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Noncancerous Enlargement Of The Prostate Gland

What Are The Warning Signs Of Benign Prostatic Hyperplasia

Medical breakthrough | Prostate gland enlargement treatment

Your prostate surrounds your urethra. When BPH causes your prostate to grow, it can cause blockage in your urethra. As a result, early symptoms of BPH include:

  • Slowness or dribbling when you pee.
  • Difficulty starting to pee.
  • Kidney damage due to pee backflow from your bladder up to your kidney. The pee backflow increases pressure on your kidney.

What Are The Treatment Options For Bph

First line treatment for BPH is dietary and lifestyle modification. If these fail to improve symptoms then medical therapy can be started. Medications can either help shrink the prostate gland or help relax the prostate and bladder. If medical therapy is ineffective, there are surgical options from which the patient may benefit. The most common procedure is a TURP . During this procedure a doctor passes a small camera through the urethra and removes excess prostate tissue with a surgical instrument. A laser can also be used to resect prostate tissue. There are also other minimally invasive therapies that can be used in BPH to help improve urinary symptoms and quality of life. Sometimes when the prostate gland is extremely large, surgical removal of the gland is performed through an incision.

How Is Benign Prostatic Hyperplasia Diagnosed

Your healthcare provider will review your medical history, ask you questions and perform a physical examination. Part of the physical exam involves a digital rectal exam.

During a digital rectal exam, your healthcare provider will carefully insert their gloved digit into your rectum. Theyll feel the edges and surface of your prostate, estimate the size of your prostate and detect any hard areas that could be cancer.

Your healthcare provider may also order:

  • A survey to evaluate the severity of your symptoms.
  • A urine flow test to measure the speed of your pee stream.
  • A study to detect how much pee remains in your bladder after youve finished peeing.
  • A cystoscopy to look into your bladder.

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What Are The Signs And Symptoms Of An Enlarged Prostate

An enlarged prostate is the most common cause of urinary problems in men as they get older. Possible symptoms include:

  • a weak flow when you urinate
  • a feeling that your bladder hasnt emptied properly
  • difficulty starting to urinate
  • dribbling urine after you finish urinating
  • needing to urinate more often, especially at night
  • a sudden urge to urinate you may sometimes leak before you get to the toilet.

You may not get all of these symptoms, and some men with an enlarged prostate dont get any symptoms at all. These symptoms can also be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicines. Blood in your urine may be a symptom of an enlarged prostate. But this is rare and is usually caused by something else.

If you have any of the symptoms above, you should visit your GP to find out what may be causing them.

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The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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How Is Bph Diagnosed And Evaluated

Early diagnosis of BPH is important because if left untreated it can lead to urinary tract infections, bladder or kidney damage, bladder stones and incontinence. Distinguishing BPH from more serious diseases like prostate cancer is important.

Tests vary from patient to patient, but the following are the most common:

Does Bph Increase Your Risk Of Developing Prostate Cancer

Based on research to date, the answer is no. However, BPH and prostate cancer have similar symptoms, and a man who has BPH may have undetected cancer at the same time.

The American Cancer Society recommends that men make an informed decision with their health care provider whether to be screened for prostate cancer. For men at average risk, this discussion should start at age 50. They also say that for men who are at high risk, such as African-American men and men with a family history of prostate cancer, screening should be considered at age 45. Men at an even higher risk, such as having more than one relative with a history of prostate cancer at an early age, should consider earlier testing.

The American Urological Association recommends against routine screening for men ages 40 – 54 who have an average risk of prostate cancer. Those with a higher risk are encouraged to discuss prostate cancer screening tests with their doctor. The association recommends that men ages 55 – 69 should weigh the risks and benefits of screening and treatment. For those who choose screening, the AUA suggests that they may be screened every two years rather than annually. Tests used to screen for prostate cancer include a blood test for a substance called prostate-specific antigen and the digital rectal exam . The AUA does not recommend PSA screening in men over age 70 or any man with less than a 10-15-year life expectancy.

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What Is The Prostate Gland

The prostate is a small organ about the size of a walnut. It lies below the bladder and surrounds the urethra . The prostate makes a fluid that helps to nourish sperm as part of the semen .

Prostate problems are common in men 50 and older. Most can be treated successfully without harming sexual function.

What Is Benign Prostatic Hyperplasia

Baragwanath the first govt hospital to treat prostate gland enlargement

Benign prostatic hyperplasiaalso called BPHis a condition in men in which the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction.

The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a mans life. Benign prostatic hyperplasia often occurs with the second growth phase.

As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retentionthe inability to empty the bladder completelycause many of the problems associated with benign prostatic hyperplasia.

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What You Need To Know

  • PAE symptoms related to Benign Prostatic Hyperplasia are present in about one in four men by age 55, and in half of 75-year-old men.
  • Treatment is only necessary if symptoms become bothersome.
  • The PAE procedure has a lower risk of urinary incontinence and sexual side effects , when compared with more invasive surgical procedures such as a TransUrethral Resection of the Prostate .

How Is Bph Diagnosed

After evaluating your medical history and giving you a complete physical, your doctor will perform a digital rectal examination.

Because the prostate gland is in front of the rectum, the doctor can feel if the back of the gland has any abnormalities during this examination. This enables the doctor to estimate the size of the prostate and to detect any hard areas that could be cancer.

Several studies may be done to help diagnose your condition:

  • A urine test called a urinalysis
  • A seven-question BPH Symptom Score Index survey to evaluate the severity of your symptoms
  • A flow study to see if the urine stream is slow compared with normal flow
  • A study to detect how much urine is left in the bladder after urination

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What Other Problems Might An Enlarged Prostate Cause

A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:

  • youre aged 70 or over
  • your prostate is very large
  • you have a raised prostate specific antigen level
  • you have severe urinary symptoms and a very slow flow.

Chronic urine retention

This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.

Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.

There are treatments for chronic urine retention, including:

  • passing a thin, flexible tube called a catheter to drain urine from your bladder
  • surgery to widen the urethra.

Acute urine retention

How Is Benign Prostatic Hyperplasia Treated

Benign Prostatic Hyperplasia (Enlarged Prostate)

Treatment options for benign prostatic hyperplasia may include

  • lifestyle changes
  • minimally invasive procedures
  • surgery

A health care provider treats benign prostatic hyperplasia based on the severity of symptoms, how much the symptoms affect a mans daily life, and a mans preferences.

Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist most often recommends treatment.

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Psa Tests For Bph And Prostate Cancer

A PSA test measures the level of prostate-specific antigen in the patient’s blood. It is the standard screening test for prostate cancer. A PSA is recommended annually for all men over 50 years old and for men over 40 who are at high risk for prostate cancer.

BPH itself can also raise PSA levels, but the test has generally been optional for men with suspected BPH. One 2000 study indicated that PSA levels may be good predictors of future prostate growth in men with BPH.

In the study, men in the lowest PSA level groups had prostate growth rates of only 0.7mL per year while those in the high PSA groups had growth rates of 3.3 mL per year. Other research has detected a specific molecular form of P SA, which has been termed BPSA because it may be a specific marker for BPH. Such findings could eventually lead to a shift from focusing on symptoms and flow rates for diagnosis to a more specific and possible preventive approach.

Certain treatments for BPH, including the drug finasteride and the surgical procedure transurethral resection of the prostate , can reduce PSA levels and possibly mask the existence of prostate cancer.

A more recent test identifies so-called free PSA, which is found in lower levels when prostate cancer is present and in higher levels with BPH. This may be more accurate than total PSA, regardless of whether a man is taking finasteride or not.

Not Treating May Be An Option

If symptoms are mild then this may be the best option. You may be happy just to see how things go if the symptoms are not too bothersome and are not affecting your life very much. The situation can be reviewed every year or so, or sooner if there is a change in symptoms. Symptoms do not always become worse. They may even improve.

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Are There Other Non

Yes, aside from BPH, there are a number of prostate problems that also have nothing at all to do with prostate cancer. Among these benign disorders of the prostate are acute prostatitis and chronic prostatitis and, rarely, prostatic infarct .

Acute prostatitis is a bacterial infection of the prostate. It can occur in men at any age. Symptoms include fever, chills, and pain in the lower back and between the legs. This problem also can make it hard or painful to urinate. Doctors prescribe antibiotic medicines for acute prostatitis and recommend that the patient drink more liquids. Treatment is usually successful.

Chronic prostatitis is a prostate inflammation that tends to recur over time. It is usually not associated with true bacterial infection but causes similar symptoms of pain and discomfort, without fevers or chills. Chronic prostatitis is difficult to treat, and the exact cause is not well understood. Antibiotics may be used in some cases as well as anti-inflammatory medicines such as ibuprofen. In many cases, symptoms will resolve on their own.

Prostate infarct is a localized area of dead prostate tissue as a result of inadequate blood supply. Prostate infarct is uncommon and may cause sudden increases in the PSA test.

What Are The Causes Of Benign Prostatic Hyperplasia

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The exact cause is not known. Enlargement of the prostate gland is a normal process that develops as men get older. Therefore it becomes more common with increasing age. it is thought that changes in the male sex hormones that occur with ageing may be at least part of the cause.

Prostate gland enlargement can be caused by other conditions such as prostate cancer, acute prostatitis and chronic prostatitis. See the separate leaflets called Prostate Cancer, Acute Prostatitis and Chronic Prostatitis.

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How Is Benign Prostate Enlargement Diagnosed

If your GP suspects that you have an enlarged prostate, you’ll be asked to complete a questionnaire to assess your symptoms.

Each question has five possible answers that carry a score, and your overall score indicates the severity of your symptoms.

Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement.

You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.

Causes Of Benign Prostate Enlargement

The exact cause of benign prostate enlargement is unknown, but research suggests that hormones probably play an important role in the condition’s development.

Hormones are powerful chemicals that can have a wide range of effects on the cells of the body.

One theory is that as some men and anyone with a prostate gets older, the levels of a type of hormone called dihydrotestosterone increases, which may stimulate the growth of the prostate.

Another theory suggests that two hormones, testosterone and oestrogen, play a role. Younger men and anyone with a prostate produce high levels of testosterone and much smaller levels of oestrogen. But as they get older, levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. It’s been suggested that the relative increase in oestrogen may stimulate prostate growth.

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What Are Symptoms Of Bph

Symptoms from BPH can include difficulty starting to urinate, a weak urinary stream, increased frequency of urination, increased night time urination, leakage of urine, incomplete emptying of the bladder, and retention of urine. The diagnosis can usually be made by a physician after taking a history and carefully examining the prostate gland. A urine sample is usually checked to make sure there is no blood or infection. A uroflowmetry test is also done sometimes to check the flow rate and a post-void residual is done to measure how much urine is being retained in the bladder.

What Causes Benign Prostatic Hyperplasia

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The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.

Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.

Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.

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