Enlarged Prostate: A Complex Problem
There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect — and how to decide.
By Jeanie Lerche Davis
From the WebMD Archives
All his life, he slept like a stone. But now, there’s an annoying trip to the bathroom every night, sometimes once or twice a night.
For most men, these nightly bathroom runs may be the first sign of an enlarged prostate. Other symptoms may include trouble starting a stream of urine, leaking, or dribbling. And, like gray hair, an enlarged prostate is a natural by-product of getting older, doctors say. Trouble is, the nightly bathroom runs become more frequent — eventually edging their way into the
daytime routine.
“They can’t sit through a meeting or a plane flight without getting up,” says Kevin Slawin, MD, a professor of urology at Baylor School of Medicine in Houston. “It’s very annoying … and when they have to go, they really have to go.”
It’s a problem that has several names — enlarged prostate, benign prostate hyperplasia, or simply BPH. According to the National Kidney and Urological Disease Information Clearinghouse, the most common prostate problem for men over 50 is prostate enlargement. By age 60, over one-half of men have BPH; by age 85, the number climbs to 90%, according to the American Urological Association (AUA).
Enlarged Prostate Symptoms and Causes
In men, urine flows from the bladder through the urethra. BPH is a benign (noncancerous) enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra — the “chute” through which urine and semen exit the body.
As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.
Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.
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.
Time to Do Something About Your Enlarged Prostate?
Most men put up with an enlarged prostate for months, even years, before seeing a doctor, says Slawin. “When they’re getting up several times a night, and have trouble falling asleep again, that’s when they come in,” he tells WebMD.
It’s not always obvious what’s going on, Slawin adds. “When men start having urinary problems, it’s hard to know the reason. They should see a doctor when anything changes, because there can be bladder cancer, stones, prostate cancer. BPH is often a diagnosis of exclusion … after we make sure nothing more serious is going on.”
Urologists use the BPH Impact Index, a symptom questionnaire developed by the American Urological Association to determine if a man’s symptoms from BPH require treatment. “It helps us understand how severe the problem is,” says Slawin. Higher scores indicate more severe symptoms.
Prostate growth — and the trouble it causes — varies greatly from person to person, says O. Lenaine Westney, MD, division director of urology at The University of Texas Medical School at Houston. “Some people have more growth than others. Some people with very large prostates don’t have trouble with voiding. It’s a very individual thing.”
Watchful Waiting With an Enlarged Prostate
When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index (less than 8), it may be best to wait before starting any treatment — what’s known as “watchful waiting.”
With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience. That’s where the BPH Index is especially helpful, Westney tells WebMD. “It lets us know how high the symptom score is … when to start treatment.”
The “driving force in treatment,” she explains, is whether the symptoms are affecting your quality of life — and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure, or other bladder problems.
A few questions to ask yourself:
How severe are your symptoms?
Do symptoms prevent you from doing things you enjoy?
Do they seriously affect your quality of life?
Are they getting worse?
Are you ready to accept some small risks to get rid of your symptoms?
Do you know the risks associated with each treatment?
Is it time to do something?
Source : The Sun Newspaper
There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect — and how to decide.
By Jeanie Lerche Davis
From the WebMD Archives
All his life, he slept like a stone. But now, there’s an annoying trip to the bathroom every night, sometimes once or twice a night.
For most men, these nightly bathroom runs may be the first sign of an enlarged prostate. Other symptoms may include trouble starting a stream of urine, leaking, or dribbling. And, like gray hair, an enlarged prostate is a natural by-product of getting older, doctors say. Trouble is, the nightly bathroom runs become more frequent — eventually edging their way into the
daytime routine.
“They can’t sit through a meeting or a plane flight without getting up,” says Kevin Slawin, MD, a professor of urology at Baylor School of Medicine in Houston. “It’s very annoying … and when they have to go, they really have to go.”
It’s a problem that has several names — enlarged prostate, benign prostate hyperplasia, or simply BPH. According to the National Kidney and Urological Disease Information Clearinghouse, the most common prostate problem for men over 50 is prostate enlargement. By age 60, over one-half of men have BPH; by age 85, the number climbs to 90%, according to the American Urological Association (AUA).
Enlarged Prostate Symptoms and Causes
In men, urine flows from the bladder through the urethra. BPH is a benign (noncancerous) enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra — the “chute” through which urine and semen exit the body.
As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.
Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.
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.
Time to Do Something About Your Enlarged Prostate?
Most men put up with an enlarged prostate for months, even years, before seeing a doctor, says Slawin. “When they’re getting up several times a night, and have trouble falling asleep again, that’s when they come in,” he tells WebMD.
It’s not always obvious what’s going on, Slawin adds. “When men start having urinary problems, it’s hard to know the reason. They should see a doctor when anything changes, because there can be bladder cancer, stones, prostate cancer. BPH is often a diagnosis of exclusion … after we make sure nothing more serious is going on.”
Urologists use the BPH Impact Index, a symptom questionnaire developed by the American Urological Association to determine if a man’s symptoms from BPH require treatment. “It helps us understand how severe the problem is,” says Slawin. Higher scores indicate more severe symptoms.
Prostate growth — and the trouble it causes — varies greatly from person to person, says O. Lenaine Westney, MD, division director of urology at The University of Texas Medical School at Houston. “Some people have more growth than others. Some people with very large prostates don’t have trouble with voiding. It’s a very individual thing.”
Watchful Waiting With an Enlarged Prostate
When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index (less than 8), it may be best to wait before starting any treatment — what’s known as “watchful waiting.”
With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience. That’s where the BPH Index is especially helpful, Westney tells WebMD. “It lets us know how high the symptom score is … when to start treatment.”
The “driving force in treatment,” she explains, is whether the symptoms are affecting your quality of life — and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure, or other bladder problems.
A few questions to ask yourself:
How severe are your symptoms?
Do symptoms prevent you from doing things you enjoy?
Do they seriously affect your quality of life?
Are they getting worse?
Are you ready to accept some small risks to get rid of your symptoms?
Do you know the risks associated with each treatment?
Is it time to do something?
Source : The Sun Newspaper
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