is prostatitis and how is it treated?
(pronounced "PRAH-stuh-TYE-tis") is an inflammation
or infection of the prostate gland. It affects at least
half of all men at some time in their lives. Having this
condition does not increase your risk of any other prostate
passing urine or pain when passing urine
burning or stinging feeling when passing urine
frequent urge to pass urine, even when there is only
a small amount of urine
and high fever
back pain or body aches
low in the belly, groin, or behind the scrotum
pressure or pain
discharge with bowel movements
and rectal throbbing
problems and loss of sex drive
ejaculation (sexual climax)
is enlarged prostate or BPH?
stands for benign prostatic hyperplasia (pronounced "be-NINE
Benign means "not cancer," and hyperplasia means
too much growth. The result is that the prostate becomes
enlarged. BPH is not linked to cancer and does not raise
your chances of getting prostate cancer—yet the symptoms
for BPH and prostate cancer can be similar.
symptoms usually start after the age of 50. They can include:
Trouble starting a urine stream or making more than
Passing urine often, especially at night
Feeling that the bladder has not fully emptied
A strong or sudden urge to pass urine
Weak or slow urine stream
Stopping and starting again several times while passing
Pushing or straining to begin passing urine
At its worst, BPH can lead to:
affects most men as they get older. It can lead to urinary
problems like those with prostatitis. By age 60, many men
have signs of BPH. By age 70, almost all men have some prostate
prostate starts out about the size of a walnut. By the time
a man is 40, it may have grown slightly larger, to the size
of an apricot. By age 60, it may be the size of a lemon.
normal part of aging, the prostate enlarges and can press
against the bladder and the urethra. This can slow down
or block urine flow. Some men might find it hard to start
a urine stream, even though they feel the need to go. Once
the urine stream has started, it may be hard to stop. Other
men may feel like they need to pass urine all the time or
are awakened during sleep with the sudden need to pass urine.
BPH symptoms take many years to turn into bothersome problems.
These early symptoms are a cue to see your doctor.
flow of normal (left) and enlarged prostate (right). In
diagram on the left, urine flows freely. On the right, urine
flow is affected because of the prostate pressing on the
bladder and urethra.
can BPH be treated?
half the men with BPH eventually have symptoms that a bothersome
enough to need treatment. BPH cannot be cured, 1 drugs or
surgery can often relieve its symptoms. BPH symptom do not
always grow worse.
are three ways to manage BPH:
with your doctor about the best choice for you. Your symptoms
may change over time, so be sure to tell your doctoi about
any new changes.
with mild symptoms of BPH who do not find them bothersome
often choose this approach.
waiting means getting annual checkups. The checku can include
DREs and other tests. Treatment is started only if symptoms
become too much of a problem.
choose to live with symptoms, these simple steps can help
Limit drinking in the evening, especially drinks with
alcohol or caffeine.
the bladder all the way when you pass urine.
Use the restroom often. Don't wait for long periods
without passing urine.
medications can make BPH symptoms worse, so talk with your
doctor or pharmacist about any medicines you are taking
of American men with mild-to-moderate BPH symptoms have
chosen prescription drugs over surgery since the early 1990s.
There are two main types of drugs used. One type relaxes
muscles near the prostate while the other type shrinks the
prostate gland. There is evidence that shows that taking
both drugs together may work best to keep BPH symptoms from
drugs help relax muscles near the prostate to relieve pressure
and let urine flow more freely, but they don't shrink the
size of the prostate. For many men, the drug can improve
urine flow and reduce symptoms within days. Possible side
effects include dizziness, headache, and fatigue.
drug, known as finasteride, shrinks the
prostate. It relieves symptoms by blocking an enzyme
that acts on the male hormone, testosterone, to boost organ
growth. When the enzyme is blocked, growth slows down. This
helps shrink the prostate, reduce blockage, and limit the
need for surgery.
this drug for at least 6 months to 1 year can increase urine
flow and reduce your symptoms. It seems to work best for
men with very large prostates. You must continue to take
the drug to prevent symptoms from coming back.
drug is also used to treat baldness in men. It can cause
these side effects in a small percentage of men:
Decreased interest in sex
Trouble getting or keeping an erection
Smaller amount of semen with ejaculation
important to note that taking this drug can lower your PSA
test levels. There is also evidence that finasteride lowers
the risk of getting prostate cancer, but whether it lowers
the risk of dying from prostate cancer is still unclear.
muscles near prostate
prostate growth, shrinks prostate
number of prostate surgeries has gone down over the years.
But operations for BPH are still one of the most common
surgeries for American men. Surgery is used when symptoms
are severe or drug therapy has not worked well.
of surgeries include:
(transurethral resection of the prostate) is the
common surgery for BPH. It accounts for 90 percent of all
BPH surgeries. It takes about 90 minutes. The doctor passes
an instrument through the urethra and trims away extra
prostate tissue. A spinal block is used
to numb the area.
Tissue is sent to the laboratory to check for prostate cancer.
TURP generally avoids the two main dangers linked to other
recovery period for TURP is much shorter as well.
(transurethral incision of the prostate) is similar
TURP. It is used on slightly enlarged prostate glands. The
surgeon places one or two small cuts in the prostate. This
relieves pressure without trimming away tissue. It has a
risk of side effects. Like TURP, this treatment helps with
flow by widening the urethra.
(transurethral needle ablation) burns away excess
prostate tissue using radio waves. It helps with urine flow,
relieves symptoms, and may have fewer side effects than
Most men need a catheter to drain urine for a period of
after the procedure.
(transurethral microwave thermotherapy) uses
microwaves sent through a catheter to destroy excess prostate
tissue. This can be an option for men who should not have
major surgery because they have other medical problems.
TUVP (transurethral electroevaporation of the prostate)
uses electrical current to vaporize prostate tissue.
prostatectomy means the surgeon removes the prostate
through a cut in the lower abdomen. This is done only in
very rare cases when obstruction is severe, the prostate
is very large, or other procedures can't be done. General
or spinal anesthesia is used and a catheter remains for
3 to 7 days after the surgery. This surgery carries a higher
risk of complications than medical treatment. Tissue is
sent to the laboratory to
check for prostate cancer.
to discuss options with your doctor and ask about the potential
short- and long-term benefits and risks with each procedure.