Prostate gland enlargement (Or Benign prostatic hyperplasia /BPH)
The prostate gland is only found in men and is a small gland under the bladder and just above the penis.
The tube called the urethra passes through the centre of the gland. If there is any enlargement in the gland this can compress the urethra causing a narrowing or blockage and altering the flow of urine.
This is a very common condition in any man over 45 and the risk goes up as you age.
Approximately 30% of all men over 50 have a problem and this rises to 90% by 85 years old.
What are the Symptoms?
-Needing to urinate more often and increasingly needing to get up in the night
-Dribbling rather than having a good flow and also dripping after you have finished
– Hard to start urinating and you may feel like you have to strain to pee
You may be more prone to urine and kidney infections .
Some people do not experience any symptoms
Diagnosis
When you see the doctor they will ask about the history of your problem and the symptoms. They will then feel if the prostrate gland is enlarged, by performing a rectal examination.
You will probably have urine and blood tests to check for any infection and to see the levels of PSA in your blood.
A raised PSA level may need treatment or just to be monitored. A high level can indicate cancer in which case they will want to do further tests such as Ultrasound scan and a cystoscopy to look up the urethra with a camera.
Treatment options
With mild symptoms you may be able to just manage the symptoms with a few simple lifestyle changes.
One easy thing to change is to reduce fluid intake in the evenings to prevent having to get up at night. It is also helpful to reduce alcohol and caffeine.
It is important to have regular checks to make sure the prostate has not enlarged further and give any reason for concern.
Sometimes medications are needed which might be alpha- blockers to relax the muscles in your prostate gland. There are also other tablets that help reduce the size of the prostate gland. Both these tablets affect you blood pressure so you will have to have this well monitored.
Surgery
If it is not responding to treatment and needs to be removed it will most likely be done by TURP (transurethral resection of the prostate)
This will be done as a cystoscopy and then an instrument will cut away excess tissue and cauterise the blood vessels at the same time.
Another type of surgery is a transurethral incision of the prostate, which requires an incision and is only used in more severe cases.
Outlook
With changes to lifestyle and some tablets or mild surgery the outcome should all be good