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Nobel Hygiene

Verma ji had been struggling with an enlarged prostate for quite a while now. He sought treatment from a doctor which helped a bit but not completely. He could not understand how to stop himself from wetting his pants in public. “Pant geeli ho jati hai, baar baar. Nikalti sirf do boondein hain, par zindagi kharaab karne ke liye kafi hain.” His grandson saw Friends Adult Diapers’ advertisement and recommended it to him. Verma ji now uses Friends Adult Diapers for important occasions, while he is playing with his pets and even when he is asleep! “Friends ne asli azadi ka anubhav karaya hai!” he says.

What is an Enlarged Prostate?

The prostate is a gland found in men. It is located right above the urethra, the pipe linking the bladder and the kidneys. The main job that this gland performs is to make fluid for the semen.

The prostate starts growing when a male reaches puberty. It starts growing again when a man reaches twenty-five years of age and continues to do so for the rest of his life. Problems arise when the prostate grows too much, and at a point it starts putting pressure on the urethra. This pressure can cause the urethra to malfunction.

More than half of men over sixty years of age suffer from an enlarged prostate, also called benign prostatic hyperplasia (BPH).

What are the causes of an Enlarged Prostate?

What is the main cause of prostate enlargement? Unfortunately, researchers have not reached any conclusions yet. No one knows for sure why the prostate gland keeps growing in size. Abnormal prostate enlargement happens for most men as they age and doesn't cause any symptoms before the age of 40. By age 85, more than 90% men report BPH symptoms.

Experts believe hormones might have a role to play. Hormones such as testosterone, dihydrotestosterone (DHT), and estrogen.

Symptoms of an Enlarged prostate

Some men with BPH have symptoms while others don't. Symptoms of prostate problems can be terrifying because they look quite similar to prostate cancer. But an enlarged prostate is much more common than prostate cancer. And one thing is absolutely certain: An enlarged prostate does not lead to cancer.

What is the normal prostate size?

Prostate size remains the same until half of an adult male’s life (around 40 years). Urologists use volume rather than weight to measure the size of the prostate. Ultrasound are used to measure this size. The average size of the prostate is 3 cm high and 4 cm wide. Its common volume is 20 cm3 for around 20 grams. The size of the prostate may vary slightly from person to person. Anything vastly higher than these numbers are considered to be an enlarged prostate size.

What is the size of an Enlarged Prostate?

A small prostate has a volume of 30 ml to 40 ml and a weight of 20 g to 70 g. A medium prostate has a volume of 40 ml to 80 ml and a weight of 20 g to 125g. A large prostate has a volume of 40ml to 100 ml and a weight of 40 g to 125 g. An abnormally large prostate can increase by 4 to 5 times compared to its initial size.

What happens if you have an Enlarged Prostate?

Complications of an enlarged prostate can include the following:

  • Urinary retention – It is a sudden inability to urinate. If things become really grave you might need surgery to relieve urinary retention.

  • Urinary tract infections (UTIs) – When you are unable to fully empty your bladder due to an enlarged prostate, your chances of urinary tract infections might increase. 

  • Bladder stones - Bladder stones are caused because your bladder is unable to fully empty itself out. It may cause infection, irritation in your bladder, blood in your urine and might even obstruct flow of urine. 

  • Kidney damage - Pressure in the bladder from urinary retention can directly damage the kidneys. It might even allow bladder infections to reach the kidneys which can be really dangerous. 

  • Constipation –The prostate sits just in front of the lower rectum. An enlarged prostate could press on the rectum, making it difficult to empty. Will an enlarged prostate cause constipation? Very rarely, as the prostate generally doesn’t grow that large.

Can enlarged prostate be treated?

Even if urinary symptoms are not bothering you, make a visit to your doctor. This is to make sure that there aren’t any underlying causes to these symptoms. Urinary problems if left untreated, might lead to the obstructions of the urinary tract.

Your doctor might ask questions about your symptoms and do a physical exam. These physical exams can include:

  • Digital rectal exam

  • Urine test

  • Blood test

  • Prostate-specific antigen (PSA) blood test

To help rule out other conditions, your doctor might recommend:

  • Urinary flow test

  • Postvoid residual volume test 

  • 24-hour voiding diary

If your condition has reached an advanced state, you might be recommended the following tests:

  • Transrectal ultrasound

  • Prostate biopsy

  • Urodynamic and pressure flow studies

  • Cystoscopy

How an enlarged prostate is treated depends on your age, size of your prostate, your specific health conditions, and the amount of discomfort the symptoms of an enlarged prostate are causing you.

Some men find that their symptoms ease without even treatment by just maintaining a healthy lifestyle.

Medication for an Enlarged Prostate

The best treatment for an enlarged prostate which shows mild to moderate symptoms is medications.

  • Alpha blockers – Helps relax bladder neck muscles and muscle fibers in the prostate, which makes urination easier. 

  • 5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.

  • Combination drug therapy. Your doctor might recommend a combination of medications.

Minimally invasive or surgical therapy

If your symptoms are moderate to severe you might be recommended minimally invasive or surgical therapy.

  • Transurethral resection of the prostate (TURP)

  • Transurethral incision of the prostate (TUIP)

  • Transurethral microwave thermotherapy (TUMT)

  • Transurethral needle ablation (TUNA)

  • Laser therapy

If you have undergone any of these procedures, your doctor might recommend some precautions that you need to take. Visit your doctor anyway if you are facing symptoms of an enlarged prostate mentioned in this blog. They can help you in selecting a treatment route based on your specific condition.