Facts About Common Prostate Gland Problems
What is prostate gland and what are the common prostate gland problems?
The prostate gland is situated just under the bladder.The size of prostate gland in a full grown male is about the size of walnut.It surrounds the urethra which is a tube that has two functions.One is to carry urine from the bladder during urination and the other one is to carry seminal fluid to during ejaculation.The prostate gland secrets and stores seminal fluid slightly alkaline in character to counter the acidic conditions of the vagina thus helping to increase the life span of the sperm in the seminal fluid.Otherwise the acidic nature of the vagina would destroy the sperm immediately upon contact.
Prostate enlargement occurs to most men as part of aging process.It is nothing to worry about as long as it is benign meaning non-cancerous.This disorder is called ‘benign prostatic hyperpalsia’.or BPH.It literally means that you have excessive cell formation in your prostate gland which is non cancerous.
This disorder affects 1 in 4 men in the age group of 50 and above.The only problem with this disorder is that you may have to make frequent trips to bath room.This happens because,the urine draining tube from the bladder passes through the prostate gland which wraps around it.When prostate enlarges it squeezes the tube to create the urge to urinate.It may also cause painful urination.
What causes prostate enlargement? As of now,the cause is not clear.What is known is that it typically happens to men who have crossed fifty years of age.Since the cause is not known,it is difficult to prevent or eradicate it.It is presumed that the excess production of hormone dihydro-testosterone as a male ages may be the culprit.
There is another school of thought that blames the junk food diet which is high in fat and low in vitamins and minerals necessary for healthy growth.This lack of vitamins lowers the body’s defenses against free radical onslaught on the body in general and prostate tissues in particular,causing prostate enlargement.
The symptoms of this disease are the urge to urinate often,a persisting feeling of inability to empty the bladder fully,painful urination,dribbling of urine and abrupt changes in the rate of urine flow.Usually the symptoms are merely annoying and causes manageable discomfort.Treatment is needed if the symptoms are so bothersome that it interferes with the quality of life.
BPH needs immediate medical attention under some situations such as urge incontinence,inability to urinate and bladder back up.
The urge incontinence as the name implies is the uncontrollable feeling to relieve yourself immediately.This may be an indication of damage to your bladder and need urgent medical help.
The inability to urinate is also called acute urinary retention.This condition may cause pain and discomfort.There is also the possibility of serious kidney damage.
The situation of ‘bladder back up’ occurs when you are unable to empty your bladder fully.This may lead to the collection of urine in the kidneys resulting in infection and kidney damage.
The aim of the treatment is to regulate and improve the urine flow so that the symptoms do not bother any more.Consult your urologist for the right type of treatment for you.To know the severity of this disorder,undergo a self assessment procedure by answering seven questions.This is called International Prostate Symptoms Score Sheet.The questions pertain to problems you face during urination.They are as follows.
How often have you had a sensation of not emptying your bladder completely after you finished urinating, over the past month? How often have you had to urinate again less than 2 hours after you finished urinating, over the past month? How often have you stopped and started again several times when you urinated,over the past month?How often have you found it difficult to postpone urination, over the past month? How often have you had a weak urinary stream,over the past month? How often have you had to push or strain to begin urination, over the past month? How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning over the past month?According to your answers your BPH condition is evaluated in points score.If you score 0-7 points,you have mild BPH.If you score 8-19 points,you have moderate BPH.If you score 20-35 points,you have severe BPH.
Remember this index is only a guide for you to know the severity of BPH symptoms.Even without undergoing this test if you feel that you can not cope with them,you may opt for treatment.
BPH is treated with combination of medications,therapies and lifestyle changes.For mild BPH you may opt for the wait and watch approach because you may be able to manage without medications which is the best choice.
There is no cure for BPH but the symptoms can be treated with drugs.There are medications to manage the symptoms of BPH such as alpha-blockers and 5-alpha reductase inhibitor drugs.If you stop taking these drugs,the symptoms return.
The purpose of alpha blockers initially was to control high blood pressure since it reduces the muscle tension on the blood vessel walls.A variant of this type of drug marketed as Flowmax is found to be useful.It is also effectively used to treat BPH as it relaxes the muscle tissue of the prostate gland to improve urine flow.The side effects of this drug are dizziness,headache and extreme tiredness as this drug causes blood pressure drop.
5-Alpha reductase inhibitor drugs(finasteride of Proscar) are used mainly in severe cases of large sized prostate to reduce the size and to improve urine flow.The problem with these drugs are that they have moderate ability to improve the symptoms and also take a long time to work sometimes up to three months of regular usage.This drug also may cause erectile dysfunction and reduction in ejaculation volume which vanish if you stop taking these drugs.
A herb known as saw palmetto is found to be very effective in fighting BPH.Saw palmetto pills are available in most of the health stores and pharmacies.Choose saw palmetto supplements containing 85-90% of fatty acids and sterols and use them for at least six months for it to work.Use one brand for two months and if there is no improvement,change to another brand of saw palmetto.If your condition does not improve still, consider other options.
Super Saw Palmetto by Action LabsAlong with medication certain lifestyle changes are necessary to see results.Avoid all over the counter decongestants and antihistamines.These may aggravate your BPH by preventing relaxation of bladder muscles which in turn will affect rate of urine out flow.Stop all fluid intake an hour before bedtime.Avoid coffee in particular as caffeine in coffee stimulates urination.Contrary to popular belief taking zinc supplements do not help in managing BPH and it is better to avoid them.
Cooled thermo therapy is another process in which a water cooled catheter containing a small microwave antenna is inserted deep into the prostate through the urethra.Microwave energy is emitted through the antenna which destroys the prostate tissue to ease pressure on the urethra there by improving urine flow.The cool water circulated through the catheter avoids heat damage to the urethra.This is found to be long lasting and safe.However it takes about a month for improvements to show.This therapy is found to be more effective than medications.
Another method is called ‘trans urethral needle abalation’ TUNA for short.This method requires the usage of local anesthesia and the process itself takes about an hour.This process uses low radio frequency waves to burn the excess prostate tissue to improve the urine flow.After this therapy,the patients can resume their normal activity within 24 hours.
Surgery should be the last option if all the other methods and medications fail.Prostate surgery is called ‘trans urethral resection of prostate’ or TURP for short.TURP is done on those whose urine out flow is seriously blocked and on those who are considered to be at great risk of kidney of bladder damage.This process involves little or no pain.In this process,a device called resectoscope is passed through urethra into the bladder.The inner core of the prostate gland is removed by a wire attached to the resectoscope which also seals the blood vessels.Hospitalization is required for three days.
Prostate cancer is the most common cancer next to lung and colon cancer in men.This potentially fatal disease can be cured easily if detected early.Fortunately most prostate cancers are slow to develop and grow hence we have enough time to detect.If not the cancer might spread to other organs nearby.
Prostate cancer does not have any symptoms.It’s presence is usually revealed during routine ‘digital rectal exam’ or DRE for short and ‘prostate specific antigen’ or PSA blood test.
Digital rectal exam(DRE) is quick and painless and is done by a doctor to detect the presence of prostate cancer.The physician inserts a lubricated gloved finger into the rectum to feel for any abnormalities or lumps on the prostate gland or in other areas inside rectum.It is advisable for men above 50 to undergo this test once in a year.
The prostate specific antigen(PSA) test is done on those who either have a family history of prostate cancer or on those who have prostate problems.This test is conducted to know the level of PSA which are produced by prostate cells.The normal levels are 4 nanograms per milliliter.A PSA score of 4-10 indicates borderline and anything above it is high.High PSA scores indicate prostate cancer and need further investigation.A small tissue sample is taken from the prostate for biopsy to determine the presence of prostate cancer.
Gleason score is done to determine whether the cancer can spread to other parts of the body.The biopsy sample is used to evaluate your Gleason score which is a prostate cancer grading system from 2-10.A score of 2-4 is indicative of low risk.A 5-6 score indicates moderate risk.A score of 7-10 denotes high risk
There are six stages of prostate cancer namely T1,T2,T3-4,N,M.T1 stage indicates that the cancer is localized inside the prostate and can be detected by PSA tests.The treatment options are radiation and radical prostatectomy.
T2 stage is when the cancer inside the prostate gland as indicated by DRE test.The treatment options are same as above,radiation and radical prostatectomy.
T3-4 stage comes when prostate cancer has spread just beyond prostate gland.The treatment options are hormone therapy and radiation.
The N stage indicates that the cancer has spread beyond prostate gland to affect the lymph nodes.The treatment options are hormone therapy and complete removal of prostate gland and lymph nodes.
M stage occurs when the prostate cancer has spread to other parts of body.The treatment options are radiation and other suitable therapies to be determined by the physician.
The prostate cancer treatment or combination of treatments is determined by studying the Gleason score,PSA levels,cancer stage and the age of patient.
The treatments for prostate cancer are radiation therapy,seed therapy,hormone therapy and radical prostatectomy.
In radiation therapy,high energy radiation is used for destroying the cancer cells before they develop and migrate to other parts of body.This therapy is used when the cancer cells are localized without spreading.This therapy also is used after surgery to prevent reoccurrence of cancer.The radiation is done five days a week for eight weeks or as directed by physician.The side effects are not pronounced but occasionally bladder and rectal problems occur.
The seed therapy is performed by placing small seed sized radioactive pellets inside prostate to destroy the cancer cells.This treatment is done on those who have the initial stage cancer.This is done as out-patient treatment and is over in an hour.The side effects are occasional which are rectal bleeding,diarrhea,erectile dysfunction and incontinence.
The hormone therapy is also called ‘androgen deprivation therapy’(ADT) and is done to reduce or block the production of testosterone to slow down the growth of cancer.It is generally performed to reduce the size of prostate gland.
The radical prostatectomy surgery is done to remove the prostate gland and also the lymph glands if cancerous.This is done carefully to avoid damage to nerves controlling bladder and erections.The success rate is above 90% and has minimal side effects such as erectile dysfunction and incontinence.These are restored over a period of time.
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