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The prostate gland normally enlarges (grows) as a man ages. Prostate enlargement is most commonly caused by Benign Prostatic Hyperplasia (BPH), a benign proliferation that causes restriction of urine flow out of the bladder. The process can be likened to putting your finger over the end of a garden hose; the bladder has to generate greater pressure to push urine out through the smaller opening. As the bladder is forced to work harder, it becomes thickened, muscular and more irritable. Eventually, the bladder may not be able to overcome the obstruction and therefore may not be able to evacuate urine sufficiently. In some cases this leads to complete urinary retention, the inability to empty the bladder.
The extent to which the prostate gland grows and the symptoms which can result can vary a great deal between individuals. By the age of 55, 25% of men will complain of a weak urinary stream. If a man lives to age 80, he has an 80% chance of having signs or symptoms of BPH and a 30% chance of requiring surgery for this obstruction. in the past, this has translated into an estimated 350,000 operations per year for BPH. |
| Symptoms The most common symptoms of BPH include: |
| * weak stream
* hesitency * frequent urination ----- ----- ----- -----(day and night) |
* urgency
* feeling that the bladder is-still full after urinating |
| Other Signs include: |
| * bleeding
* urinary tract infection
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| The symptoms of BPH typically develop gradually over time. Occasionally, a man with underlying BPH will suddenly find himself unable to urinate . This painful condition is known as acute urinary retention and it can be brought on by immobility (after minor surgery), cold weather, and from the use of over-the-counter cold medications ( decongestants). |
| Diagnosis |
| The best way of diagnosing symptomatic prostate enlargement is by talking with your doctor and undergoing a thorough physical exam. Essential to the initial exam are the digital rectal examination and urinalysis. The rectal exam gives your doctor an idea about the size and consistency of the gland. This may allow him/her to differentiate between benign enlargement and cancer. The following tests may be necessary to assess the urinary tract and its ability to empty: |
| Urine flow Study | to assess the flow pattern during voiding
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| Bladder Scan | a simple ultrasound test to assess how well the bladder emptied
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| Intravenous Pyelogram (IVP) | an x-ray study of the urinary tract to check for any blockage or damage to the kidneys
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| Cystoscopy | an office procedure with local anesthetic where a small flexible telescope is passed up through the urethra to evaluate the inside of the urethra, prostate and bladder |
