Health

Enlarged Prostate: A Complex Problem

What Is an Enlarged Prostate ?

 The prostate gland surrounds the urethra, the tube through which urine passes out of the body. … Prostate enlargement happens to almost all men as they get older. An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.

What Causes an Enlarged Prostate?

 The prostate gland, which is normally about the size and shape of a walnut, wraps around the urethra between the pubic bone and the rectum, below the bladder. In the early stage of prostate enlargement, the bladder muscle becomes thicker and forces urine through the narrowed urethra by contracting more powerfully. As a result, the bladder muscle may become more sensitive, causing a need to urinate more often and more suddenly.

 The prostate grows larger due to an increase in the number of cells (hyperplasia). However, the precise reason for this increase is unknown. A variety of factors may be involved, including androgen (male hormones), estrogen, and growth factors and other cell signaling pathways (cell-to-cell communication).

 As the prostate grows larger and the urethra is squeezed more tightly, the bladder might not be able to fully compensate for the problem and completely empty. In some cases, blockage from prostate enlargement may result in stagnation and backing up of urine, which in turn may cause repeated urinary tract infections, bladder stones, bladder diverticulitis (outpourings or pockets inside the bladder), and gradually result in bladder or kidney damage. It may also cause a sudden inability to urinate (acute urinary retention) — a painful medical emergency that requires urgent drainage.

What Are Enlarged Prostate Symptoms and Signs

Symptoms of enlarged prostate can include:

  • A weak or slow urinary stream
  • A feeling of incomplete bladder emptying
  • Difficulty starting urination
  • Frequent urination
  • Urgency to urinate
  • Getting up frequently at night to urinate
  • A urinary stream that starts and stops
  • Straining to urinate
  • Continued dribbling of urine
  • Returning to urinate again minutes after finishing

When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones, blood in the urine, incontinence, and acute urinary retention (an inability to urinate). A sudden and complete inability to urinate is a medical emergency; you should see your doctor immediately. In rare cases, bladder and/or kidney damage can develop from BPH.

When Should Someone Call the Doctor About an Enlarged Prostate?

 If you experience bladder pain or burning with urination, blood in the urine associated with fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospital’s emergency department.

 For acute symptoms such as acute urinary retention (you feel uncomfortably full but cannot urinate), you should immediately go to the closest emergency medical facility for bladder drainage, usually with a catheter, which is a tube inserted into the bladder.

Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.

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