Prostate enlargement is observed in men starting from the early fifties, and this growth brings with it some problems.
Prostate is a gland that is part of the male reproductive system. The main function of the prostate is to produce a secretion that is incorporated into semen. Prostate secretion is very important for male productivity. The prostate is the size of a chestnut and weighs about 20 grams. Due to its location, the prostate surrounds the beginning of the urinary tract like a ring, which allows urine to come out of the bladder and pass through the penis.
Changes in the prostate gland begin at the age of 40-45 and manifest themselves as growth in the 50s. The cause of this enlargement of the prostate is not fully understood. It is usually seen in aging men and is thought to be due to hormonal changes and familial influences. Benign prostatic hyperplasia affects half of men aged 50-60 and 90 percent of men over 80 years of age. Prostate enlargement usually occurs as a benign event, therefore it is called benign prostate enlargement. Some of the prostate enlargements are malignant growths and are defined as prostate cancer. Benign prostate enlargement and prostate cancer are two separate diseases that can coexist but are not caused by each other. Although prostate enlargement is so common, not every enlargement causes a problem and does not require treatment. The prostate is treated not only because it is enlarged, but also if it causes symptoms or will harm the body.
Since the prostate surrounds the urinary tract, as it grows, it compresses the urinary tract and can make it difficult to expel urine from the bladder. The patient cannot pass urine easily and a feeling of obstruction occurs. The most common findings are:
urinating 8 or more times a day
inability to delay urination when the need arises
difficulty in starting urination
weak and intermittent urine flow
dribbling at the end of urination
frequently waking up and urinating at night
incomplete emptying of the bladder
complete obstruction in advanced cases
p>Benign prostate enlargement is diagnosed by taking the patient's history, examination and medical tests. Since other diseases may also cause urinary complaints, the patient's complaints and other diseases are questioned. Patient complaints are scored and graded as mild, moderate or severe.
Anal digital examination is performed, which is important in distinguishing benign prostate enlargement from cancer. The most common laboratory tests are urine analysis and Prostate Specific Antigen (PSA) blood test. In patients with high PSA values, a biopsy is planned to distinguish it from prostate cancer. Ultrasonography, voiding test and post-voiding urine measurement are also of particular importance in diagnosis.
The main factor when determining benign prostate treatment is the severity of the complaints and the occurrence of some effects on the body resulting from prostate enlargement.
Mild. Observing and waiting is an important option in patients with severe symptoms. This protects the patient from unnecessary treatments and surgery. There is no rule that the complaints will necessarily increase over time. In some patients, urinary complaints ease over time. It is necessary to start serious treatment in patients who develop recurrent urinary tract infections over time, patients who develop bladder stones, patients who begin bleeding in the urine, and patients who are heading towards kidney failure due to obstruction.
In cases where medications are not sufficient and complaints increase and begin to damage the body. Surgical treatments may be required.
Surgical treatments can be done by closed or open methods. For very large prostates, open surgery is a suitable method to remove the prostate. Vaporizing the prostate with a laser or cutting it out are also among the methods applied. After these surgeries, although rare, problems such as bleeding, infection, stenosis, certain degrees of urinary incontinence, and semen leaking back into the bladder during ejaculation may occur.
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