Nearly every man over the age of 50 experiences symptoms of prostate gland enlargement. The symptoms are going to the bath room frequently, poor force of the urine stream, dribbling after urination and perhaps the most troublesome of all is getting up at night to urinate. Every night, between 12 and 15 million men in the U.S. are likely to have loss of sleep because of an enlarged prostate gland. This article will discuss the purpose of the prostate gland and what treatment options are available for this common condition.
The prostate gland is typically the size and shape of a walnut and is located in the lower part of the pelvis, below the bladder. It envelops the urethra, the tube through which urine flows from the bladder out of the body. When the prostate gland grows bigger – which happens to virtually every man as he ages – it can compress the urethra and make it difficult to pass urine.
Benign enlargement of the prostate gland does not cause prostate cancer or affect a man’s ability to have, but if the symptoms bother you, seek treatment. If left untreated, BPH can lead to urinary retention and cause bladder, urinary tract and kidney problems.
Try behavioral changes. Perhaps the easiest suggestion is limiting your fluid intake at night and not drinking anything for two hours before bedtime. I also caution to decrease those foods and beverages that are diuretics (and will therefore prompt you to urinate more), such as coffee, caffeinated tea, herbal tea, lemon juice, chocolate, pineapple, grapes and cherries.
If those behavioral changes don’t help much, consider medication. A change in habits will help some but not all men with BPH, and for those whose symptoms aren’t relieved, medication is an option. The most commonly used medications are alpha blockers, (Flomax) which can relax the muscle at the base of the bladder and the prostate, and 5 alpha reductase inhibitors, (Proscar) which can, over a period of months, shrink the prostate. Like nearly all medications, they do have side effects. For example, alpha blockers can cause the man taking them to faint and by decreasing his blood pressure when moving from laying down to standing upright quickly. Alpha blockers also can cause sexual side effects like decreasing the volume of the ejaculate or having no ejaculation at all. The 5 alpha reductase inhibitors can cause sexual dysfunction, such as impotence. Some physicians are also prescribing tadalafil, commonly known by its brand name Cialis, which is often marketed as a drug that treats erectile dysfunction, but can also help to relax the muscles in the prostate gland and thus relieve urinary symptoms.
If behavioral changes and medication don’t work or cease to be effective, surgical procedures are an option. Until recently the two most common procedures are a transurethral resection or TURP, in which an instrument is inserted up the urethra to cut out the part of the prostate that’s blocking urine flow, and a laser procedure, which vaporizes the tissue obstructing the urethra. Both procedures are typically effective but carry the risk of side effects such as erectile dysfunction. Other, newer procedures, such as the UroLift System, in which a urologist places tiny implants in the prostate to increase the opening of the urethra and allow for greater urine flow. This procedure can be accomplished in the outpatient or ambulatory treatment center or even in the doctor’s office. The advantage of the UroLift is that there are no sexual side effects and the results are noted almost immediately after the procedure.
Bottom Line: The enlarged prostate gland affects millions of American men. It significantly impacts a man’s quality of life. Help is available. Speak to your doctor.