The prostate is a plum-sized gland located in front of the rectum and just below your bladder, where urine is stored. The prostate gland surrounds the urethra, which is the canal through which urine passes out of your body. The urethra also secretes fluid that forms part of semen.
The prostate gland often enlarges with age. This condition is known as benign prostatic enlargement (BPE), benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. As the prostate enlarges, its capsule (layer of tissue surrounding it) stops it from expanding outwards. This causes the prostate gland to press inwards against the urethra like a clamp on a garden hose.
As a result, the bladder wall thickens and the bladder contracts even with small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, resulting in residual urine left in the bladder.
If you have BPE, you may experience symptoms that include:
Some men with greatly enlarged glands have little obstruction and few symptoms. Others, whose glands are less enlarged, may have more blockage and greater problems. Sometimes you may not know you have any obstruction until you suddenly find yourself unable to urinate at all. This condition, called acute urinary retention, may be triggered by taking certain cold medications that prevent the bladder opening from relaxing and allowing urine to empty.
Severe BPE can, over time, cause serious problems such as urinary tract infections, bladder or kidney damage, bladder stones, and incontinence. If your bladder is permanently damaged, treatment for BPE may be ineffective. If BPE is found in its earlier stages, your risk of developing such complications is lower.
BPE occurs because of a complex interaction between the male hormone dihydroxytestosterone (DHT - active component of testosterone), small amounts of oestrogen (female hormone), and other growth factors. This results in an imbalance of cell growth and death, and subsequent prostate growth and enlargement.
Increasing age is a risk factor for BPE. There is no convincing evidence that your diet or lifestyle are risk factors for the condition.
Some of the common tests to diagnose BPE include :
Treatment may not be needed in mild cases. In moderate to severe cases, the following treatment options are available:
Drugs that relax the smooth muscle of the prostate and bladder neck are Transurethral resection of the prostate (TURP) is the most common technique used to treat BPE. used to improve urine flow and reduce bladder outlet obstruction. Drugs that inhibit production of the male hormone DHT, which is involved with prostate enlargement, are used to prevent progression of growth of the prostate or actually shrink the prostate in some men.
Most urologists recommend removal of the enlarged part of the prostate as the best long-term solution for someone with BPE. With surgery for BPE, only the enlarged tissue that is pressing against the urethra is removed; the rest of the inside tissue and the outside capsule are left intact. Surgery may be performed by the following methods:
Sexual Function After Surgery
Most men are able to continue to have erections after surgery. After prostate surgery, the neck of the bladder is widened, so the semen takes the path of least resistance and enters the wider opening to the bladder rather than be expelled through the penis. Later, it is harmlessly flushed out with the urine. The main impact of prostate surgery is that you will not be able to father children in the normal way as you have a dry ejaculate. However, most men find little or no difference in the sensation of orgasm or sexual climax after surgery.
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