What You Need To Know-About Prostate Health
It is roughly the shape of a walnut and weighs approximately 20 grams. The corç Hiisgnd is a hollow tube through which the urine flows, to empty the bladder
With a large chunk of the Indian population over 50 years of age and with increasing longevity, men’s prostate health, is fast becoming a major issue, because as age advances, the prostate gland starts to grow and if it enlarges inwards into the urethra, it causes problems while passing urine. Situated at the neck of the urinary bladder, the prostrate surrounds the urethra.
It is roughly the shape of a walnut and weighs approximately 20 grams. The core of this gland is a hollow tube through which the urine flows, to empty the bladder. The enlargement of the prostate gland outside the urethra, towards the rectum, has no relevance, as there is enough space to accommodate the enlarging prostate gland. However, sometimes, the prostatic cells undergo uncontrolled growth, resulting in cancer of the prostate gland.
Functions Of The Prostate Gland
When a person is young, the prostate gland produces a liquid in which the sperms float, However, as age advances, it starts to enlarge in size. The subsequent blockage of urinary passage results in urinary symptoms of varying degrees, depending on how big the prostatic growth is.
Symptoms Of Prostate Enlargement Into The Urethra
In the past, any urinary complaint was deemed to be due to prostate enlargement and was operated upon on based on this assumption. However, the symptoms can be divided as follows:
The first symptom is nocturia (excessive urination at night) followed by daytime frequency. Further enlargement leads to difficulty in starting the flow (hesitancy) and the urinary stream starts to slow down. It the symptoms are ignored, there is retention of urine – a situation in which emergency catheterization needs to be done.
The triad of frequency, urgency, and dysuria are usually due to instability of the urinary bladder musculature. However, operation on the prostate gland with only these symptoms can result in failure of surgery, as the symptoms are generally due to urinary bladder problems and not due to prostatic obstruction.
Combination Of Obstructive And Irritative Symptoms:
Sometimes the irritative symptoms are secondary to obstruction, due to an enlarging prostate gland. Surgery for such a situation is justified.
Unusually, a patient may face issues like recurrent urinary tract infections, episodes of bleeding along with urine, or even kidney failure.
Treating Prostate Gland Issues
In the years gone by, the only treatment available was surgery. But now, with increasing understanding of the pathophysiology, an array of medicines are available that can control the symptoms and indeed cause shrinkage of the prostate gland. Such has been the transformation that roughly only 20 per cent of symptomatic patients, require surgery. The rest can be controlled by medicines.
Surgery Of The Prostate Gland
- Surgery is now confined to cases that do not respond to medical treatment or for those who cannot take medical treatment, because of its side effects.
- Other indications for surgery are when a patient experiences retention of urine, or when frequent treatment is required for urinary tract infections.
Types Of Surgery
Trans Urethral Incision Of Prostate (TUIP):
This is the simplest surgical procedure which is useful in cases of a small prostate with predominantly a bladder neck problem.
Trans Urethral Resection Of Prostate (TURP):
This continues to be a gold standard for prostate surgery and the operation is performed through the urethra and therefore no cuts are involved.
This is an extension of the standard TURP where a laser beam is used to cut through the enlarged gland. Such a surgery is safer in patients who are on blood thinners, immune compromised patients or patients with low haemoglobin. Three types of laser machines are used in this method – diode, holmium and green light laser. However, they all have plus and minus points.
The Role Of PSA (Prostate Specific Antigen)
This is a blood test and this antigen was initially thought to be increased only in cases of prostate cancer. With better understanding, it is now realized that the levels can also go up in other conditions affecting the prostate gland like prostatitis, very large prostate, post catheterisation, etc. Therefore, while an increased level of S-PSA may suggest cancer, it is only by Trans Rectal Ultrasound Guided Multicore Prostatic Biopsy that the presence or absence of cancer can be determined.