Let’s start with the basics – what is a prostate? The prostate is a small gland, located in the pelvis, between the penis and the bladder. This position means that issues with the prostate often manifest themselves as issues with the bladder or urination. Whilst prostate cancer is the widely discussed illness associated with this part of the body, the prostate can also cause other less serious health issues.
Benign Prostatic Hyperplasia- often known as prostate gland enlargement is a common condition that men suffer from as they get older. Men over 50 have a 50% chance of having BPH while men over 80 have a 90% chance. An enlarged prostate gland can place pressure on the bladder and urethra (the tube through which urine passes). This can cause uncomfortable urinary symptoms such as:
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
It can also lead to more serious bladder, urinary tract, or kidney problems. The cause of BPH remains unclear however, it generally isn’t a serious threat to health and symptoms are often mild.
Simple ways to treat minor prostate problems are lifestyle changes such as:
- drinking less alcohol, caffeine, and fizzy drinks
- limiting intake of artificial sweeteners
- exercising regularly
- drinking less in the evening
- medication can also be given to reduce the size of the prostate and relax the bladder to treat moderate symptoms of enlarged prostate
In more serious cases, prostate problems can stop the bladder emptying at all and this leads to what’s called ‘retention of urine’. This is the sudden inability to urinate at all. This will cause severe pain in the lower abdomen and a very large bladder (which can be felt in the abdomen – almost like a small football). If this happens, it’s classed as a medical emergency and should be treated in A&E. This can be treated with medication or surgery if necessary.
There are minor surgical options when drug therapy isn’t enough to relieve symptoms of BPH. The two major methods are TUMT and TURP.
TUMT- TUMT or Transurethral Microwave Thermo-therapy is normally done as an outpatient procedure. It is the process by which microwaves destroy the prostate tissue with heat. TUMT won’t cure BPH but will relieve the symptoms for a period of time.
TURP- TURP or Transurethral Resection of the Prostate is performed under general anaesthetic and normally requires a 1-3-day stay in hospital. The procedure involves removing part of the prostate gland using a device called a resectoscope that’s passed through the urethra. A catheter is used during the operation to pump fluid into the bladder and flush away pieces of prostate that have been removed. The catheter is often left in place for a few days after the operation as the urethra will be swollen and may not allow urine to be passed normally at first.
Rezum- Alongside these established treatments is a new steam treatment called Rezum has recently become available and is starting to be rolled out on the NHS. This process is minimally invasive and can be done under local anaesthetic without an overnight hospital stay. It involves passing a small probe up the urethra to inject a puff of steam into the troublesome area which kills off some of the enlarged tissue to ease symptoms, and the dead cells are reabsorbed by the body. Rezum, is an alternative to invasive surgery and is said to have fewer side-effects, such as impotence and incontinence. Despite this, patients may have to take antibiotics, have a urinary catheter for some days after the procedure, and some activities, including sexual intercourse, should be avoided for up to one month.
In the UK about 1 in 8 men will be diagnosed with prostate cancer at some point in their lives so it is important to know the risks, the signs, and the facts.
Who does it affect?
Age- Prostate cancer largely affects men over 50 and the risk increases with age. The average age for men to be diagnosed with prostate cancer is between 65 and 69 years. Men under 50 have a very low risk of getting prostate cancer.
Lifestyle- Research suggests that being overweight or obese can also increase the risk of being diagnosed with prostate cancer that’s aggressive (more likely to spread) or advanced (cancer that has spread outside the prostate).
Ethnicity- Black men are more likely to get prostate cancer believed to be due to genetic links and around 1 in 4 black men will get prostate cancer at some point in their lives.
Unfortunately, there are no early symptoms to recognise prostate cancer and symptoms only appear when the cancer has started to press on the urethra or is spreading. These symptoms may include:
- needing to urinate more frequently, often during the night
- needing to rush to the toilet
- difficulty in starting to urinating (hesitancy)
- straining or taking a long time while urinating
- weak urine flow
- feeling that your bladder has not emptied fully
- blood in urine or blood in semen
It’s always best to visit the doctor if you’re over 50 and have one or more risk factors. Men, in general, have a tendency to ignore problems in the hopes that it will just ‘sort itself out’. Don’t do this. An early diagnosis could, quite literally, be life saving. If something isn’t right, it’s always better to be safe, be smart, and get checked.
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