$Unique_ID{BRK01471} $Pretitle{Genitourinary System} $Title{A Discussion of the Prostate} $Subject{prostate enlargement genitourinary benign prostatic hyperplasia bph bladder urethra hormones androgens urinary stream urination hesitancy nocturia rectal examination terazosin prazosin phenoxybenzamine prostatic transurethral prostatectomy tur resection enlargements growth growths hormone androgen exam} $Volume{J-15} $Log{ Anatomy of the Male Reproductive System*0006001.scf Types of Urinary Tract Infections*0007101.scf Predisposing Factors for Urinary Tract Infections*0007102.scf Benign Hypertrophy of the Prostate*0007602.scf} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. A Discussion of the Prostate ------------------------------------------------------------------------------ QUESTION: It is certainly a sign of advancing years when we sit around and all we talk about is our prostates. Although one of us has already had an operation, it is amazing how little we understand about the condition, where it comes from and the treatment. Would it be too much to ask you to provide us with a discussion of the problem? Surely there must be many other readers of your column who would profit from the information. ------------------------------------------------------------------------------ ANSWER: You must referring to a most common problem of older men, called "Benign Prostatic Hyperplasia" (BPH), and it most certainly is of interest to many of my readers. While the condition is rarely seen before age 40, it's seen with increasing frequency in men over the age of fifty, and by age eighty 75 percent of all men are affected. About a third of the affected men will require some type of treatment. The prostate is an organ that is located at the neck of the bladder, and the tube that carries urine from the bladder through the penis (the urethra) runs through the gland. In benign hyperplasia, the tissues of the gland begin to grow larger and start to compress the urethra. It is thought that certain male hormones (androgens) play a role in this growth. As the urethra becomes compressed, the symptoms of BPH become more pronounced. They include: a reduction in the force of the urinary stream, hesitancy in starting urination, post voiding dribbling, and nocturia (excessive urination at night). The diagnosis can be made by the infamous but most important rectal examination, during which the enlarged gland can be palpated. A variety of other laboratory tests and analysis, including a tissue needle biopsy, are sometimes performed to clinch the diagnosis. In many cases no treatment is necessary except for close and regular observation. Certain medications that help voiding, such as terazosin, prazosin and phenoxybenzamine, are available and useful in some cases. A number of surgical techniques have been developed to correct the problem, including the insertion of a balloon catheter through the urethra to dilate the channel and push back the overgrowth of prostatic tissue. Other techniques cut through the urethra and remove a portion of the gland (trans urethral prostatectomy or TUR) or open surgery through the abdomen that removes the growth may also be employed. The results of all these procedures are generally good with improvement in symptoms for most patients. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.