Causes and symptoms of enlarged prostate

The problem of an enlarged prostate or benign prostate hyperplasia is a very common occurrence as you grow older. It's known to strike men above the age of 50, with more than 50% of men after the age of 60, having this complaint.

Causes of enlarged prostate

A non-cancerous condition, enlarged prostate makes the passing of urine from the bladder through the urethra difficult. The multiplication of the prostate cells causes an enlargement of the gland, leading to a buildup of pressure on the urethra, affecting the discharge of urine from the body. The narrowing of the urethra, due to this benign condition, forces the bladder to contract more vigorously so as to push urine out of the body.

As time passes, the muscles of the bladder get significantly affected, causing them to become extremely sensitive, thicker and stronger. As a consequence, the bladder begins to contract, even if the amount of urine in the organ is negligible, causing episodes of frequent urination. Gradually, the bladder fails to completely empty itself of urine due to the constriction of the urethra. This can give rise to a number of health problems including the formation of bladder stones, urinary tract infections, blood in the urine and so on.

How can you identify the signs of the condition?

Signs of enlarged prostate are very easy to identify and include:

- A slow or weak urine flow
- Difficulty in initiating urination
- Instances of frequent urination
- A feeling of not completely emptying one's bladder
- Frequent urination during the night
- Exerting a lot to urinate
- Instances of dribbling
- Urgency to pass urine
- A feeling of urinating again minutes after doing so
- Urination that starts and stops



What Leads to an Enlarged Prostate?

The prostate gland in males surrounds the urethra, through which urine and sperm are passed out of the body. Its function is to secrete a fluid, which provides nourishment to the sperm. It is about the shape of a walnut and is present between the pubic bone and the rectum.

As a man crosses 40, the prostate gland begins to increase in size due to an increase in the number of cells. This is known as hyperplasia.  The condition is usually benign and therefore the name benign prostate hyperplasia (BPH). As it continues to grow, there is an increased pressure on the urethra. Therefore, there can be problems with urination. The bladder, being a muscular organ, compensates to some extent and so the problems with urination are mostly managed. If left untreated, this can continue to be a major problem and the bladder may not be able to compensate. In men who are 60-plus, BPH is very common.

Signs and symptoms 

One of the initial symptoms of BPH is when the urine stream begins to grow weak.
There could also be a reduced speed of passing urine.
Men with BPH never have a feeling of complete emptying of the bladder.
On the other hand, there is also a constant difficulty in initiating a urine stream. There could be intermittent breaks in the urine stream.
The person may feel the need to strain to initiate the stream and to ensure complete emptying.
There could be dribbling of urine after passing urine.
The duration between two bathroom visits can constantly reduce, with the constant urge to urinate.
There is a constant urge to visit the bathroom, which is more common in the night. One of the most annoying features of BPH is the walking up at night to urinate, but with an inability to initiate a stream and an inability to completely empty the bladder, it leaves the person very irritated and frustrated.
There could be blood in the urine. In fact, blood in the urine accompanied by fever, chills, nausea and vomiting are indications of an emergency.
There could be blockage of urine completely, if the enlargement is quite severe.
Diagnosis
If you are having any of these symptoms, then the doctor will first test for an enlarged prostate through a digital rectal exam. Then a test is done to check a chemical called prostate specific antigen.  Increased levels of this chemical is almost always indicative of BPH. In addition, X-rays and scanning may be used to confirm diagnosis. 

Treatment
Though medications are available, confirmatory treatment is through surgical removal. The procedure needs a inimum of 2 to 3 days.

Enlarged Prostate - 10 Warning Signs To Watch Out For

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery.

Know About Laser Prostate Surgery

Prostate cancer is a cancerous tumor in a man s prostate gland, a small gland that is responsible for producing the seminal fluid which transports and nourishes the sperm. It is a very common type of cancer among men. A few cases of prostate cancer tend to develop slowly while others may progress very fast.
Symptoms-
In the initial stages, prostate cancer may not show any symptom. However, in the latter stages, there may be symptoms such as:
Pain in the bones.
Erectile dysfunction.
Urination can get troublesome.
Presence of blood in the semen.
Pain and discomfort in the pelvic region.
Causes-
The exact causes of prostate cancer are not known. It starts to develop when certain cells in the prostate gland start to mutate. These mutations cause these cells to multiply at a very fast rate and thus, soon form tumors. Although the causes are not known, certain factors tend to aggravate this condition; them being:
Color: According to certain medical reports, a darker skin may mean increased chances of suffering from prostate cancer.
Age: The risk of developing prostate cancer tends to increase with age.
Genetics and Family History: Faulty genes could be another cause of this condition. Also, having some member in the family who is diagnosed with this type of cancer only increases the risks of you suffering from them.
Obesity: If you are obese, then you are more likely to develop prostate cancer.
Treatments-
The treatments for prostate cancer include:
Radiation Therapy: In this procedure, high energy rays are used to target and destroy cancer cells. Usually X-rays or protons are used to treat the cancer cells.
Hormone Therapy: Hormone therapy is a type of treatment wherein certain medications are administered to prevent your body from producing testosterone.
Surgery: If the other treatment methods do not produce desired results, then a surgery is carried out for the removal of the prostate gland. In addition to the prostate gland, some adjoining lymph nodes and tissues are also removed.
Chemotherapy: Chemotherapy is method of destroying cancer cells by injecting chemicals into the body. The medicines are injected into the veins in the arms. 

All About Prostate Cancer

Cancer is the most dangerous disease noticeable throughout the world. The most common type of cancer that affects men is prostate cancer. Prostate is a small exocrine gland situated directly below the bladder and in front of the rectum. This is gland is approximately in size of a walnut and plays an important role in production of a milky fluid during orgasm of sex in which the semen travels. During the climax stage of the prostate gland is forced to push the fluid and remove the semen out of the reproductive structures.

Prostate gland is a slow progressive disease which makes many males left unidentified even the presence of prostate cancer even until they die. 6 out of 100 male over the age of 60 are getting prostate cancer. Though prostate cancer can be cured at a better rate when compared to other type of cancer it is always best to stay protected. Prevention is always better than cure. Here are few tips to keep your prostate healthy.

Signs and symptoms of prostate cancer-

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

The patient urinates more often

The patient gets up at night more often to urinate

He may find it hard to start urinating

He may find it hard to keep urinating once he has started

There may be blood in the urine

Urination might be painful

Ejaculation may be painful (less common)

Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

Bone pain, often in the spine (vertebrae), pelvis, or ribs

The proximal part of the femur can be painful

Leg weakness

Urinary incontinence

Fecal incontinence

Ways to have a healthy prostate  

Diet and weight   the most important factor is the diet to maintain a healthy weight. Avoid fatty food items and take fats from vegetables than from animals. Avoid dairy products and increase the intake of fresh fruits and vegetables.

Exercise   have a regular practise of doing exercise at least for 30mins a day. This really helps you to keep your body fit.

Be precautious   if you have a family history of prostate cancer or if you feel you are at high risk of getting prostate cancer talk with your doctor about it and take preventive drugs as per the doctor s advice.

Red foods   research shows that men who consume red foods like watermelon, tomato and other red fruits are at lower risk of getting prostate cancer as they contain a powerful antioxidant called lycopene

Caffeine   three to four cups of coffee per day reduces your risk of getting prostate cancer.

Stop smoking   if you are at high risk of getting prostate cancer it is best advised to quit smoking and alcohol.

Prostate Cancer - What To Expect

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

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