Tue | Dec 6, 2016

The enlarged prostate

Published:Saturday | August 30, 2014 | 12:00 AM

Dr. Douglas Street, Contributor

There is an ongoing debate about whether size matters. Well, for the prostate, it definitely does! This male reproductive organ grows throughout life, paradoxically, much to the dismay of many a man!

It tends to add to the list of challenges with which older persons have to deal. What can we do about it?

The prostate's purpose is to produce and store a liquid that makes up 20 to 30 per cent of semen. This liquid helps sperm to survive longer and move faster in the female genital so that they can complete the task that they have set out to accomplish. The prostate surrounds the outlet of the bladder, so as it grows, it obstructs the outflow of urine from the bladder.

Benign prostatic hyperplasia/hypertrophy (BPH) is a very common problem in older men. In fact, about 50 per cent of men have it by age 60 and 90 per cent by 85. In 40 to 50 per cent of these men, the condition will cause symptoms. If the muscles around the channel that takes the urine out of the bladder (urethra) in the prostate are contracted, the symptoms are more likely.

In fact, there may be obstruction without an enlarged prostate, and vice versa. The symptoms are usually more aggressive in black populations.

The symptoms of an enlarged prostate include slow-flowing urine, increased night-time urination, increased overall frequency of urination, straining to pass urine, a sensation of incomplete bladder emptying, and increased time for urination to start and stop. These symptoms are usually progressive, as the prostate grows larger.

Interventions

Some lifestyle changes that may help include reducing alcohol and caffeine intake, as they increase the production of urine. Also, reduce the intake of fluids close to bedtime and seek to have regular planned times to urinate.

Nutritional and herbal supplements (e.g., saw palmetto) have not been proven reliable in treating this condition, either in relieving the symptoms or slowing down its growth. There are medications available that can relax the muscles of the urethra in the prostate that give relatively fast relief of the symptoms. Some medication can shrink the prostate over time. Combining them has the better outcome.

Surgery (prostatectomy) may be used to remove the obstruction, and heat may be used to selectively destroy some of the prostate, reducing the size. The heat may be supplied by laser, high-intensity ultrasound, microwaves, radiofrequency energy, and high-voltage electrical energy.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall, at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril. Send feedback to drdougstreet@yahoo.com.