladder Damage

When there is frequent incomplete emptying of bladder, it causes the bladder to be stretched and weakened. The bladder does not contract properly and may or may not improve after prostate surgery.

  • ŸBladder Stones

Stones are caused in the bladder due to mineral deposits. These deposits cause infection, bladder irritation, blood in the urine and obstruction of urine flow. This happens due to the inability to empty the bladder.

  • ŸKidney Damage

The urinary retention can cause increased pressure in the bladder, which in turn causes kidney damage. Sometimes, infection in the bladder can travel to the kidney and damage it. Hydronephrosis is the swelling of urine collecting structure of one or both kidneys, which can happen due to obstructed kidneys.

  • ŸUTIs

Enlarged prostate can cause repeated urinary tract infections. This might require the person undergoes surgery to avoid such infections.

How Can Enlarged Prostate Be Treated?

The treatment for enlarged prostate depends on the severity of the symptoms and how much it affects your life. Any treatment might not completely get rid of all the symptoms, but they can improve the symptoms to a great extent.

1.  Medication

Depending on the severity of the symptoms, medication will be prescribed. They help in easing the symptoms and making them less bothersome. Some of the common medications are:

Medication

Description

Alpha-blocker

The various alpha-blockers available are prazosin, indoramin, tamsulosin, alfuzosin, doxazosin and terazosin.

These medications work by relaxing the smooth muscles of prostate and the bladder, which improve the urine flow. The effect of the medicine can be seen within six weeks. There can be possible side-effects like drowsiness, headaches and dizziness.

5-alpha reductase inhibitor

Alternative to alpha-blockers, they are available as finasteride and dutasteride. They work by blocking the conversion of testosterone to dihydrotestosterone, which is done by blocking a key enzyme: 5-alpha reductase. It can take up to 6 months to notice the effect.

2.  Surgery

When medication does not help and the symptoms are very bothersome, a part of the prostate is surgically removed. 1 in 4 men will undergo surgery for enlarged prostate. The common surgeries are given below:

Surgery

Description

TURP

Transurethral resection of the prostate is the most commonly performed operation. Performed under anesthesia, small chips of prostate are cut off by electric current passed through a cystoscope.

Good results are seen after this surgery, although 80-90% men report of retrograde ejaculation or dry orgasms.

TUIP

Transurethral incision of the prostate is done when there is only a slight enlargement of the prostate. Small cuts are made in the prostate at the point where it meets the bladder, resulting in better urine flow by relaxing the bladder opening. The risk of developing retrograde ejaculation is less in this operation.

Open Prostatectomy

This is a traditional approach and rarely performed these days. This is done when the prostate is very large and cannot be removed by cystoscope. In this surgery, the skin is needed to cut for reaching the prostate and removing it.

Laser Prostatectomy

Laser is used to achieve the results obtained by TURP or open prostatectomy. It requires short hospitalization, has less side effects and needs less time for catheter to be inserted.

Green light laser vaporizes the prostate tissues to create a cavity, whereas holmium laser removes large pieces which are broken down to smaller pieces.

3.  Other Treatments

Some other forms of treatment include using implants, which lift the urethra and improve the flow of urine. Using microwaves, radiofrequency waves, high-intensity ultrasounds and high voltage electrical energy instead of laser.

The video below introduces some natural ways to treat enlarged prostate that you can try:

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