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!

Benign prostatic hyperplasia or BPH is a condition where the prostate gland gets enlarged. This is mostly common in men who are ageing. When the prostate gland gets enlarged, the flow of urine through the urethra gets blocked, and hence, several problems related to urination may occur. BPH occurs as a result of hormonal imbalance. If untreated, BPH can lead to severe bladder and urinary health conditions.
There are several symptoms and signs of benign prostatic hyperplasia. Here are 7 common symptoms:

1. A frequent need for urination: Men affected by BPH feel an increased need to urinate frequently. This gets enhanced during the night and is called nocturia. The patient may even need to urinate more than eight times a day. Due to the enlarged prostate gland, more pressure is put on the urethra, which leads to uncontrollable urination.
2. Urinating difficulties: The act of urination becomes difficult. Because of enhanced pressure on the urethra, the flow of urine to the penis from the bladder gets blocked. This makes a urine stream hard to start. The urine stream gets weak and interrupted, and more difficulty may be experienced during the end of urination.
3. Pain during urination and ejaculation: Due to pressure on the urinary tract and reproductive system, pain can accompany urination and ejaculation. Some patients tend to push urine out, which results in pain. The pain may also occur because of infection during BPH.
4. Blood in urine and an unusual color/smell: Urine may take a dark color and have an unusual smell due to urinary retention. Unpleasant urine smell signifies urinary tract infection. Blood in the urine may also result because of dilated veins present on the surface of the enlarged prostate.
5. Urinary retention: When a patient is unable to pass any urine, it is called urinary retention. Such a condition requires immediate treatment, and you need to consult a doctor immediately.
6. Urinary tract infections: Bacteria may start growing in the bladder when the bladder is not fully emptied of urine. This bacterial infection causes darkening of the urine, and emission of a foul odor.
7. Bladder stones: Bladder stones may develop because of the inability of the bladder to empty itself completely. This is a major symptom of BPH. Hard lumps of minerals or bladder stones are formed when the urine present in the bladder gets highly concentrated, which causes the crystallization of minerals. Bladder stones may cause infections, result in blood in urine, cause bladder irritation and may also block urine flow.

So you see that benign prostatic hyperplasia involves the enlargement of the prostate gland, and results in several problems related to urination and different symptoms. Hence, immediate treatment is advisable.

7 Symptoms of Benign Prostatic Hyperplasia

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

Enlarged prostate surgery is a very common type of surgery that many have to undergo nowadays. An enlarged prostate causes many health problems including urinary tract obstructions and urinary tract infections. It may also lead to the passing of blood via urine. Thus, enlarged prostate must be treated as soon as possible as neglect may lead to prostate cancer and its associated health issues. There are various types of prostate surgeries that a doctor performs on his/her patients. However, of late, radical prostatectomy is the most popular of them all.

What is Radical Prostatectomy?

This process can be handled in two ways. Firstly, the prostate can be reached through an incision in the abdomen. This would help the doctor work with precision and carefully avoid all the other nerves and muscles in the area the operation take places. The prostate is examined and any nodule or lymph formed over it is carefully removed. The advantage of this surgery is that the patient is less likely to suffer from any erectile problems post- surgery. The second option would be to make an incision between the scrotum and the anus. This process is best for those who are obese. The surgery is performed quickly and there is less loss of blood. Furthermore, the healing time is less too.

How To Recover From The Surgery?

Like most other prostate operations, even in radical prostatectomy, you would have to wear a catheter till you recover completely. For a few days post the surgery your urine would be collected through a urine bag attached to the catheter. One might feel a little sore in his/her genitals after the surgery, but that is quite normal to occur. The soreness is caused due to the surgery and the incisions made and would heal in a matter of a few days. Interestingly, since the urethra plays an important role in this surgery, the catheter has to be in place for at least two to three weeks but the patient can be discharged after a two to three night stay at the hospital. It is advised that the patient takes ample rest. But this does not mean all rest and no work. In fact, it is seen that patients can walk a little and even go back to a normal diet within a week to ten days of the operation. But regular checkups, till the urethra is healed, are compulsory.

Hence, these are some of the recovery procedures after an enlarged prostate surgery. Such surgeries are quite common and heal quickly.

What To Expect Post An Enlarged Prostate Surgery?

The prostate gland in a man begins to grow in size on reaching 25 years of age quite naturally, and this is known as benign prostatic hyperplasia abbreviated as BPH. Now the problem arises when the enlargement of the prostate is more than normal.

In men, the urine flows through the urethra from the bladder. An abnormally enlarged prostate blocks the flow of urine through the urethra. The cells of the prostate slowly multiply to cause it to enlarge. This puts pressure on the urethra thereby giving rise to a number of problems, most of which manifest as symptoms.

Common Symptoms of an Enlarged Prostate Gland
The condition of enlarged prostate gives rise to some noticeable symptoms which provide the signs that you need to visit a doctor to get it treated. A weak or slow urinary system is one of the most common symptoms of being affected with an enlarged prostate. This includes urinating more often, an increase in the urgency to urinate, difficulty in starting urination and a feeling of incomplete bladder emptying immediately after urinating. At times, it is seen that passing urine becomes very strenuous. All these above symptoms indicate that there is an enlargement of the prostate gland and medical help should be sought immediately to prevent the condition from worsening.

Steps to Manage an Enlarged Prostrate

Effective medication is usually the first step in the management of an enlarged prostate gland. Alpha blockers are the drugs that are most commonly used in this situation. These drugs do not reduce the size of the prostate, but they are great in relieving the symptoms to allow free and painless passage of urine. Another group of drugs known as 5-alpha reductase inhibitors can help in shrinking an enlarged prostate. The drugs work by the reducing the levels of the male hormone called dihydrotestosterone.
In some advanced stages of prostate enlargement, minimally invasive treatments are used for the effective management of the condition. Transurethral Microwave Thermotherapy or TUMT is used to treat mild blockages that reduce the frequency of urination, the urgency, and straining. However, it is not able to correct the bladder emptying issues. Transurethral Radio Frequency Needle Ablation or TUNA helps in the destruction of the prostate tissues resulting in an improvement in the flow of urine.
Prostatic stents are also sometimes used for the management of the condition of an enlarged prostate. In this treatment procedure, a small metal coil is inserted into the urethra for widening it and keeping it open. In most severe case of prostate enlargement, only surgical methods remain as the opted method of treatment. Laser surgeries are performed to destroy the tissues of the prostate for easing of the condition. Ultimately, an open prostate surgery is performed when the transurethral procedure cannot be used. In this surgery, the tissues of the prostate are removed by the surgeon in case of great enlargement.
The condition of an enlarged prostate gland requires medical attention and treatment for the most effective management, and it is best that a medical professional is consulted as soon as any of the symptoms surface.
Enlargement starts usually after 50 years. Surgery 'Transurethral resection of prostate (TURP)' either by monopolar or bipolar electrocautery. Enucleation of prostate by laser is also an option.

Enlarged Prostate - How Can It Be Managed?

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?

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