The prostate gland is located around the urethra, just below the bladder. It is usually the shape and size of a large walnut. It produces much of the slime found in semen.
During puberty, a boy’s prostate grows as part of pubertal maturation. In many men it continues to grow without problems throughout life, in some men more than others, a condition called Benign Prostate Hyperplasia (BPH).
The glans is getting bigger because the number of all kinds of cells inside the prostate is increasing, but the new cells are normal cells. This continued growth is caused in part by a variant of the male sex hormone, dihydrotestosterone. Inflammatory reactions are also often present as a causal factor or as a consequence of the condition.
In some men, the enlarged prostate constricts the urethra and bladder so that urination is difficult or urinary function is impaired. This rarely happens before the man is past middle age. Specific symptoms of an enlarged prostate include the following:
– On examination the prostate is enlarged. Often one can feel soft, smooth lumps, which are essentially normal enlarged sections of the prostate. The prostate is usually without altered symmetry and without distinct irregularities. At first this is the only symptom.
– The prostate area may feel swollen or tender, the man may feel a burning sensation when urinating, but other pain is rarely felt.
– Urine takes longer to start flowing, the flow may stop for a while before starting again, the flow of urine will weaken with less pressure at the outlet, and sometimes the urine just dribbles.
– In severe cases, the urethra is completely obstructed, so the urine must be removed with a catheter.
– Often the bladder does not empty completely during urination and after a while the bladder can become permanently distended.
– The man may have to urinate more frequently, for example at night, due to incomplete urination and pressure on the prostate.
– Some men lose control of urination, resulting in involuntary dribbling or sudden release of urine.
BPH is diagnosed by considering the reported symptoms and by inspecting the prostate gland. This is done first by palpation towards the superior wall of the rectum with an inserted finger. The prostate is then often looked at using an ultrasound probe inserted into the rectum. Urinalysis, blood sample analysis, and other tests will also be performed to rule out cancer, infections, or other conditions that can give the same symptoms as BPH:
Benign prostate growth is usually only treated if it causes symptoms. There are several types of treatment:
– The condition is often treated with medications such as finesteride (Proscar, Propecis) and alpha-blockers. Finesteride blocks the production of the hormone dihydrotestosterone and, over time, will cause the prostate to shrink. Alpha blockers relax the muscles in the prostate and the area around it so urine flows more easily. However, one is reluctant to start treatment with these pharmaceuticals due to the high risk of side effects.
– Finesteride, but in lower and safer doses, is also used to treat male pattern baldness, and men treated with finesteride for prostate growth often get better hair growth as a useful additive effect.
– One can treat the condition with microwaves which reduce the size of the prostate by heating. A similar treatment involves inserting a needle into the prostate and running an alternating current through it, which heats parts of the prostate and evaporates them. These treatments typically use a working catheter inserted through the urethra and a catheter inserted into the rectum to get an overview of the prostate area or to measure the temperature in this area.
– For severe problems with urination, the entire prostate or parts of it may be surgically removed, which is called a prostatectomy. The surgery is usually done with instruments inserted through the urethra. Such surgery can cause erection problems or retrograde ejaculation, a condition in which semen passes into the bladder instead of out through the urethra.
– In the market you can also find natural remedies to reduce the size of the prostate and inflammatory reactions in the prostate. Many of these are based on saw palmetto or the substance cernitine extracted from the pollen. According to some scientific studies carried out so far, they seem to be effective and without major side effects. Therefore, products based on these ingredients may be a good first choice for the treatment of benign prostate growth.