Diagnosing Benign Prostate Enlargement
You might have several different tests to find out if you have an enlarged prostate.
A GP may do some of these tests, such as a urine test, but others might need to be done at a hospital.
Some tests may be needed to rule out other conditions that cause similar symptoms to BPE, such as prostate cancer.
Association Of Clinical Prostatitis And Bph
BPH is a disease of ageing men An estimated 42% of men 51 to 60 years of age have histological BPH. The incidence increases to over 70% in men 61 to 70 years of age and to almost 90% in those 81 to 90 years of age. The prevalence of LUTS associated with BPH parallels that of pathological BPH > 50% of men over 50 are believed to experience LUTS secondary to an enlarged prostate gland.
Prostatitis has traditionally been considered a condition which inflicts younger men, but it is apparent that it is as common in older men . Compared to men aged 51 and higher the odds of a documented prostatitis diagnosis is only 2-fold greater in younger men . Approximately 8% of men over 50 years of age report at least some mild prostatitis-like symptom in the past week compared to 11% of younger men . Little attention has been given to the association between BPH and prostatitis, despite the high prevalence of both conditions in ageing men.
Many physicians have trouble clinically distinguishing prostatitis from BPH in the older male population . In 1992, 31,681 United States health professionals without prostate cancer provided information on urological diagnoses and lower urinary tract symptoms . 57.2% of the 5,053 men with prostatitis also reported a history of BPH while 38.7% of the 7,465 men with BPH reported a history of prostatitis.
Medical Treatment For Chronic Prostatitis
The treatment of chronic prostatitis is similar to what we have described in acute prostatitis. However, recovery often takes longer. It is also more common to use multiple medications in the same patient to control the symptoms. The most important drugs are as follows :
- Antibiotics: Once again, infection is often the cause of chronic bacterial prostatitis. However, in this case, the infection may take a very long time to cure, and therapy may extend for more than two months.
- Alpha-blockers: Patients with urinary tract symptoms and prostate pain usually need alpha-blockers. They are often diagnosed with chronic pelvic pain syndrome and need these drugs to relieve their urinary tract symptoms.
- Nonsteroidal anti-inflammatory drugs: They are required in most cases of chronic prostatitis. It is especially the case of chronic pelvic pain syndrome.
After reviewing the medical treatment of BPH and prostatitis, lets consider the most important natural treatments, too.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What type of prostatitis do I have?
- What is the best treatment for this type of prostatitis?
- What are the treatment risks and side effects?
- How can I avoid getting prostatitis again?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostatitis is a common problem that affects many men. Unfortunately, theres a lot of confusion about the disease. People use the word prostatitis to describe four different conditions. There isnt a one-size-fits-all treatment for prostatitis, which is why an accurate diagnosis is so important.
Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
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What Causes Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is a type of infective prostatitis. It is caused by a persistent infection with a germ of the prostate gland. A man with chronic bacterial prostatitis will usually have had recurring urine infections. Chronic bacterial prostatitis is usually caused by the same type of germs that causes the urine infections. The prostate gland can harbour infection and therefore recurring infections can occur. Chronic bacterial prostatitis is not a sexually transmitted infection.
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Pain Or Burning During Urination
The urinary tract becomes inflamed and swelling, as well as the prostate. This leads to an overactivation of nerve terminals. They become irritated, and any additional impulse will be translated into pain. Then, urination can feel burning or painful, as if the patient had a urinary infection. Infected urine and prostatitis have in common this symptom, and sometimes it can be a bit difficult to differentiate them.
Painful urination is often attributed to urinary infections. It is often found as a symptom in patients with recurrent urinary tract infections. If thats the case and doctors prescribe antibiotics, the symptoms will be solved in bacterial prostatitis. But in nonbacterial prostatitis, antibiotics are unlikely to resolve the problem.
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Benign Prostatic Hyperplasia Causes
Benign prostatic hyperplasia mostly affects older men, although its exact aetiology is unclear. Further, men having testicles removed before adolescence do not experience benign prostatic hyperplasia. For this rationale, some experts think age and testicular factors may contribute to BPH causes.
Men produce little quantities of oestrogen, a female hormone, and testosterone, a masculine hormone, throughout their lifespan. Mens active testosterone levels in blood decline with age, leaving a larger percentage of estrogen. According to scientific research, BPH may happen because the prostates greater estrogen content stimulates the function of molecules that encourage prostate cell growth.
Dihydrotestosterone , a male hormone that affects the growth and development of the prostate, is the subject of another hypothesis. Some studies have shown that elderly men continue to develop and deposit significant quantities of DHT in the prostate despite declining blood testosterone levels. So the buildup of DHT may promote the survival and growth of prostate cells. According to researchers, men who do not make DHT do not experience benign prostatic hyperplasia.
Role Of Inflammation In The Pathogenesis Of Histological Bph
Three recent reviews on the pathogenesis of BPH have provided an evidence based thesis that strongly suggests a role of inflammation in the propagation of histological BPH . Kramer and Marberger have recently outlined the current state of knowledge in regard to the influence of inflammation on the pathogenesis of BPH. Chronic inflammatory infiltrates, mainly composed of chronically activated T cells and macrophages frequently are associated with BPH nodules . These infiltrating cells are responsible for the production of cytokines which may support fibromuscular growth in BPH . Immigration of T cells into the area is attracted by increased production of proinflammatory cytokines such as IL-6, IL-8 and IL-15 . Surrounding cells become targets and are killed , leaving behind vacant spaces that are replaced by fibromuscular nodules with a specific pattern of a Th0/Th3 type of immune response .
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Prostatitis Signs And Symptoms
Symptoms of prostatitis vary, the acute phase of the disease more acute, chronic symptoms and diverse, mainly: dysuria, sexual dysfunction, local pain and physical abnormalities and other symptoms. Urinary disorder: mainly manifested as frequent urination, urgency, dysuria, urinary incontinence or dysuria, sometimes in the urinary tract, but also accompanied by urethral drops white phenomenon. Some patients only showed abdominal distension, and some patients showed testicular discomfort or pain. Recommended regular hospital examination and treatment, do not blindly medication, to maintain a cheerful and optimistic attitude of life, should be alcohol, avoid spicy food avoid holding back urine, sedentary and long ride, riding, pay attention to warm, strengthen physical exercise.
Prostatitis: prostate massage and hyperthermia: prostate massage is one of the traditional treatment methods, studies have shown that appropriate prostate massage can promote prostatic duct emptying, increase the local drug concentration, thereby alleviating the clinical symptoms of chronic prostatitis. Hyperthermia mainly use a variety of physical means of the thermal effects, increase the prostate tissue blood circulation, speed up the metabolism, is conducive to the effect and eliminate tissue edema, relieve pelvic floor muscle spasms.
Why Is This Relevant
It matters because chronic prostatitis can also cause a set of symptoms and painful defecation is one of them. Some men with prostatitis also have irritable bowel syndrome.
While prostate size itself is not the common factor for problems with bowel movements, in some cases, it can happen.
Besides chronic or acute prostatitis, other BPH-related complications can also affect bowel movements. One of those complications is chronic urinary retention. Although rare, this complication can lead to large bowel obstruction.
You see, a common symptom of enlarged prostate is the inability to empty the bladder completely. When left untreated, this symptom leads to urinary retention.
In turn, urinary retention may lead to compression of the sigmoid colon against the sacrum . As a result, large bowel obstruction may occur. Considered a medical emergency, large bowel obstruction is a blockage that prevents the passing of food and liquid.
In other words, certain complications of BPH may impair bowel movements and lead to a medical emergency.
Besides the abovementioned complications, its also useful to mention that prostate enlargement can contribute to constipation. An enlarged prostate can form too much pressure on the rectum, making it difficult to defecate.
In addition to BPH, other prostate problems can act on the bowels too. A good example is prostate cancer or tumor, which may cause disruptions such as bowel incontinence or fecal incontinence.
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How Do You Tell The Difference
In the lists above, you have probably seen that both prostatitis and BPH have lower urinary symptoms in common. They include voiding symptoms, storage symptoms, and post-micturition symptoms. In prostatitis, the most predominant are storage symptoms.
For example, having urinary urgency, incontinence, waking up several times at night to urinate, and having increased volume and frequency of urination.
Voiding symptoms such as weak urinary flow may appear in patients with prostatitis. However, they are much more common in BPH. Post-micturition symptoms are almost solely found in BPH patients.
On the contrary, chronic inflammation and bacterial infection only occur in prostatitis. They do not feature in BPH. If you have symptoms such as fever, chills, urethral discharge, joint, and muscle pain, it is most likely prostatitis instead of BPH. It is prostatitis that causes prostate pain triggered by the digital examination .
What Are The Symptoms Of Bph And Prostate Cancer
BPH and prostate cancer have similar symptoms, so its sometimes hard to tell the two conditions apart. As the prostate grows for any reason, it squeezes the urethra. This pressure prevents urine from getting down your urethra and out of your body. Prostate cancer symptoms often dont start until the cancer has grown large enough to put pressure on the urethra.
Symptoms of both BPH and prostate cancer include:
- an urgent need to urinate
- feeling the urge to urinate many times during the day and night
- trouble starting to urinate or having to push to release urine
- weak or dribbling urine stream
- urine flow that stops and starts
- feeling like your bladder is never fully empty
If you have prostate cancer, you might also notice these symptoms:
- painful or burning urination
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How Is Prostatitis Diagnosed
If you suspect you have prostatitis, make an appointment with your doctor. Theyll need to rule out other possible causes of your symptoms. For example, an enlarged prostate, cystitis, and some other conditions can cause similar symptoms.
Your doctor will perform a physical exam, including a prostate exam. Your prostate is located in front of your rectum. During a digital rectal exam, your doctor will feel your prostate and check for enlargement. In some cases, they may recommend a cystoscopy. In this procedure, your doctor will insert a small scope through your urethra to look at your bladder and prostate gland.
Your doctor also needs to determine the type of prostatitis you have. They may order blood tests and urine analysis.
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About Half Of Men Older Than 50 Have An Enlarged Prostate Here Are Some Of The Basic Facts You Need To Know About This Common Condition
As men age, many experience prostate gland enlargement. This condition is known as benign prostatic hyperplasia .
The prostate gland surrounds the urethra, the hollow tube that carries urine out of the body. When the prostate gets bigger, it can squeeze or partially block the urethra, which leads to problems urinating.
BPH is quite common in older men. In fact, the condition impacts about 50% of men between the ages of 51 and 60. For men 80 and older, the prevalence of BPH is approximately 90%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
While BPH can have serious complications, it is not a cancer and is generally linked to a mans aging process. Although the causes of BPH are not entirely understood, some researchers have investigated whether hormonal changes and cell growth as men age could be related to the development of the condition. If left untreated, BPH can lead to bladder, urinary tract or kidney problems.
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What Is The Prognosis For Bph And Prostatitis
Unlike prostate cancer, prostate BPH is a benign disease. Prostatitis is also benign and even more manageable than BPH. Thus, both disorders have a very favorable prognosis.
However, patients with prostatitis and BPH should undergo careful follow-up. This is a useful way to make sure their condition is being controlled appropriately. Otherwise, they would become affected by other complications that will affect their quality of life.
Among the most important methods to evaluate the prognosis, we have PSA levels. With PSA, it is possible to tell when prostate cancer is the cause of an increase in the size of the prostate.
In the majority of cases, a prostate biopsy wont be required. On the other hand, prostatic abscess formation is a complication of prostatitis. It is very rare and often appears in immunocompromised patients.
In chronic prostatitis, it is a more insidious process, but with more consequences. Prostatitis does not cause mortality but impair the patients quality of life. Chronic cases link with erectile dysfunction when they feature severe symptoms .
Different Symptoms Of Bph Vs Prostate Cancer
Other than skin cancer, prostate cancer is one of the most common cancers for American men. One in nine men will be diagnosed with prostate cancer during his lifetime, according to data from the American Cancer Society.
Just because prostate cancer is so common, that doesnt mean the symptoms youve been experiencing are, in fact, cancer. Many symptoms of prostate cancer are the same for other conditions like infections or abnormal cell growth, also known as BPH. The symptoms of BPH vs prostate cancer can be similar. This is what you need to know and when to see a doctor.
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How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
Sexual Function After Surgery
Many men worry about whether surgery for BPH will affect their ability to enjoy sex. Some sources state that sexual function is rarely affected, while others claim that it can cause problems in up to 30 percent of cases. However, most doctors say that even though it takes awhile for sexual function to return fully, with time, most men are able to enjoy sex again.
Complete recovery of sexual function may take up to 1 year, lagging behind a persons general recovery. The exact length of time depends on how long after symptoms appeared that BPH surgery was done and on the type of surgery. Following is a summary of how surgery is likely to affect the following aspects of sexual function.
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What Are The Common Symptoms Of Prostatitis In Men
The prostate gland is a walnut-sized gland located just below the bladder. The urethra, which carries urine and semen, passes through the prostate gland. Prostatitis can be caused by bacterial infection, inflammation, or both.
Prostatitis is classified into four different variations three can be diagnosed easily through their symptoms. But the fourth type, asymptomatic inflammatory prostatitis, can be diagnosed during a doctor visit for another health problem concern. Some common symptoms include:
- Urinary Urgency: A sudden urge to immediately empty your bladder
- Painful Urination: Discomfort or pain during or after urination
- Painful Ejaculation: Discomfort or pain during or after the release of semen
- Urinary Frequency: An often feeling to go to the bathroom to pee
- Nocturia: Having to wake up often at night to go to the bathroom.