Prostate is the male reproductive gland that contributes to the production of seminal liquid, which transports sperm during ejaculation. This gland surrounds the urethra, the conduit through which urine leaves the body.
From the age of 30, the progressive growth of the prostatic gland occurs. As the gland grows, it can squeeze the urethra and cause urinary symptoms.
Prostate enlargement is generally called Benign Prostatic Hypertrophy (BPH). It is not cancer and it does not increase the risk for prostate cancer.
What are the causes?
The causes of the disease are unknown. Factors linked to ageing and testosterone (a male hormone produced by the testicles) can play an important role in the growth of the gland. Men who have their testicles removed at an early age (for example, as a consequence of testicular cancer) do not develop hyperplasia.
What are the symptoms?
Less than half of men with hyperplasia develop symptoms. The following are some of them:
-Weak urine stream.
-Intermittent urine stream.
-Difficulty starting urination.
-Dribbling after urination.
-Feeling of incomplete emptying of the bladder.
-Urge to urinate.
-Need to get up to urinate at night.
-Urgency that produces urinary incontinence.
Benign Prostatic Hypertrophy can cause complications such as bleeding, recurrent urinary infections, Urinary retention that requires bladder catheterization, development of stones or diverticula and renal insufficiency.
Diagnostic tests
At the consultation, our specialists will make a complete medical history, then perform a physical examination, which can include performing a digital rectal examination to palpate the prostate gland. There are a series of diagnostic tests for this disease:
-A symptomatic questionnaire (IPSS) to assess the severity of symptoms.
-Urinary flowmetry.
-Ultrasound of the urinary system (to determine prostate size).
-Post-void residual estimation by ultrasound.
-Urinalysis with culture to verify the presence of blood or infection.
-Blood test with determination of prostate-specific antigen or PSA to detect possible hidden prostate cancer.
-A voiding diary (record of the frequency and urinated volumes) to rule out nocturnal polyuria.
-Additionally, in specific cases, it may be necessary to perform a urethrocystoscopy (insert a camera through the urethra, to rule out possible urethral narrowing or to assess the bladder). When in doubt about the advisability or not of operating, a urodynamic study or from a pressure-flow study. Occasionally, an intravenous urography or uro-CT scan may be appropriate.
Treatment
The choice of appropriate treatment is based on the severity of the symptoms, the degree to which they affect daily life and the presence of any other condition. Treatment options include regular check-ups, introducing lifestyle changes, medications, or surgery.
If you are over 60, you are more likely to have symptoms, but many men with an enlarged prostate have only mild symptoms. Generally, lifestyle changes are enough to make you feel better.
At the Harley Street Hospital, we have some of the best specialists to diagnose and treat Benign Prostatic Hypertrophy. Book an appointment to get a checkup.
You might also want to read: Medical treatment for enlarged prostate
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