Prostate Problems

The prostate is a male gland that opens into the urethra just below the bladder. The urethra is the tube passing down from the bladder and carrying urine out through the penis. The prostate is involved in the production of semen. It comes into activity at puberty at about the age of twelve it continues to function well into old age. The gland tends to enlarge throughout life and by the seventies and eighties it can become quite enlarged and cause problems. This enlargement presses on the urethra and impedes the flow of urine.

The enlargement of the prostate is mostly benign enlargement and is not cancerous.

The main signs and symptoms develop because this gradual swelling of the gland as it surrounds the urethra gradually blocks the tube off producing a difficulty in passing urine, a sluggish flow which eventually, if left unchecked, will cause an acute obstruction to the flow of urine. Such an acute blockage can be relieved by catheterisation by a tube being passed through the penis and up the urethra through the obstruction into the bladder where it relieves the blockage and allows the urine to flow out of the bladder.

As the swelling of the prostate gradually develops over the years the patient will pass small amounts of urine at frequent intervals. the blockage sops the bladder from being emptied during urination. There can be associated attacks of infection of the urine which gathers inside of the bladder. The back pressure up into the kidneys can cause kidney disease as well.

The treatment for this enlarged prostate gland is removal of the prostate - a prostatectomy - which can be done through the wall of the lower abdomen and it is called open surgery, or through the urethra itself - a trans-urethral resection of the prostate gland - which does not require open surgery or leave a scar.

Medication is also available which “shrinks” the prostate, and several new techniques using diathermy, radio waves and heat are being used.

To diagnose enlargement of the prostate x-rays of the bladder show the residual urine and outline the gland as it presses into the lower end of the bladder. Ultrasound also can show up prostatic enlargement. The doctor in his surgery can make the initial diagnosis by rectal examination using a gloved finger.

Occasionally prostate enlargement can be cancerous. If the symptoms begin in someone less than fifty or progress very quickly and especially if there is bleeding from the penis the underlying cause may be cancer. This requires early diagnosis and a more extensive operation.

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