Enlarged prostate (BPH)
For many men experiencing an enlargement of their prostate is a natural stage of them getting older. For some men, once they hit their forties, their prostate undergoes another episode of prostate development. As a strong layer of tissue surrounds the prostate, the prostate compresses inwards onto the urethra which then starts to obstruct the flow of urine.
Some Prostate statistics
* Men over the age of 50 have a 50% chance of developing an enlarged prostate
* By the time they are 80, the percentage of men developing an enlarged prostate goes up to 80-90%
An enlarged prostate is not life threatening it isn’t cancerous and it can be managed reasonably well. However cancer can also be present as well as an enlarged prostate.
It’s not really understood why BPH (enlarge prostate) occurs, but the manufacture of testosterone and oestrogen probably has some bearing on it. Testosterone is a male hormone and oestrogen is female. Normally men only produce very small amounts of oestrogen. However it is thought that as men get older, the amount of testosterone he produces becomes less, this is thought to encourage cell growth within the prostate gland which then leads to enlargement.
Other theories include the possibility that the production and build up of dihydrotestosterone (DHT) which is a by product of testosterone encourages the growth of cells.
Many men discover an enlarged prostate for themselves. Especially if they start to suffer from the more common symptoms such as problems with urination, otherwise it is usually detected by a doctor during routine examinations.
A urologist is the doctor who specialises in the type of problem relating to the urinary tract and the male reproductive system, and he/she will ensure the problem is managed as comfortably as possible.
The doctor will have done an initial examination rectally (Digital rectal examination) this is the only way to physically feel the prostate gland. Once he’s satisfied the prostate is enlarged, he may then go onto further tests such as an
* International Prostate Symptom Score which is a short questionnaire that asks specific questions about symptoms etc.
* A laboratory test of the urine (to rule out the possibility of infection in the bladder etc)
* A Prostate-Specific Antigen (PSA) blood test which is used to rule out the possibility of prostate cancer as the cause of symptoms.
Other tests may include
* A Urinary flow study – this measures strength and volume of urine flow.
* Imaging tests – this is an ultrasound carried out to estimate the size of the prostate. It can also be used to look for prostate and kidney stones or any type of obstructions (including cancer).
* Cystoscopy – a cystoscope is inserted into the urethra to detect problems which may include prostate enlargement or the development of stones in the bladder.
* Urodynamic studies – The urologist often recommends a series of tests which measure the bladder pressure and function if they think symptoms may be related to a bladder or neurological problem, and not an enlarged prostate.
* Post-void residual volume test – this is where ultrasound imaging is used to determine if you can empty your bladder completely.
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