The prostate gland is located under the urinary bladder in men and surrounds the channel called urethra, through which urine is expelled from the urinary bladder. The weight of the prostate gland in an adult man is around 25-30 grams. The main function of the prostate is to produce the liquid part of the semen and help expel this liquid during sexual ejaculation.
The prostate gland begins to grow gradually starting from the age of 40. Especially the inner part of the prostate may enlarge and the prostate gland, which is normally the size of a chestnut, may reach the size of an apple or even an orange. This condition is called benign prostatic hyperplasia, or with its medical name BPH (benign prostatic hyperplasia).
BPH and its symptoms
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Frequent urination.
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Urinary incontinence
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Having a burning and aching feeling while urinating
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Decrease in urine strength and thickness
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Difficulty in starting urination
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Intermittent urination
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Dripping at the end of urination
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Feeling of not being able to empty urine completely
DIAGNOSIS:
Finger Rectal Examination (DRE):
The physician examines the size, consistency and shape of the prostate with DRE. In benign prostate enlargement, the prostate has an elastic consistency and its volume can be detected to increase. . If hardness is felt in the prostate, cancer should be suspected.
PSA test:
The prostate gland produces an enzyme called Prostate Specific Antigen (PSA) to create the consistency of semen. A very small part of it enters the bloodstream. Increased blood levels can be seen in BPH or Prostatitis, or PSA levels in the blood also increase in Prostate Cancer. When age-specific PSA values (for example, it should be less than 2 ng/ml in those younger than 50 years of age, and less than 2.5 ng/ml in the 50-60 age range) are high and hardness is found on digital rectal examination, prostate cancer should be definitively excluded. While not every PSA elevation means the presence of cancer, it is another fact that cancer may be present even if PSA is normal.
Urina analysis:
Urina analysis shows the presence of cancer. If inflammatory cells or blood cells are found, the presence of another disease that causes this should be ruled out. (such as urinary tract infections, urinary tract stones, urinary bladder tumors).
Urinary flow rate. :
Normal maximum urine flow rate should be 15 ml per second and average flow rate should be 10 ml. Normal urination time is 30 seconds, or half a minute. If the prostate blocks the urinary tract in BPH, these values will decrease and the time to urinate will be longer. For this test to be healthy, the amount of urine produced must be at least 150 ml.
Ultrasonographic examination:
The size of the prostate is determined from the abdominal surface or rectally using sound waves. It is useful to obtain information about its structure and the changes it causes in the urinary tract. Rectal ultrasonography is also used to perform prostate biopsy.
PMR (Postmicturition residue) determination and Urodynamics; Pressure-Flow study:
It is the determination of the amount of urine remaining in the bladder after urination (PMR determination). It is usually done with a special ultrasound device called "bladder scan". A more accurate measurement can be made by placing a catheter through the urinary tract, but it is a method that causes discomfort to the patient.
When there is a suspicion that the complaints about urination are due to prostate enlargement (especially in young or very old patients; patients whose prostate volume is not large), the urinary tract With a catheter placed, bladder pressures, flow rate and pressures in the urinary tract are measured with a urodynamic device. Thus, it is understood whether the patient's complaints are caused by bladder contraction disorders.
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