Every
man’s prostate increases in size with age, particularly after the age of fifty (Benign prostatic hyperplasia BPH). If this enlargement is moderate or severe it can cause a blockage, impeding the passage of urine from the bladder, sometimes in a sudden, acute and agonising manner (acute retention). In many men, however, even quite marked enlargement is not necessarily associated with much in the way of symptoms. Associated with the symptoms of blockage – poor stream, dribbling – can often be the symptoms of bladder irritability – frequent passing of urine, getting up in the night to pass urine and a feeling of urgency. These symptoms of bladder irritability are sometimes found in men with a normal sized prostate. Chronic obstruction to the passage of urine by an enlarged prostate can result in back pressure, causing damage to the kidneys. It is essential, however, that when a man has symptoms, suggesting prostate problems, he must be checked by a doctor to make sure that he does have BPH and not prostatic cancer. The blood test, PSA (prostatic specific antigen) is particularly useful in this respect, but like all tests, it is not perfect, and can give results which may be confusing. Other tests may be necessary, including digital examination. It is now realised that the development of some cancer cells in the prostates of all men, eventually, is the norm. There are few men of ninety who would have none at all. But this is not the same thing as having clinical cancer of the organ. That having been said, with our increasing longevity, a longer shelf life for the prostate is to be hoped for.
As in atherosclerosis, choose your parents wisely. There is a family tendency that makes the development of prostatic problems more likely in some than in others. There are now available medications that can help with BPH and reduce bladder irritability. The main surgical treatment is the TURP (trans-urethral resection of prostate) in which a wedge of prostate tissue is removed, making the passage of urine easier. |
