A recent study reported in the times of london found that 89 per cent of the men surveyed did not know where the prostate was located. They also didn't know the function of the gland or the problems associated with it. Is the situation any better in our country? According to experts, awareness about the prostate and irs problems depends largely on the socioeconomic background of the patient in India. Further,many men feel uncomforatble talking about it as the gland plays a role in both sexual life and urination.
KNOW YOUR BODY
prostate enlargement arising from ageing is a common medical problem among men . Normally os the size of walnut, the prostate gland is part of the male reproductive system. Enclosed by a layer of tissue, it surrounds the urethra-the canal through which urinepasses out - and is located below the bladder. its major function is to contribute to seminal fluid. Problems related to the prostate gland include:
* Inflammation (prostatitis )
* Enlargement Prostate (benign prostatic hyperplasia or BHP)
* prostate cancer
PROSTATITIS
Prostatitis or inflammationof the prostate gland is a comman condition in men of all ages. Through the usual cause for prostatis is bacterial infection, in older men it could be as a result of hormonal changes. Urine retention owing to inflammation can result in infection of the bladder urethra and kidney. key symptoms include pain in the area between the scrotum and retum; difficulty in passing urine; frequent urination usually accompanied by a burning sensation;dribbling after urination ; sense of fullness of the bladder; and blood or pus in the urine . later , symtoms can also include lower back pain and impotemce.
ENLARGED PROSTATE
Enlarged prostate, or benign prostate hyperplasia (BHP), is the gradual enlargement of the prostate owing to hormonal changes. Overproduction prostate cells causes enlargemnent of the gland in over 60 per cent of men over the age of 50, and 75 per cent of men over 70. Over time , the enlarged prostate cause serious problems.
When the prostate enlarges, the surrounding layer of tissue stops it from expanding , causingit to press against the urethra. As the bladder exerts greater preassure to pass urine through the narrowed urethra , the bladder wall becomes thicker and more sensitive. The bladder begins to contract even when it contains small amount of urine , creating a need to urinate more frequently.Eventually the bladder weakens and loses the ability to empty itself completely. Urine retention and strain on the bladderca lead to recurrent urinary tract infection, bladder stone formation, and urinary incontineence (the inability to control urination). Risk of developing such complications is lower when BPH is diagnosed in early stages.
The size of the prostate does not always determine severity of the symptons or degree of obstrucion . While some men with significantly enlargement glands may have hardly and obstruction and few symptons , others with less enlarged glands have more blockage and problems. Sometimes the narrowing of the urethra may be unaware of any obstruction until he suddenly finds himself unable to pass urine- a condition becomes a medical emergency.
PROSTATE CANCER
Prostate cancer is the second most prevalent form of cancer, with approximately 80 per cent chances of occurrence in men over the age of 65. Around 20 per cent of the cases of enlargement prostate are cancerous but most of them grow slowly, symptons are similar to that of prostatitis and BHP, and it is not unusual for prostate cancer to occur without any warning gigns. Althought prostate enlargement is neither cancer nor does it increase chances of developing of prostate cancer at the time or may develop it in future. An oprtation for enlarged prostate does not eliminate the risk of development prostate cancer.
DIAGNOSTIC TESTS
If a doctor finds the prostate enlarged during medication examination, he refers the paitient to a urologist ( who specialises in problems of the urinary tract and male reproductive system).
SYMPOTOMS
* Hesitant or interrupted urine stream
* Decreased force and calibre of urine stream
* Incomplete emptying of the bladder
* Double voiding (need to urinate within two hours)
* Straining to urinate
* Post - void dribbing
* Sudden urgency to urinate
* Frequent urination
* Nocturia (need to pass urine at night)
* Blood in urine
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A physical examination , patient history , and evaluation of symptoms help the urologist mak a diadnosis and decide whether surgery ir required.
Tests usually carries out are:
* Digital rectal examination (DRE) to detect size, shape and consistency of prostste
* Uroflow study to measure urine flow
* Ultrasound (USG) of kidney, ureter and prostate to check post void residual urine
* Cystoscopy to determine size of gland and identify location and degree of obstruction
* Prostate - specific antigen to rule out cancer as a cause of urinatory symptons
* Transrectal sonography if prostate cancer is suspected
* Biopsy if prostate cancer is suspected
* Upper tract imaging (IVP) recommended only in case of concomitant urinarytract disease or complications from BPH
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