Prostate enlargement in men

D. Karim Mamoun

The prostate in humans can suffer from many problems, such as benign enlargement, inflammation or cancer, although each has its own specificity, but many people are not aware of the difference and confuse them, so we will know in this article the most common of these diseases, benign prostate size.

What is the prostate?

The prostate or prostate is a gland found only in humans: it is part of the male reproductive system, lies behind the bladder and surrounds the urethra, the tube that carries the Bladder urine to the outside of the body.

The prostate is composed of two parts: a glandular central part (larger, causing what is called a large prostate) and a peripheral muscle and fibrous tissue (that is occurs at the expense of prostate cancer). ).

This gland plays a vital role in the formation of sperm by producing a thick white liquid transformed into a less dense liquid by a protein called PSA, which mixes with the sperm produced by the testes to form sperm. Means of transport for sperm and securing the center and food and protection during the outpatient trip to complete the vaccination process.

What's a benign prostate?

The size of the prostate increases naturally with age, so that it becomes 60 to 60 times larger than its initial size, but when it swells, it is called benign prostatic hyperplasia (BPE), also Benign Prostatic Hyperplasia (BPH) Anatomy is a fibrous tumor that often occurs in the central part of the prostate, but the layer of tissue that envelops the prostate prevents enlargement, resulting in pressure Prostate on the urethra and prevents the process of production of urine, as well as congestion and contractions of the prostate also hinder the fall of urine. The patient has troublesome urinary symptoms.

The size of the benign prostate is very common in men: it is observed in 40% of men over 50 and in 90% of men after the age of eighty-five.

What causes benign prostatic hyperplasia?

Although the prevalence of this disease remains the exact cause of the unknown occurrence, but many studies suggest that the reason is to increase the sensitivity of prostate cells to the male hormone testosterone, which leads to continued growth in the years following puberty, and there are risk factors that increase the risk in men enlargement of the prostate, and these factors:

Aging: Prostate enlargement rarely causes symptoms in men under 40 years of age, while one-third of men over 60 suffer from moderate to severe symptoms, up to half at age 80 .

Family History Genetics play an important role in most prostate diseases. Thus, a first degree relative (father or brother) has an enlarged prostate that increases the chances of a man's infection.

Diabetes and heart disease: Some studies show that diabetes and heart disease and the use of beta-blocking drugs increase the risk of prostate enlargement.

Lifestyle: Obesity and poor eating habits increase the risk of prostate enlargement, while moderate physical activity decreases.

What are the symptoms of prostate enlargement?

Prostate size does not necessarily determine the severity of symptoms: some men with benign prostatic hyperplasia may have severe symptoms, while others with severe prostatic hypertrophy may have weak symptoms. Symptoms develop over time in some men and may improve.

1 – repeated or urgent need to urinate: especially at night, can cause incontinence.

2 – the need to use the internal effort to urinate.

3 – difficulty urinating: frequency and difficulty starting urine flow, or double urination, or cutting, or distilling at the end of urination.

4 – feel pain during urination or ejaculation.

5 drops of blood during urination: the blood causes the expansion of the veins on the surface of the enlarged prostate.

6. Do not empty the bladder completely.

7 – Urinary Retention: This situation requires an emergency intervention to empty the bladder through the introduction of catheterization urine, and although the number of sudden urines doubling more compared to an offer, it can in many cases be the first and only way to give an idea of ​​the size of the prostate, and it can be repeated several times intermittently. One of the main reasons for using surgery as a treatment.

What are the complications of prostate enlargement?

1. Urinary tract infections: Due to the inability to empty the bladder of urine, bacteria can develop in the bladder and emerge from the odor.

2 – Impotence: occurs in about 50% of cases.

3. Damage to the bladder: Failure to empty the bladder causes an increase in the thickness of the bladder, thereby losing its ability to contract normally.

4 – renal injury: may occur as a result of renal bladder infection or as a result of prolonged ascites of the kidneys caused by obstruction of the urethra.

5 – Bladder stones: Due to the impossibility of emptying the bladder, it completely condenses the urine and calculus in the form of stones, which can cause severe inflammation, a build-up of blood in the bladder. urine, bladder irritation and blocked flow of urine.

How to diagnose prostate enlargement?

If there is suspicion of an enlarged prostate, you should contact the urologist, who may have recourse to the following tests:

Urinalysis: to check if the symptoms are caused by an urinary tract infection such as a cystitis or nephritis.

Anal Touch: This exam is the first exam performed by the medical specialist. The doctor brings his finger into the anus and tries to probe the prostate through the rectum. This review provides preliminary information on the size of the prostate and its condition.

PSA (PSA): A PSA test is performed in parallel with an anal exam to help detect prostate cancer in men 50 years and older, a significant increase in normal rate that may indicate the presence of the prostate. Prostate cancer, but can not solve the diagnosis.

Ultrasound across the abdominal wall: The size of the prostate is measured and the amount of urine remaining in the bladder after urination.

Transcranial ultrasound: a special probe is placed inside the rectum, through which the size of the prostate is measured, and the presence of prostate cancer can be ruled out.

What are the treatment options?

Depending on the size of the hypertrophy, the severity of the symptoms and their impact on the quality of life, the age of the patient and his general state of health, immediate treatment may not be necessary when the symptoms are mild : just change the lifestyle, but regular monitoring of the prostate Treatments include:

I. Lifestyle change: Some tips can help relieve symptoms or at least help to make them worse, including:

• Be careful not to take medication that may worsen symptoms such as antidepressants, beta-blockers, antihistamines, and antihistamines.

● Determine how much fluid is consumed in the evening, especially two hours before sleeping, to reduce the number of times you wake up at night.

● Avoid work that requires long periods of sitting, which increases the pressure on the prostate and exacerbates urinary incontinence at the origin of frequent infections.

● Avoid soft drinks and sweets, as well as stimulant-rich drinks like coffee and tea, as well as alcohol, as they increase the amount of urine and irritation of the bladder, accentuate the feeling of dysentery and exacerbate the anxiety already caused by frequent awakenings during sleep.

• Keep the body warm because cold temperatures can cause urine retention and increase the urge to urinate.

● Go to the bathroom as soon as you feel the need, because waiting too long can stretch the bladder muscles and cause injury.

● Exercise, avoid exercising and avoid inactivity: some exercises can help reduce urinary problems caused by enlarged prostate.

• Increased consumption of vegetables, fruits and foods rich in plant fiber as they reduce constipation, hard stool build-up and prolonged pressure during defecation of the prostate and increase urinary symptoms, foods rich in omega-3 (salmon, ground flaxseed, walnuts) Sesame seeds, pumpkin seeds, almonds and vestibules.

Drugs: Drugs are the most widely used therapeutic option for the management of mild and moderate urinary symptoms.

● In simple cases, pumpkin oil pills.

● In intermediate cases, alpha receptor antagonists, relaxation of bladder neck muscles such as doxazosin, tirazocine, alpososine and thamsolacin are used. These medications have troublesome side effects such as dizziness and ejaculation (healthy state in which sperm returns to the bladder). Exit through the penis nozzle). Inhibitors of 5-alpha-reductase can be used, reducing the size of the prostate by inhibiting hormonal changes leading to enlarged prostate, including finasteride and dostraide. Medications from both groups of medications can be used together when one does not relieve the symptoms.

Surgical treatment: this option is used in patients with prostate hypertrophy in specific cases, the most important being:

● Moderate or severe urinary symptoms.

• The failure of pharmacotherapy in the relief of symptoms.

● Obstruction of the urinary tract, bladder bumps, hemorrhoids and kidney problems caused by recurrent urinary obstruction.

• The patient's desire for radical treatment of the problem.

The hypertrophied prostate is surgically removed by laparoscopy or laparoscopy in the urethra.Laser surgery has recently been introduced by inserting a high probe into the urethra into the urethra and releasing the laser beam towards the urethra. of the prostate, which causes the dissection and dissection of the tissue. This has many advantages over the traditional method of obtaining immediate results, by bleeding less, shortening the length of stay in hospital, and gives surgery excellent results for troublesome urinary symptoms, but It involves many complications that need to be taken into consideration, and perhaps the most important complication is the possibility of impotence and erection disorders as a result of nerve injury. in the area of ​​surgery.

Finally, we note that the relationship between the incidence of high prostate cancer and benign prostate cancer is one of the most serious errors associated with prostate disease, statistics have shown that the incidence of Prostate cancer is equal in those who have a natural prostate and an enlarged prostate, which does not lead to prostate cancer, both diseases are common among older men.

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