Prostate - Your Prostate

Prostate – Your Enlarged Prostate
 

1.       What is the prostate gland?

The prostate is a brownish gland about the size of a walnut.  It surrounds the opening of the bladder and about the first 2.5 cm of the urethra which is the urine tube passing from the bladder to the penis.  The prostate produces substances that make up a small part of the semen in the ejaculation.

2.       What causes the problem with the waterworks?

The trouble with the waterworks is usually caused by the enlargement of the prostate gland. Almost every man over 45 years of age will have some degree of the prostate enlargement in which the majority is due to benign prostate hypertrophy (BPH).  Some medications, such as alcohol, medications used to treat depression, Parkinson’s disease, irregularity of the heart beats and over the counter ephedrine-like compounds for cough and colds can cause or exacerbate prostate enlargement.  Although prostate enlargement is common in men over 45 years old, it rarely causes any problems before the age of 50.  About 50% of men over the age of 55 will have waterworks trouble. This proportion increases to 80% for men over 80 years old. Serious waterworks trouble affects 2 in 10 elderly men.

3.       What are the symptoms?

·         Frequency of urination.

·         The urge to urinate without warning.

·         Waking up at night to urinate.

·         Difficulty with the start of urination.

·         Poor stream of urine.

·         Tendency to dribble at the end of urination and the needs for double voiding to empty
  the bladder.

·         Abdominal pain and blood in the urine are uncommon symptoms in BPH.

4.       What are the risks?

BPH is not dangerous, but it can causes problems with your normal waterworks function as described in the above symptoms. More serious problems are the urine infection, sudden acute blockage of the urine, called acute urine retention, and slow blockage of the urine, called chronic urine retention. If this is to occur, a urinary catheter can be inserted by your doctor to relieve severe urine obstruction.

5.       What tests can be done for your prostate?

When you see your doctor for a prostate check-up, your doctor usually asks you a number of related medical questions regarding to your prostate.  Your doctor will then perform a prostate examination with a gloved finger to feel your prostate through the back passage. After that, your doctor may choose to order a prostate blood test called PSA.  All of the related medical history, examination as well as the blood test will help your doctor to determine the state of health and condition of your prostate. It is highly advised that you should have a regular prostate check-up if you are a middle aged man or older and have any waterworks trouble, or have a personal or family history of prostate problems, or if you are taking medications that can affect your prostate.

6.       What is the treatment?

a.      General measures:

·        Avoid or minimise alcohol intake with and after evening meals.

·        Avoid fluids for at least 3 hours before retiring.

·        Get up immediately at night if you need to urinate.

·        Visit the toilet when you need to go and don’t hold your urine.

b.      Medications:  
There are many medications available to relieve and improve the flow of your urine. Your doctor can advise you about these appropriate medications accordingly.

c.       Operation:  
About 1 in 10 men may need a prostate operation.  It is usually done through the penis using an instrument to remove the obstructive prostate tissue. The operation is called Trans-Urethral Resection Prostatectomy (TURP).  TURP is usually done by your prostate specialist.