Prostrate Problems

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Dr Ochi Igboko

What Is the Prostate?

The prostate is a small gland in men that is part of the reproductive system. It is about the shape and size of a walnut. The prostate rests below the bladder and in front of the rectum. It surrounds part of the urethra, the tube that carries urine from the bladder. The prostate helps make semen, which carries sperm from the testicles when a man ejaculates.

Enlarged Prostate

As a man ages, the prostate can grow larger. When a man reaches the age of 40, the prostate gland might have increased from the size of a walnut to that of a lime. By the time he reaches the age of 60, it might be the size of a lemon.

Because it surrounds part of the urethra, the enlarged prostate can squeeze the urethra. This causes problems in the passing of urine. Typically, these problems passing urine do not occur in men until they are age 50 or older. They can, occasionally occur earlier.

An enlarged prostate is also called benign (noncancerous) prostatic hyperplasia or BPH. It is common and cannot be prevented. Age and a family history of BPH are risk factors. Eight out of every 10 men eventually develop an enlarged prostate. About 90% of men over the age of 85 will have BPH. About 30% of men will find their symptoms bothersome.

Symptoms of an enlarged prostate may include:

  • Trouble starting to urinate or urinating freely
  • Having to urinate frequently, particularly at night
  • Feeling that the bladder is not empty after urinating
  • Feeling a sudden urge to urinate
  • Having to stop and start repeatedly while urinating
  • Having to strain to urinate

To maintain prostate health, it is important for men who have early symptoms of BPH to see their doctor. BPH is a progressive disease. It can lead to serious, although rare, health problems, such as kidney or bladder damage.

Treatments include:

  • Watchful waiting. Patients who have an enlarged prostate but who are not suffering symptoms or whose symptoms are not bothersome may be advised by their doctor to merely get an annual checkup, which might include a variety of tests.
  • Making lifestyle changes. Changes could include limiting drinking at night and before bedtime, especially drinks containing alcohol or caffeine.
  • Drug therapy. Two common treatments for BPH are alpha-blockers, which alleviate BPH symptoms, and 5 alpha-reductase inhibitors, which help shrink the prostate. Many men take them together.
  • Surgery. This is generally used for men with severe symptoms who have not been helped by other treatment.

Prostatitis

Prostatitis is an infection or inflammation of the prostate. It can affect men in their late teens to those well into old age. Its symptoms include trouble passing urine, chills and fever, and sexual problems. The condition is not contagious and cannot be transmitted sexually to a partner. Treatment usually includes antibiotics.

A man who has recently had a catheter or other medical instrument inserted into his urethra is at higher risk of bacterial prostatitis. Some sexually transmitted diseases, such as chlamydia, may cause chronic prostatitis.

PROSTATE CANCER

Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is detected early — when it is still confined to the prostate gland — has a better chance of successful treatment.

Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that is more advanced may cause signs and symptoms such as:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the semen
  • Discomfort in the pelvic area
  • Back pain
  • Erectile dysfunction

 Prostate Health: Tests

Doctors use several tests to check on the condition of the prostate. They include:

DRE, or digital rectal exam: This is the standard prostate test. A doctor feels the prostate from the rectum, checking for things such as size, lumps, and firmness.

PSA , or prostate-specific antigen test: This blood test measures the amount of a protein called PSA that is produced by prostate cells. Elevated levels may indicate cancer. They are not proof that a man has prostate cancer. Levels may be elevated with noncancerous prostate conditions such as an enlarged prostate or prostatitis. Levels may be low with prostate cancer.

Screening for prostate cancer is controversial.

It is however recommended that from 50 years men should get screened every year.

Prostate biopsy : Men with high PSA results or other symptoms of cancer may have a tissue sample taken of their prostate to determine if cancer is present.

According to the American Cancer Society, more than 190,000 new cases of prostate cancer are diagnosed in the U.S. each year. The Nigeria statistic is not certain but may be higher than this. Fortunately, there is a lot you can do to keep your prostate healthy as you age—and stay ahead of the game.

  1. Keep a healthy weight and exercise regularly.
  2. Eat more fruits and vegetables. Tomatoes, watermelons, pink grapefruits, guava and pawpaw contain lycopene, a powerful antioxidant. Cruciferous vegetables such as broccoli, cauliflower, cabbage, Brussels sprouts, are good choices.
  3. Let your doctor know if you have a family history of prostate cancer. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease.
  4. Include more soy in your diet.
  5. Do not smoke.
  6. Eat more selenium-rich foods such as wheat germ, tuna, herring and other seafood and shellfish, beef liver, kidney, eggs, sunflower and sesame seeds, cashews, mushrooms, garlic and onions. Selenium reduces risk of prostate cancer.

Get a PSA blood test and digital rectal exam annually, beginning at age 50.

About author

Dr Ochi Igboko

Consultant Anesthesiologist & Critical Care Physician. Email: drigboko@yahoo.com

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