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The well-trained urologists at Cedars-Sinai Marina del Rey Hospital review patients with prostate enlargement and advise an individualized treatment plan for each patient. The patients can choose from a number of non-surgical and surgical treatment options available. The treatment that is best for the symptoms and severity of prostate enlargement will be considered.
Prostate enlargement also called as benign prostatic hyperplasia or BPH is a condition in men where the prostate gland is enlarged and it is not cancerous. In all men, the prostate gland goes through two main growth periods. The first growth occurs early in puberty during which the prostate gland doubles in its size. The second stage of growth begins around the age of 25 and this continues during throughout a man’s life. Benign prostatic hyperplasia often occurs during the second growth phase. When the prostate enlarges in size, the gland presses over the urethra and the bladder wall becomes thicker, which further leads to the weakening of the bladder. This, in turn, results in the loss of the ability to empty the bladder completely, which causes many of the problems associated with benign prostatic hyperplasia.
Urologists recommend surgery when:
Surgery to remove enlarged prostate tissue includes:
TURP: Transurethral resection of the prostate is a procedure used for treating urinary problems due to an enlarged prostate. A resectoscope is inserted through the penis and then through the urethra. Using the resectoscope, excess prostate tissues that block the urine flow will be removed.
Laser surgery: Laser surgery is used to obtain relief from medium to severe symptoms caused by the enlargement of the prostate gland. During laser surgery, a scope is inserted through the penis into the urethra. A laser beam that passes through the scope removes extra tissue that is preventing the urine flow.
Open prostatectomy: This surgery is performed under general anesthesia. By making an incision through the skin of the prostate, a portion of the prostate will be removed. This surgery is performed if the enlarged prostate causes complications and when the bladder needs repair due to damage.
TUIP: TUIP is a procedure done to broaden the urethra. During this procedure, a cystoscope is inserted and another instrument which uses an electric current or a laser beam is passed through the urethra till the prostate. The urologist then broadens the urethra by removing the excessive tissue in the prostate gland and in the neck of the bladder.
Treatment is not necessary in the case of a mildly enlarged prostate gland that does not cause any symptoms affecting routine life. In such cases, the doctor may recommend regular checkups. If prostate enlargement symptoms pose any health risk, your doctor will recommend a treatment plan.
Treatment options for prostate enlargement may include:
Symptoms of prostate enlargement may include the following:
Your doctor may perform any of the following tests to confirm a diagnosis of enlarged prostate gland:
Urinalysis: Urine analysis is nothing but testing urine sample. The patient collects a urine sample in a given container in a laboratory. A laboratory technician tests the sample during a hospital visit in a lab. For the urine test, a technician places a dipstick into the urine. Changed color patches on the dipstick are signs of a urinary infection.
PSA blood test: A blood sample is drawn for a PSA test during a hospital visit and the sample is sent to a lab for the test. PSA is a protein created by prostate cells. A higher amount of PSA in the blood indicates prostate cancer but prostate enlargement, infections of the prostate, inflammation, age, and normal fluctuations often cause high PSA levels.
Urodynamic tests: A urodynamic test includes many procedures which look at the bladder’s ability to hold urine and empty steadily and completely and the ability of urethra to store and release urine. Urodynamic tests can be performed in an outpatient center or a hospital. Some urodynamic tests can be performed without anesthesia; others may require local anesthesia.
Cystoscopy: Cystoscopy is done by using an instrument called cystoscope which is like a tube, and is used to look inside the urethra and bladder in order to find out if there is any blockage or stone within the urinary tract. A cystoscope should be inserted through the opening at the tip of the penis and into the lower urinary tract. This procedure can be done under local anesthesia or general anesthesia.
Transrectal ultrasound: A transrectal ultrasound (TRUS) is a procedure by which an image of the prostate gland and the surrounding tissue is created by utilizing sound waves. In this procedure, an ultrasound probe is inserted into the patient's rectum. An ultrasound probe sends sound waves through the rectum and into the prostate and the surrounding tissues. Transrectal ultrasound is used to find any abnormalities in the rectum and the prostate.
Biopsy: For prostate biopsy a special needle is inserted into the prostate gland and a small sample of tissue is collected. This tissue sample is then sent to a laboratory for testing for the presence of cancerous cells. A biopsy can be performed in an outpatient center or a hospital under light sedation and local anesthesia and in some cases, the patient may require general anesthesia.
Though the cause of prostate enlargement is not well known, it occurs mainly in elderly men.
Scientific studies have suggested that a higher level of estrogen within the prostate enhances the activity of substances which promote cell growth, which in turn causes the prostate enlargement.
As per some other theory, there is an emphasis on a male hormone dihydrotestosterone (DHT), which leads to prostate growth and development. Few studies have indicated that a decreased level of testosterone in the blood causes in elderly men increased levels of DHT. The aggregation of DHT may enhance the prostate cells to further grow. It is also noted that benign prostatic hyperplasia cannot be seen in men who do not produce DHT.
Herbal medicines are also used in the treatment of prostate enlargement. Some of the best herbs used in the treatment of this condition include Beta-sitosterol, Pygeum, Rye Grass Pollen Extract, and Stinging Nettle. It is better to take a healthcare professional’s advice and consent before taking up such herbal remedies.
There is no known preventive method to avoid prostate enlargement. However, men with lower urinary tract symptoms should undergo regular prostate exams, and talk to the doctors for any further assistance.
Research has not noted that food, diet, and nutrition play a role in either causing or preventing prostate enlargement. However, a physician can provide his advice about how changes in eating, diet, or nutrition could help.
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