Enlarged prostate is such a common problem among men over a certain age that one in two men over 60 will suffer from it while the statistics for the over 50s is one in three. The gland, not more than the size of a walnut when not enlarged, is situated below a man's bladder. Here it surrounds the urethra which is the tube through which the urine is drained from the bladder. When it increases in volume, this tube is narrowed rather like a hosepipe with a clamp on it.
Because the enlarged prostate acts like a clamp on the urethra, difficulty in urinating is the main symptom together with increased frequency, burning sensation and difficulty in emptying the bladder. The condition is also known in medical circles as BPH which is an acronymn for benign prostatic hyperplasia.
The doctor will order a PSA test which is a blood test which reveals the presence of an antigen which is a tumor marker – that tells us whether there are any cancerous cells around. A scan sometimes needs to be done if the results from the PSA are borderline or a more sophisticated blood test (the free PSA) can be carried out.
Secondly, what is a DRE? It is a digital rectal examination when the urologist or doctor where he can feel with his finger the size and the consistency of the prostate behind the rectal wall. He can tell if it is bigger than it should be and how smooth it is – that is a good sign.
Thirdly, men need to know about surgical procedures and the risks involved. Laser techniques and other procedure are now common and nerve spring is almost standard in the effort to prevent incontinence or impotence after surgery. The percentage of these problems is very small. The doctor has to assess the overall condition of the patient and make a recommendation.
Fourthly, what medication is available? Many doctors advise watchful waiting and may recommend medication which lowers levels of hormones produced by the prostate and reduces the size of the prostate gland while increasing the urine flow rate. The common drugs used are beta blockers (such as Flomax and Cardura) which help the muscles around the bladder to relax while other drugs (such as Proscar) will actually shrink the size of the gland if it is large.
In fifth place, a change in diet, if the condition is mild or moderate, is recommended.. So a low-fat diet, with lots of fibre from fruit and vegetables, tomatoes and soya and a reduced intake of coffee and alcohol can help. Some herbal remedies and supplements are also possible- the best known ones to be effective are :- saw palmetto, zinc, pumpkin seeds, beta sitosterol and selenium.
Thankfully surgery is not often an option now but the doctor and patient together can make an informed decision about which treatment is best. Herbal supplements are sometimes used in conjunction with standard medication. They may also be used instead of these medicines. In the final analysis, the patient has to decide what is best for him.
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