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Prostate gland enlargement - Overview, Symptoms, Diagnosis, Risk factors, & Treatment

The prostate gland is located just below a man's bladder. It surrounds the top portion of the tube that drains urine from the bladder (urethra). The primary function of the prostate gland is to produce most of the fluids in the semen, which nourishes and transports sperm during ejaculation.

The prostate gland enlarges with the age. As a man progresses from birth to young adulthood, the prostate gland grows from about the size of a pea to the size of a walnut. Most men experience a second period of prostate growth in their middle ages. Due to growth, cells in the central portion of the gland, where the prostate surrounds the urethra, begin to multiply rapidly. This growth of cells results in enlargement of the prostate gland.

As tissues in the area enlarge, they often compress the urethra tube and partially block urine flow. Prostate gland enlargement is also known as Benign Prostatic Hyperplasia (BPH). The presence or absence of prostate gland enlargement is not related to the development of prostate cancer.

Signs and symptoms of Prostate gland enlargement

• Weak urine system
• Pain while urinating or blood in urine
• Increased frequency of urination
• Incomplete emptying of the bladder
• Urgent need to urinate
• Urinary tract infection
• Night time urination, the urge to go urinate 2 to 3 times per night
• Stopping and starting again while urinating
• Dribbling after urination

Prostate gland enlargement - Risk factors

The main risk for enlargement of the prostate gland is old age. Prostate enlargement is rarely seen in people who are younger than 40 years.

Hereditary
If a man has a family history of prostate enlargements, he is at risk of enlargement of prostate gland.

National origin
Enlargement of the prostate gland is found to be more common in men belonging to American and European countries. Asian men are at less risk of this disorder.

Marital status
According to researches, married men are liable to suffer from enlarged prostate as compared to single men. There has been no evidence that proves the link between sexual activity and enlargement of the gland.

Diagnosis of Prostate gland enlargement

Usually the first test done is the digital rectal exam (DRE). The doctor will insert a finger into the rectum to feel the size and condition of the prostate gland. Rectal Ultrasound is also carried out if there is a suspicion of prostate cancer. A probe is inserted in the rectum that detects sound waves at the prostate gland. The echo of sound waves forms an image of the gland on the screen for check up.

A blood test called Prostate Specific Antigen (PSA) Blood Test is carried out. In men with prostate problems, a protein called PSA is frequently present in high levels.

The doctor may conduct urine flow study. The patient may be asked to urinate in a special device, which measures the flow of urine. Reduction in flow suggests enlarged prostate.

Intravenous Pyelogram (IVP) is an x-ray of the urinary tract. Any blockage in the urinary tract becomes visible when a dye is inserted into the vein that makes urine visible on the x-ray.

In Cystoscopy the doctor inserts a small tube through the opening of the urethra in the penis. The tube called a cystoscope, contains a lens and a light system, which helps the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.

Prostate gland enlargement treatment

Medicines
Finasteride reduces the size of the prostate gland by lowering the levels of hormones produced by the prostate and increases urine flow. It also helps in decreasing symptoms of BPH.

Alpha 1-Blockers like doxazosin, prazosin, tamsulosin, and terazosin relax the muscles of the bladder neck and allow easy urination.

Antibiotics are also prescribed to treat chronic prostatitis or inflammation of the prostate that may accompany BPH.

Surgical Treatment

Removal of the enlarged part is regarded as best treatment option for patients with enlarged prostate. With surgery only the enlarged tissue pressing against the urethra is removed which helps in relieving the obstruction and incomplete emptying caused by BPH.
A procedure called TURP (transurethral resection of the prostate) is used most of the surgeries done for BPH. With TURP, an instrument called a resectoscope is inserted through the penis. The surgeon uses the resectoscope's wire loop to remove the obstructing tissue one piece at a time. The pieces of tissue are carried by the fluid into the bladder and then flushed out at the end of the operation.
Another surgical procedure is transurethral incision of the prostate (TUIP). This procedure widens the urethra by making a few small cuts in the bladder neck, where the urethra joins the bladder and in the prostate gland itself.
Open surgery is often done when the gland is greatly enlarged. In cases where there are complications or when the bladder has been damaged and needs to be repaired doctors prefer open surgery.

Laser surgery employs side-firing laser fibers and Nd: YAG lasers to vaporize obstructing prostate tissue. The laser fiber passes through the urethra into the prostate using a cystoscope and delivers several bursts of energy lasting 30 to 60 seconds. The laser energy destroys prostate tissue and shrinks it.

It can be said that the prostate gland is an important organ of the male anatomy. However, if due to any reason, enlargement in this gland takes place, it can lead to discomfort and other complications leading to cancer.