What is Prostate?
The prostate is located around the urethra under the bladder in the lower urinary tract. It is found only in men. Produces the fluid contained in the semen. Includes smooth muscles that help to expulsion of semen during ejaculation.
A healthy prostate has the size of a large walnut and has a volume of 20-25 milliliters. In men it grows slowly with aging.
Benign Prostate Growth
Prostate diseases are usually associated with aging. It can usually cause irritating symptoms in the lower urinary tract in men older than 50 years. Often these symptoms are associated with the condition known as benign prostate enlargement.
Benign prostate enlargement is a benign condition in every man. This is related to the hormonal changes that occur with the aging of men.
In contrast, this growth may inhibit urine flow in a condition called benign prostate inhibition.
Prostate disease is worrying, but it is important to know that it is not prostate cancer. Although untreated, benign prostate enlargement does not turn into prostate cancer, but may develop at the same time with prostate cancer.
Your concerns can be consulted by your urologist.
Symptoms
Benign prostate growth affects the way you urinate. This occurs when the enlarged prostate presses the urethra at the urinary bladder outlet.
Your symptoms may sometimes be mild. For example, you may need to urinate more often, or it may be difficult to drain your bladder completely. These mild symptoms can be a normal part of the aging process such as the decrease in motion-memory and flexibility. Your doctor may not recommend treatment for these mild symptoms.
Symptoms can sometimes be very uncomfortable and can adversely affect your quality of life. In this case, you can benefit from the treatment.
Benign prostate enlargement may slow your urine flow and cause you to pause when you empty your bladder. Or wait for your urine to start and then required to push again.
It may cause you to urinate very often during the day and to wake up from the sleep (nocturnal) to empty your bladder at night. It can also cause sudden jams and sometimes involuntary incontinence (known as inkontians).
After urinating, you may feel that your bladder is not empty. Your urine flow ends in drip. After you urinate and get out of the toilet, your underwear may be dripping.
These symptoms, often referred to as lower urinary tract symptoms (LUTS), can often caused by benign prostate growth.
Diagnosis
Doctors and nurses perform some tests to understand what causes your symptoms. This is called diagnosis.
The symptoms listed in the previous section can be a sign of many diseases, not only benign prostate growth. Therefore, your doctor may need some tests before a diagnosis. First, your doctor or nurse learns your medical history and conducts your physical examination. Then, urine and blood tests, bladder and prostate imaging and, if necessary, can do other tests.
Treatment
1. Wait and See
If you have a benign prostatic enlargement but you have not encountered any distressing lower urinary tract symptoms (LUTS), you will often not need medication or surgical operation to improve symptoms. In this case, your urologist will tell you how your disease progresses, how you can handle your symptoms and problems. Your urologist will strictly monitor your illness in the months or years that follow, and will start treatment if necessary. This is called wait-and-see.
If your symptoms are mild and do not disturb your quality of life, wait is a good alternative for you.
This approach is not a passive way, but includes regular checks to ensure that your disease does not progress.
For most men with benign prostate enlargement, it is recommended to wait before starting any treatment.
Severe complications in this period are very rare and for this reason it is highly recommended. Indeed, some of your symptoms may resolve spontaneously, while others may not progress for years.
Wait and see treatment:
- Evaluation of your symptoms
- Physical examination
- Blood and urine tests
- Training on your disease
- Support and relief
- It covers lifestyle and self-management proposals.
2. Medication
Medication is recommended when symptoms are irritating and affect quality of life. There are different medications you can discuss with your doctor. You can decide which treatment is best for you.
Factors influencing this decision:
- Your symptoms
- Size of prostate
- Your medical history
Drugs used in treatment:
- Herbal Medicines
- Alpha-blockers
- 5 Alpha-reductase inhibitors (5ARI)
- Muscarinic receptor antagonists (MRA)
- Phosphodiesterase 5 inhibitors (PDE5)
- Combinations of these drugs
Each drug group acts in a different way and causes different results and side effects.
3. Surgical Treatment
The aim of surgery is to alleviate the symptoms of benign prostate enlargement and to increase the flow of urine. There are different treatment methods that you can talk to your doctor. You can decide together the best method for you.
Factors that affect your decision making are:
- Your symptoms and quality of life
- Size of your prostate
- Your medical history
- Your current treatment in your hospital and your doctor’s experience.
Ask your doctor about his experience on the treatment he recommended. You have the right to know the complication rate of your surgeon.
When should I consider surgery?
- If your symptoms worsen despite medication
- When benign prostate enlargement complications develop or increase.
Complications are:
– Kidney failure
– Kidney enlargement
– Unable to urinate
– Recurrent urinary tract infection
– Bladder stone
– Repeated bleeding in urine
- If you cannot tolerate drug therapy
- If you prefer surgical treatment to medication
During surgical treatment, the doctor removes the enlarged portion of the prostate (known as adenoma). There are different surgical treatment methods.
Basic surgical methods:
- Transurethral resection of the prostate (TURP)
- Transurethral prostate incision (TUIP)
- Open prostatectomy
- Laser treatments
- Prostate stents
- Transurethral needle ablation (TUNA)
- Transurethral microwave therapy (TUMT)
Each process has its own advantages and disadvantages. The choice of treatment is based on your personal circumstances and preferences.
Life with Benign Prostate Growth
- Many men with benign prostate enlargement must struggle with lower urinary tract symptoms (LUTS) as their age progresses. In some, this situation causes unhappiness and unrest, while others feel only slight discomfort. For example, a patient may be uncomfortable to wake up at night to urinate, but this may not affect another. That is why your personal training and quality of life cannot be underestimated. They are as important as diagnostic tests and treatment results. A quality life involves physical and mental health together. In addition to feeling healthy, it is important that you do not feel the psychological pressure of living with benign prostate growth. There are many ways to keep the symptoms under control. These symptoms should not prevent you from being happy in your relationships within your community, in your social, cultural and economic life.
Prostatic inflammation: Prostatitis
- Prostatitis is a general name given to prostate inflammation. Microbes that often come through the outer urine channel cause inflammation in the prostate. For the definitive treatment of prostatitis, the correct diagnosis should be made. Prostatitis is difficult to diagnose and to type. Patients generally have subjective complaints such as burning, high fever, stinging, forced urination, frequent urination, night urination, back pain, pain during sexual intercourse. Disease-causing microorganism (such as coli bacillus, Pseudomonas Aurogenosa) can be detected in a very small group of patients. It is necessary to make the diagnosis correct in order to be able to perform the correct treatment in acute and chronic prostatitis. More age-related prostate enlargement and prostate cancer are observed in men older than 50 years of age, men under 50 years of age are more likely to have prostatitis.
