What Is The Prostate Gland
The prostate is a small organ about the size of a walnut. It lies below the bladder and surrounds the urethra . The prostate makes a fluid that helps to nourish sperm as part of the semen .
Prostate problems are common in men 50 and older. Most can be treated successfully without harming sexual function.
Diagnosis Of An Enlarged Prostate
In order to establish the possible underlying causes for an enlarged prostate, doctors will perform a variety of tests.
Tests which are commonly used to find the cause of an enlarged prostate include:
- A digital rectal exam. A physician or nurse will insert a gloved finger into the patientâs rectum to digitally examine the prostate for swelling and/or enlargement.
- Swab tests for urethral discharge or urine. To determine underlying conditions such as STIs/STDs and urinary tract infections. A swab of discharge or urine is taken and sent to a medical laboratory for culturing, so that any microorganisms are identified.
- Urinalysis. A urine sample is sent to a medical laboratory for analysis and may be tested for urea nitrogen or creatinine, among other things.
- Blood tests. A sample of blood is sent to a medical laboratory for analysis, which may include tests for creatinine or blood urea nitrogen, as well as antibodies and infectious agents.
- Prostate-specific antigen test. A blood sample is sent to a medical laboratory to be tested for prostate-specific antigen , an enzyme produced by cells in the prostate. A change in PSA levels can indicate that there is a problem with the prostate.
If patients are referred to a urologist, they may have further tests, including:
Before referring the patient for tests, the physician may also ask questions in order to determine the possible causes of the discomfort, their severity, and their duration. Such questions may cover:
Metastatic Spinal Cord Compression
Metastatic spinal cord compression happens when cancer cells that have spread from the prostate grow in or near to the spine, and press on the spinal cord. MSCC isnt common, but you need to be aware of the risk if your prostate cancer has spread to your bones or has a high risk of spreading to your bones. The risk of MSCC is highest if the cancer has already spread to the spine. Speak to your doctor or nurse for more information about your risk.
MSCC can cause any of the following symptoms.
- Pain or soreness in your lower, middle or upper back or neck. The pain may be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, go to the toilet, or lie down. It might get worse when you are lying down. It may wake you at night or stop you from sleeping.
- A narrow band of pain around your abdomen or chest that can move towards your lower back, buttocks or legs.
- Pain that moves down your arms or legs.
- Weakness or loss of control of your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
- Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest, that doesnt go away.
- Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.
Dont wait
It is very important to seek medical advice immediately if you think you might have MSCC.
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What Procedures Or Tests Diagnose This Prostate Problem
A doctor or other health care professional usually can detect an enlarged prostate by rectal examination. A medical professionals may perform a rectal examination to ensure that there are no “nodules,” which are hard, irregular areas in the prostate suspicious for prostate cancer, as well as to assess the size of the prostate. Assessment of prostate size and shape is better assessed with an abdominal or transrectal ultrasound or cystoscopy. A cystoscope is a long, thin telescope-like instrument that has a light source and lens allowing one to look at the urethra, the prostate, and the bladder when inserted through the opening at the tip of the penis. Cystoscopy and/or ultrasound is recommended prior to surgical treatment of BPH. Other tests that medical professionals may perform include: bladder scanner postvoid residual determination and uroflowmetry . Lastly, a PSA is often obtained and if abnormal may require further evaluation to rule out prostate cancer.
The American Urological Association recommends that men with BPH complete the AUA-symptom index , which assesses the degree to which symptoms bother. It is a useful way to assess changes in bothersome symptoms with treatment.
Belly Acupressure And Massage
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What Are The Symptoms Of Prostatitis
These are the most common symptoms of prostatitis:
- Need to urinate often
- Burning or stinging while urinating
- Pain when urinating
- Less urine when you urinate
- Rectal pain or pressure
- Fever and chills
- Pain in your lower back or pelvis
- Discharge through the urethra during bowel movements
- Erectile dysfunction or loss of sex drive
- Throbbing sensations in the rectal or genital area
The symptoms of prostatitis may look like other medical conditions or problems. Always see your healthcare provider for a diagnosis.
Using Palliative Care To Ease Discomfort
For both urinary and bowel incontinence that is caused by compression of nerves in the spinal cord as a result of prostate cancer that has spread to the spine or bones, palliative treatments for metastasized cancer may be of use. These treatments include radiotherapy, medication, or surgical removal of spinal cord tumors. However, these treatment options are not indicated for every situation. Your doctor will help you determine what path is right for you and to improve your quality of life. As always, coping with quality of life symptoms like these can take a toll on an individual or their caretaker both mentally and physically. For this reason, it can be a good idea to consult a therapist or counselor if needed for extra support.
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What Are The Signs Of Prostatic Disease
Enlargement of the prostate gland is common with most prostatic diseases. Since the urethra passes through the prostate, enlargement of the gland compresses the urethra and urination becomes difficult and uncomfortable.
Complete urethral obstruction rarely occurs with prostatic problems, but an affected dog will spend a prolonged time urinating and will often produce only a thin stream of urine. If the prostate is very enlarged, the colon, located just above the prostate, may also become compressed, causing difficulty with passing bowel movements. Dogs with prostatic enlargement often have a history of straining to urinate or defecate.
“A dog with prostatic enlargement often has a history of straining to urinate or defecate.”
In addition, some dogs with prostatic disease will have blood in the urine however, bloody urine is not specific for prostatic disease as this is a sign for other diseases affecting the urinary system.
Are The Treatments For Prostatitis And Bph Different
The treatment for an enlarged prostate and prostatitis are very different.
BPH treatment may include an interactive questionnaire to determine the extent of your symptoms. The results of the questionnaire may influence what medications or other treatments you may need. Drugs used to treat BPH include:
- Alpha receptor blockers
- Phosphodiesterase inhibitors
- Anticholinergic agents
Some patients with more severe prostatic enlargement may need surgery. A transurethral resection of the prostate is the usual procedure to reduce pressure on the urethra by reducing the size of the prostate.
Treatment for prostatitis depends on the type.
- Bacteria acute and chronic prostatitis are typically treated and cured with antibiotics like fluoroquinolones or trimethoprim. These infections typically take longer to cure so you may have to take antibiotics for as long as 4-8 weeks. Some infections of the prostate gland are resistant or unresponsive to treatment so antibiotics like gentamicin or doxycycline may need to be injected directly into the gland.
- Type III, chronic bacterial prostatitis and pelvic pain syndrome, is treated similarly with antibiotics, however, alpha-blockers and NSAIDs , for example, aspirin, ibuprofen , naproxen also are used.
- Type IV, asymptomatic inflammatory prostatitis, in most patients requires no treatment. However, some doctors prescribe antibiotics and NSAIDs for this condition.
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Other Professionals Who Can Help
Your doctor, nurse or GP can refer you to these professionals.
- Physiotherapists can help with mobility and provide exercises to help improve fitness or ease pain. This can help you stay independent for longer.
- Counsellors, psychologists or psychotherapists can help you and your family work through any difficult feelings and find ways of coping. Many hospitals have counsellors or psychologists who specialise in helping people with cancer. You can also get free counselling on the NHS without a referral from your GP. Visit nhs.uk/counselling to find out more.
- Dietitians can give you advice about healthy eating, which might help with fatigue and staying a healthy weight. They can also help if you are losing weight or having problems eating.
- Occupational therapists can provide advice and access to equipment and adaptations to help with daily life. For example, help with dressing, eating, bathing or using the stairs.
- Social services, including social workers, can provide practical and financial advice and access to emotional support. They can give you advice about practical issues such as arranging for someone to support you at home. Whats available varies from place to place. Your GP, hospital doctor or nurse might be able to refer you to some services. The telephone number for your local social service department will be in the phonebook under the name of your local authority, on their website and at the town hall.
What Are The Symptoms Of Benign Prostatic Hyperplasia
Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include
- urinary frequencyurination eight or more times a day
- urinary urgencythe inability to delay urination
- trouble starting a urine stream
- a weak or an interrupted urine stream
- dribbling at the end of urination
- nocturiafrequent urination during periods of sleep
- urinary incontinencethe accidental loss of urine
- pain after ejaculation or during urination
- urine that has an unusual color or smell
Symptoms of benign prostatic hyperplasia most often come from
- a blocked urethra
- a bladder that is overworked from trying to pass urine through the blockage
The size of the prostate does not always determine the severity of the blockage or symptoms. Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms. Less than half of all men with benign prostatic hyperplasia have lower urinary tract symptoms.3
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What Are The Diseases That Cause The Prostate To Enlarge
There are at least seven diseases affecting the prostate.
Your Gp Practice Nurse And District Nurse
Your GP, practice nurse, and district or community nurse will work with other health professionals to co-ordinate your care and offer you support and advice. They can also refer you to local services. They can visit you in your home and also help support your family. They might also care for you if you go into a nursing home or hospice.
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Managing Bladder And Bowel Incontinence
Some common treatments are:
-
Changes in food or drink. Increasing your fiber intake can help manage diarrhea and constipation. Drinking plenty of fluids can also ease constipation. Not drinking fluids at certain times can help manage overactive bladder and urinary incontinence.
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Exercises. Kegel exercises can strengthen the sphincter muscles and pelvic floor. This can help you have better control.
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Medicines. Some medicines can help control bowel incontinence. Antidiarrheal medicines can help manage diarrhea. And medicine can help bladder muscles relax to give you better control.
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Keeping a bathroom schedule. Setting a regular schedule for using the toilet can give you better control. This includes attempting to urinate or move your bowels at the same time each day.
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Electrical stimulation. This therapy can stimulate damaged nerves. This may give you better muscle control in your bladder or bowel.
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Surgery. In rare cases, you may need surgery to repair damage to muscles or nerves.
Your healthcare provider will work with you to create a treatment plan.
About Half Of Men Older Than 50 Have An Enlarged Prostate Here Are Some Of The Basic Facts You Need To Know About This Common Condition
As men age, many experience prostate gland enlargement. This condition is known as benign prostatic hyperplasia .
The prostate gland surrounds the urethra, the hollow tube that carries urine out of the body. When the prostate gets bigger, it can squeeze or partially block the urethra, which leads to problems urinating.
BPH is quite common in older men. In fact, the condition impacts about 50% of men between the ages of 51 and 60. For men 80 and older, the prevalence of BPH is approximately 90%, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
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Can Enlarged Prostate Cause Constipation
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Further Treatments To Control The Cancer
Your first treatment may help keep your cancer under control. But over time, the cancer may change and start to grow again. If this happens you might be offered other treatments, including:
- more hormone therapy
- clinical trials
More hormone therapy
Your prostate cancer may respond well to other types of hormone therapy, such as abiraterone , enzalutamide , steroids or oestrogens, or to a combination of treatments.
More chemotherapy
If youve had hormone therapy on its own as a first treatment, you might be offered a chemotherapy drug called docetaxel . This may help some men to live longer, and can help to improve and delay symptoms. If youve already had docetaxel, you might be offered more docetaxel or another chemotherapy drug called cabazitaxel .
Radium-223
This is a type of internal radiotherapy that may be an option if your cancer has spread to your bones and is causing pain. A radioactive liquid is injected into your arm and collects in bones that have been damaged by the cancer. It kills cancer cells in the bones and helps some men to live longer. It can also help to reduce bone pain and delay some symptoms, such as bone fractures. Read more about radiotherapy for advanced prostate cancer.
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When Should I Call My Doctor
You should call your doctor if:
- You have a fever higher than 100° F or 38° C
- You have pain in your stomach,
- You are unable to pass gas
- You have nausea and/or vomiting with your constipation
- Your stomach looks swollen and/or feels hard when you touch it.
- You have not had a bowel movement in three days after following the directions your doctor has given you to relieve your constipation.
If you have any of these signs talk to your doctor or health care team. There are medicines and treatments that can help you feel better. It is important that you talk to your doctor or health care team about any side effects you may have during or after your treatment. Your health care team can help treat these problems.