The prostate is a walnut-sized gland that is part of the male sex organs. With increasing age, one sets Prostate enlargement one that presses on the urethra and causes various ailments. The enlargement of the prostate that is not of abnormal origin is also called benign prostatic hyperplasia or Prostate adenoma designated.
What is an enlarged prostate?
A Prostate enlargement is a benign enlargement of the prostate as a result of increasing cellular material. Hyperplasia is to be distinguished from hypertrophy (growth in cell size), even if the terms are sometimes used synchronously in the case of prostate enlargement.
Prostate enlargement involves an increase in the number of stromal and epithelial cells, resulting in the formation of large, relatively discrete nodules in the area of the prostate surrounding the urethra. If they are large enough, the nodules press on the urethra, causing an obstruction to normal urine flow.
An enlarged prostate leads to symptomatic urinary behavior such as frequent urination, dysuria (painful urination) and an increased risk of urinary tract infections. Despite the symptoms that cause discomfort, an enlarged prostate does not lead to cancer or an increased risk of cancer.
causes
The increasing tissue growth of the prostate begins around the age of 30. An estimated 50% of men by the age of 50 have histological signs of enlarged prostate. By the age of 80, 40-50% of all men have clinically significant prostate enlargement.
The cause of prostate enlargement has not yet been clarified, so risk factors can hardly be named. It is assumed, however, that the increasingly higher proportion of estrogen stimulates the growth of female tissue in the posterior urethra. Another hypothesis assumes that an enlarged prostate results from a decreased production of dihydrotestosterone (DHT) in old age.
Other studies suggest that prostate enlargement could be predisposed. According to this, certain cells are activated in later life, which signal the other cells of the gland to grow or to react more sensitively to hormones.
Symptoms, ailments & signs
Enlarged prostate primarily affects urination. The most common symptom is the urge to urinate frequently at night. In addition, with an enlarged prostate, there is often a sudden and strong urge to urinate.
At the same time, urinating becomes more difficult: the urine stream is weaker and people who have an enlarged prostate often feel that the bladder is not completely empty. In fact, in men with enlarged prostates very often residual urine remains in the bladder, which encourages the occurrence of bladder and urethral infections. In very rare cases, total urinary retention occurs and the kidneys are endangered.
Urination itself often takes longer than usual for those affected. Occasionally, those affected have severe difficulties even starting to urinate. Often urine drips after urination or incontinence symptoms occur. Sometimes there may be a reduced amount of ejaculation or temporary erection problems.
The symptoms that can occur in the context of benign prostate enlargement do not necessarily depend on the strength of the enlargement. In some men, despite a greatly enlarged prostate, there are no or very few symptoms.
Diagnosis & course
In the stimulus stage of a Prostate enlargement The first symptoms appear regarding the frequency of urination and bladder function. The second stage of prostate enlargement is characterized by incomplete urinary retention and the onset of organ failure.
In the untreated final stage, the bladder function fails completely, which would result in urine poisoning. Additional complications, such as urinary tract infections or kidney damage, are possible. To fully diagnose prostate enlargement, first a rectal urological examination is necessary.
A protein-based PSA blood test or rectal ultrasound can be done to rule out cancer as the cause of prostate enlargement. If suspicious, a biopsy of suspicious tissue is taken for microscopic examination. In cystoscopy, the doctor inserts a small tube through the opening of the urethra into the penis under local anesthesia. This allows the inside of the urethra and bladder to be examined to determine the extent of the enlarged prostate.
Complications
Changes in the prostate that are not treated promptly can be associated with a number of complications. Benign enlargements can also block the flow of urine. The increased accumulation of urine in the urinary bladder increases the risk of bladder stones, as well as urinary tract infections and a number of more serious complications.
Due to the permanently increased bladder filling and the associated increased pressure when urinating, after some time a reactive growth of the bladder wall muscles occurs. The excessive muscle growth can cause the bladder wall to lose its elasticity.In addition, the storage of collagen in the tissue increases, which can lead to the formation of pseudodiverticles, i.e. small bulges in the bladder wall.
A backlog of urine can cause urine to enter the renal pelvis through the ureters. If this is the case over a longer period of time, the kidneys are damaged, in severe cases it can lead to kidney failure. There is also a risk of uremia.
Certain metabolic by-products such as creatinine, uric acid or urea have to be excreted in the urine via the kidneys. If this does not happen, or not to a sufficient extent, because the kidneys are damaged, these substances accumulate in the body, which leads to symptoms of poisoning. Typical symptoms are nausea, vomiting and severe itching. Untreated uremia can be fatal.
When should you go to the doctor?
Since an enlarged prostate can indicate another serious condition, it should always be checked by a doctor. Only through early diagnosis and treatment can further complaints and complications be avoided. The earlier the disease is diagnosed and treated, the higher the probability of a positive course of the disease.
The doctor should be consulted in the case of prostate enlargement if the person concerned has to go to the toilet very often during the night without having had much to drink. Erectile problems can also indicate an enlarged prostate and should be examined by a doctor if they occur regularly and for no particular reason. It is not uncommon for patients to show incontinence, which can also damage the kidneys. The symptoms of prostate enlargement can vary in severity and significantly limit the life of the person affected.
The diagnosis of enlarged prostate can be made by a urologist. For further treatment, however, the involvement of other specialists is necessary. Whether the prostate enlargement leads to a reduced life expectancy of the person concerned depends to a large extent on the exact cause of the disease, so that no general prediction is possible here.
Treatment & Therapy
As soon as the first complaint occurs, treatment measures should be taken to prevent the progression of the Prostate enlargement to dampen. Most of these minimally invasive treatments apply heat to the affected tissue that is pressing on the bladder.
If the symptoms are severe and the heat treatments are unsuccessful, surgery should be considered. In addition to naturopathic medicinal herbal teas made from nettle, willowherb or the buds of the trembling aspen, enlarged prostate can also be treated with medication.
The natural hormones finasteride and dutasteride prevent prostate enlargement. So-called alpha blockers such as terazosin, doxazosin, tamsulosin or alfuzosin can treat symptoms of enlarged prostate.
However, side effects such as dizziness, tiredness and drowsiness are to be expected. The symptoms of an enlarged prostate can be alleviated with red light and hip baths or warm and moist compresses. In order to counteract the congestion of blood in the prostate, regular sexual intercourse or masturbation is also an effective therapy.
prevention
A Prostate enlargement is part of the aging process in men. Basically, a light diet rich in vitamins and carbohydrates that contains little protein is recommended for prevention. Fat, meat, and beer should be renounced in favor of non-carbonated drinks and fruits. Pumpkin seeds, which inhibit the growth of proliferating prostate tissue, are a valuable alternative to chips. Sitting too long, hypothermia or forcibly suppressing the urge to urinate should also be avoided.
Aftercare
In the case of prostate enlargement due to the formation of a carcinoma, surgical treatment and the associated removal of the affected tissue usually takes place. This also happens in some cases of benign prostate enlargement. After such treatment, regular examinations by the attending physician are of great importance. The aim is to identify the possible occurrence of further tumors after the treatment at an early stage.
In the event of a previous operation, the wound must also be followed up. The attending physician ensures that the wound does not become infected and that there is little scarring. If there is severe scarring, additional surgery can be performed. The disease and treatment of the prostate can also lead to difficult sexual function and incontinence.
This can lead to psychological problems in the patient. Therefore, a therapy and a cure, which is often covered by the statutory health insurance, are advisable to make the patient's situation easier. Self-help groups and other advice centers at the clinics can also be used. Any incontinence that may occur can be improved with special pelvic floor exercises.
You can do that yourself
Enlargement of the prostate is usually a benign clinical picture that is not always operated on immediately, but is also accessible to the patient to help himself. Some measures with which the patient can help themselves in everyday life are listed below.
The first step is to make the urge to urinate, which most patients perceive as a recurring symptom, more bearable. This often succeeds in that patients drink the recommended amount of water, but not before certain occasions, such as going to bed or a social obligation, in order to be relieved of the urge to urinate in the best possible way.
Another possibility for self-help is to avoid diuretic drinks. Dehydrating drinks should also be avoided. Coffee, tea, and alcohol in particular are on the list of unfavorable drinks. After urinating, it is advisable to try again to empty the bladder after a short break. Any subsequent urine is then also withdrawn and the pause for the next urination is significantly extended. Bladder training is also very useful.
It is also used, for example, for the irritable bladder, to train the bladder to tolerate larger amounts of filling. In this way it is also possible to better control the urge to urinate. This is also made possible by medicines on a freely available basis, such as pumpkin extracts.
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