Ageing and prostate enlargement in men

  •   Mon, Sep 30 2013
  •   Interview with Dr Nischith D'Souza, MS, MCh (Urology)

October 1, 2013

 
A middle aged man, who slept well all his life, now visits the bathroom twice or thrice every night and sometimes more. His other symptoms include straining and trouble starting a stream of urine. In most men, this may be the first sign of an enlarged prostate andis a natural process of getting older.

It is a problem that has several names -- enlarged prostate, benign prostate hyperplasia, or simply BPH. It is the most common problem for men over the age of 50, affecting over 50% of men over 60 years and 90% of men over 85 years.These symptoms become more bothersome if not diagnosed and left untreated and significantly affect their quality of life.

On the occasion of World Elders Day on October 1, we discuss about prostate enlargement and its problems in the elderly with consultant urologist, Dr Nischith D’Souza.


What is prostate gland?

The prostate is a gland found only in males. It is present just below the bladder and in front of the rectum. The size of the prostate varies with age. In younger men, it is about the size of a walnut, but it can be much larger in older men. The urethra is the tube that carries urine and it runs through the center of the prostate. The prostate contains cells that make some of the fluid that protects and nourishes the sperm.


 

What is prostate enlargement?

The prostate keeps on growing with age under the effect of the male hormones. This causes BPH (benign prostatic hyperplasia) which can lead to problems passing urine because the prostate can press on the urethra. BPH is not cancer and does not change into cancer.



 

What causes prostate enlargement?

It is not yet fully understood what causes the prostate gland to enlarge. The chances of developing enlarged prostate increases as you get older than 50 years but not all will develop symptoms.The balance of hormones in the body changes as one grows older and this may cause the prostate gland to grow.Men with family history and obesity may be at a higher risk of developing an enlarged prostate.


What are the consequences of prostate enlargement?

In men, urine flows from the bladder through the urethra. BPH is a benign enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra, through which urine exits the body. As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.

Over time, the bladder muscle may gradually become stronger, thicker, and sensitive,and contracts even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra, it becomes weak and urine remains in the bladder and it is not completely emptied.When the bladder does not empty completely, there may be an increased risk for developing urinary tract infections, incontinence and acute urinary retention (an inability to urinate). In rare cases, bladder and/or kidney damage can develop from BPH. A sudden and complete inability to urinate is a medical emergency and necessitates catheterization.



 

What are the symptoms?

Symptoms of enlarged prostate can include:

• A weak or slow urinary stream
• A feeling of incomplete bladder emptying
• Difficulty starting urination
• Frequent urination
• Urgency to urinate
• Getting up frequently at night to urinate
• A urinary stream that starts and stops
• Straining to urinate
• Dribbling of urine
• Returning to urinate again minutes after completion
 

How is an enlarged prostate diagnosed?

The severity of symptoms is assessed with the IPSS score. Apart from physical and rectal examination, an ultrasound of the abdomen with post void residue, uroflowmetry, blood andurine tests, and a serum PSA in certain cases is recommended.


 


What are the treatment options for an enlarged prostate?

Incidental finding of an enlarged prostate gland on ultrasound, without symptoms, need not be treated. It is also important to understand that the larger the prostate size does not mean worse the symptoms. Bothersome symptoms and complications as mentioned earlier, necessitate treatment. A range of treatments can relieve enlarged prostate symptoms – medications, endoscopic surgery i.e. TURP (transurethral resection of prostate) and prostatic stents. The treatment decision depends on the symptoms, their severity and associated medical conditions and is decided by the urologist.
 


Is a person likely to get prostate cancer if he has an enlarged prostate? If so, what are the symptoms?

No. Having an enlarged prostate does not put one at greater risk of getting prostate cancer. However, it can arise independently and it is possible to have both an enlarged prostate and prostate cancer at the same time. Early prostate cancer does not cause any urinary symptoms. As it progresses, the urinary symptoms are the same as that of benign prostatic enlargement.


What is your message?

The number of ageing population has increased and with it a myriad of health problems peculiar to the elderly. Urinary problems are common with advancing age and many consider it as a part of ageing and suffer in silence. It is important that we be aware of prostate gland and its symptoms, and that it can be diagnosed and treated.

The elderly have a right to health and fulfilling their physical, psychological and emotional needs of elders is the key to provide thema good quality of life.On the occasion of World Elders Day,let usalso say thanks to all the elders for bringing us up, giving us all the knowledge and made us what we are today. Thank you.

Dr Nischith can be contacted at ‘Mangalore Kidney Urology Centre’, Don Bosco Hall Cross Road, Falnir, Mangalore. Ph: 0824-2422166/2422167,9945087949. E mail: nish25@gmail.com. Website: www.mangalorekidneyurrologycentre.com

 

 
Interview with Dr Nischith D'Souza, MS, MCh (Urology)
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Comment on this article

  • John Tauro, M'lore / Kuwait

    Wed, Oct 02 2013

    My heartfelt thanks to Dr. Nischith D'Souza for this highly informative article.

  • Lani Pinto, Kinnigoli / Mangalore

    Wed, Oct 02 2013

    very good information about Prostate gland.Thank u Dr.Nicschit D'souza and god bless u.

  • James, Mangalore

    Tue, Oct 01 2013

    Thank you Dr Nishith for this very informative article.I have read your previous articles on kidney stone and kidney failure. your articles are simple and informative.

  • francis pinto, mangalore

    Tue, Oct 01 2013

    I have also read dr nischith's earlier articles in daijiworld on kidney stones and kidney transplantation. They are very succint in their narrative, which reflects an intelligent and clear thought process, as also reflected in his cv in an earlier article. At the CASK centenary jubilee our honourable MLA Mr. JR Lobo mentioned that that our community is dimishing in number, not many shining in public life and rapid migration of our talented people from mangalore. It is very important that we identify gifted and highly intelligent individuals like this doctor, nurture them as they are the pillars of our future society and also the few shining rays of light in an otherwise fading sky, lest we lose them to centres in other cities in india and abroad .

  • Henry Pinto N Family, Mullakad/Orlando, USA

    Tue, Oct 01 2013

    Very informative article. Very much impressed with your success. All the best. You are making our family proud.

  • stan dsouza, mangalore / mumbai

    Tue, Oct 01 2013

    The elderly have a right to health and fulfilling their physical, psychological and emotional needs of elders is the key to provide them a good quality of life.On the occasion of World Elders Day,let us also say thanks to all the elders for bringing us up, giving us all the knowledge and made us what we are today. Thank you.
    Touching words. Gracious words. This article should be archived. May God bless you abundantly Dr Nischith.

  • Vincent Sequeira, Belthangady/Riyadh

    Tue, Oct 01 2013

    Dear Dr Nischith

    Very informative. Wish you all the best.

    Vincy/Riyadh

  • CHARLES SALDANHA, MALAD-MALWANI

    Tue, Oct 01 2013

    THANK YOU DOCTOR FOR YOUR USEFUL INFORMATION.THIS IS A AGE RELATED PROBLEM AND EARLY DETECTION AND EARLY TREATMENT CAN DEFINITELY HELP THE ELDERLY PEOPLE TO LEAD A NORMAL LIFE.

  • JOHN PRABHU, MANGALORE

    Tue, Oct 01 2013

    Recently Dr. Nischith conducted a free check up camp for kidney scanning at Urwa school grounds, under the umbrella of Lions club of Valencia, wherein many people have availed this opportunity. And I am one of them. Fortunately I did not have Kidney problem, but unfortunately landed up with prostate enlargement. This is a wake up call for those above 50 years of age. Early detection will avert forthcoming health problems.Thank you Dr. Nischith for your timely help.

  • Glenn, Mangalore/Kuwait

    Tue, Oct 01 2013

    Thank you doctor for good information.Could you please guide us what are the treatments available? Suppose a aged patient may have other complications like heart problems,diabetes etc.In such cases is surgery recommended? Is it minimum invasive surgery with local anaesthesia? kindly advice.

  • Ronnie D'Souza, Mumbai

    Tue, Oct 01 2013

    Doctor thank you for the information. I am
    sure many will benefit with these information.

    DW we readers are grateful. I am suffering with the Prostate, thank God being treated
    by an urologist and feeling better.

  • Vincent Rodrigues, Katapadi/Bangalore

    Tue, Oct 01 2013

    Really very educative piece of medical information.Thanq so much Doctor and we request you please flash this type of important medical information often to educate the public.All the best.Thanq.

  • Roshan, Udupi

    Tue, Oct 01 2013

    Good information... Every one must read these articles...

  • Manohar Dsouza, Mangalore/Bahrain

    Tue, Oct 01 2013

    Very useful information, good article


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