Prostate gland enlargement

Prostate gland enlargement

MALE DISORDERS – Prostate gland enlargement 

The gifts that God has given specially to a man may by itself turn to be a burden like the inflammation caused in the prostate gland named Prostatis. Even though Prostatis is a common condition for aged men, the frustration caused by it to the patients and clinicians are more.

The topic speaks of aggravated urinary complaints and sexual problems at night. The prostate

gland is present only in men. This gland is located just below a male’s bladder and surrounds the top portion of the urethra. It is very close to the muscles which control the uretric sphincter and the duct which controls ejaculation during sexual activity.

So, any problem with the prostate will affect urine flow and sexual activity. Behind the prostate is the rectum. The prostrate gland’s primary function is to produce most of the fluids in semen that nourishes and transports sperm. The fluid is added to the semen at the time of ejaculation. The fluid released from the prostate is made up of alkaline phosphatase, citric acid, proteins, enzymes, fat and sugar to feed the sperm and also form a swimming media for sperm to reach the egg.

The normal prostate in young men is about the size of a small plum. From birth to young adulthood, the prostate grows from about the size of a pea to the size of a plum. Most men experience a second period of prostate growth in their 40s. Prostate enlargement affects about half of men in their 60s and up to 90 per cent of men in their 70s and 80s. When prostatis is caught at an early stage, there is a good chance it can be cured. It can be a danger to health if it is recurrent or progressive.

The prostate enlargement is usually named BPH – Benign prostatic hypertrophy. In BPH, the normal elements of the prostate gland grow in size and number. The problem starts with the reproduction of the cells rapidly in the central portion of the gland, so the tissues enlarge, and often compress the urethra, totally or partially blocking urine flow. This urethral compression leads to urine retention and the need for frequent urination, adding to infection and complications.

BPH is not a forerunner to prostate cancer. The presence or absence of prostate gland enlargement is not related to the development of prostate cancer. Prostate cancer is the second most common cancer in men, though it mainly affects older men. Cancer develops as a result of a breakdown, leading to cells growing in an uncontrolled way. The mass of excess cells form a tumour (growth), which may be benign or malignant. The tumour is described as malignant if it is able to invade other healthy tissue.

Complications – Renal complications arise from prolonged obstruction. They can include hydronephrosis, renal infection, renal calculi, uremia and renal failure.

CAUSES: The causative factor for prostate enlargement is unknown but predisposing factors are:

1. Male hormones (androgens) influence the enlargement of the prostate. It is rare to see enlargement of the prostate in men whose male hormone levels are very low. Only a few men with enlarged prostate have significant symptoms or require treatment.

2. The prostate gland may get infected by many organisms, including the one that causes gonorrhea. Infections elsewhere in the body may also be carried to the prostate gland through the bloodstream. Sometimes the prostate may become inflamed simply by enlargement of the gland or by excessive sexual activity.

3. Another important cause of prostate enlargement is overproduction of a hormone metabolite called DHT, which is the prime culprit in the development of BPH and possibly prostate cancer. The prostate enlargement is directly dependent on increased dihydrotestosterone (DHT) production, the principal androgen hormone in the prostate which increases as age advances.

4. Zinc has long been associated with male sexual health. This is because zinc is an integral part of hormone structures and a major constituent of seminal fluid and is involved in the production of sperm. As age increases, deficiency leads to impotence and prostate enlargement because the prostate tissue grows to collect more zinc to maintain its health.

SYMPTOMS FOR BPH Normal urination should have a time period gap of more than 2 hours during the day unless large amounts of liquids such as water, coffee, tea are consumed. During the night, urinating once can be admitted as normal. The BPH patient faces symptoms such as:

• Inconvenient, painful and debilitating urination
• Waiting for a long time for the urinary flow to start up
• A slow flow of the urine stream with a decreased strength and force is felt while urinating.
• Inability to empty bladder fully. This is due to bladder outlet compression made by BPH. Due to this, stagnation occurs which favours infection. As the bladder cannot empty fully, urine may need to be passed quite frequently.
• Frequent night urination and urgency – due to irritated bladder from infection.
• Straining is required to force urine through the constricted urethra. This causes thickened bladder muscles. Constant straining may also cause the bladder muscles to weaken. Many men wake up in the morning with an erection and with an urge to urinate which cannot be implemented due to the erection. The bladder sphincter is designed to remain closed in the presence of an erection. This prevents any ejaculation that occurs from entering the bladder. When the valve gets damaged and an ejaculation occurs, the semen takes the shorter route into the bladder. This is called retrograde emission.
• Sometimes there is a strong desire to pass urine but only leakage of urine occurs without any continuity, leading to great discomfort and embarrassment.
• Occasionally, an enlarged prostate will cause blood to appear in the urine. The urine may look bloody or cloudy.
• Prostate enlargement can cause a complete blockage to urine flow. This then requires emergency treatment.
• In case of prostatis, fever may be present with lower abdominal pain and distention. There is also loss of appetite and fear to take water due to fear of urination. A hard lump in the angle of the thighs or rectum is felt which becomes painful when pressed.

ALARMING SIGNS OF BPH
1. A slow flow of urine – even though there is urgency

2. Leaking after the initial stream subsides.

3. Frequent urination by getting up more times in the night

4. Feeling of fullness in the bladder very frequently

5. Inability to empty the bladder

6. Total inability to urinate due to blockage of the urethra

7. Painful urination and painful ejaculation

8. Impotence

DIAGNOSIS OF BPH

Behind the prostate is the rectum. So prostate can be easily detected by a physician by rectal examination. During a rectal examination, the prostate should be free, smooth and pliable. If there is any difference in the soft tissue of BPH with irregularities, patients should go for all other lab tests. A standard recommendation is to avoid vigorous digital examination of the prostate, because it may induce bacterial infection or worsen it.
Diagnostic tests also include blood test to detect prostate specific antigen (PSA), a cell surface protein normally found on prostate cells. Elevated PSA levels indicate an enlarged prostate, which may be caused by a benign or cancerous growth.

• Ultrasound scanning may provide detailed information.
• Cultures and microscopic examination of urine and prostatic secretions will also give a clear picture.

TYPES OF PROSTATE PROBLEMS

There are three main types of prostate problems
1) Prostatis (infections and inflammation)

2) Enlargement (benign prostatic hypertrophy)

3) Cancer

1. Prostatis – Inflammation in the prostate is common and the easiest complaint to diagnose and treat. This form of prostatis leads to a range of very uncomfortable and painful symptoms, including chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination and body aches. There is also a clear infection of the urinary tract, with white blood cells and bacteria in the urine. Culture and sensitivity test will also guide for treatment. Early treatment is good to control and prevent recurrences.

2. Enlargement- This can be due to

Acute bacterial prostatitis – Acute bacterial prostatis may be considered as a type of urinary tract infection. The disease causing organisms are primarily gram-negative, coliform bacteria. The most commonly found organism are E-coli, Klebsiella, Proteus, Enterococci and Pseudomonas. Sometimes cultures grow Staphylococcus aureus, Streptococcus faecalis, and Chlamydia species. Patients usually have fever, chills, low back pain, perineal or ejaculatory pain, dysuria, urinary frequency, urgency, myalgias and obstruction. The duration of therapy will sometimes be long.

Chronic bacterial prostatis – This form of prostatis is associated with an underlying defect in the prostate. Symptoms can be similar to those of acute bacterial prostatis, and there are also signs of infection. Patients have recurrent urinary tract infections with persistence of the same strain of pathogenic bacteria in prostatic fluid or urine. Symptoms can be quite varying, but many men experiences irritating voiding symptoms, possibly with pain in the back, testes, epididymis or penis, low-grade fever, arthralgias and myalgias

3. Prostate cancer – Prostate cancer is the second most common cancer among men next to lung cancer. The peripheral (outer) zone of the prostate is the area most susceptible to developing cancer. BPH is an excessive growth of normal prostate cells. In prostate cancer, a tumour consisting of abnormal cells is the culprit behind the disease. At first the tumour is small, but a tumour may eventually grow so large that it infiltrates and occupies the entire prostate. Another difference is that a prostate with BPH will be fairly soft and pliable. A cancer tumour can be made up of very tightly packed cells. Here prostate gland is tender and warm, swollen, firm and irregular.

GENERAL TREATMENT FOR BPH:

BPH affects each man differently. Each man is different and each manifestation of the disease is different, there is no single treatment for all men. The type of treatment can be chosen depending on how much the symptoms bother. Often the symptoms gradually or suddenly worsen. The bladder may hardly empty at all or may cause back pressure on the kidneys, causing kidney failure. Such a complication may produce general sickness, but may get advanced condition without giving any symptoms at all.

The first line of treatment is usually conservative with tablets. Medicines are chosen for the muscles in the prostate to relax and to reduce the size of the prostate. This will give a significant improvement in symptoms. Nowadays, allopathic doctors use medicines like Hytrin, which belongs to a class of drugs called alpha-1 blockers and relax the smooth muscle of the prostate and the bladder neck. Relaxing these muscles helps relieve the urinary obstruction caused by the enlarged prostate. Also, they are using anti-androgens, which stop the action of male hormone levels on this gland (finasteride). These are useful if the gland is quite large.

Side-effects for these drugs are very much annoying. They include erectile dysfunction, fatigue, dizziness, heart palpitations, sinus congestion and, in some cases, severe low blood pressure. For patients taking alpha blocker drugs, the most common side-effects are feeling dizzy and tired and having headaches Side-effects of finasteride include less interest in having sex, decreased erection, and problems with ejaculation. Alpha-antagonists or hormonal agents to reduce the prostate’s size may cause erectile dysfunction, loss of libido, feminisation and thromboembolism.

Surgical options – Surgery has more risk than the other treatments. But for any serious complication of BPH, surgery is the only choice. Surgery is recommended when complaints are out of control.

There are three main types of surgery for BPH:

• Transurethral resection of the prostate
• Transurethral incision of the prostate
• Open prostatectomy

A new line of treatments for BPH appear every year. Examples are laser surgery, microwave thermal therapy and new drugs.

Side-effects of these surgeries are that bloody urine is likely for several days. Also, recurrence of blocks, urine incontinence and erection dysfunction is common. One other problem is retrograde ejaculation. Men with this problem may not be able to father children. But it does not affect the ability to get an erection or have sex. This is common with surgery and rare with alpha blocker drug treatment.

HOMEOPATHIC APPROACH FOR BPH

First of all, the patient should accept that they are ageing, i.e. in childhood they run for everything and in the adult stage they walk for everything and when aged, they walk slowly even for urgent matters. Likewise as they grow older, the passing of urine should also to be done in a very relaxed manner, i.e. if they are straining more they cannot expel even a drop since the muscles around the bladder get tightened and close the urethral orifice more tightly instead of relaxing them to pass urine. So, the first thing to be followed is go to the urinal

1) Before the bladder gets filled up and

2) Go in a relaxed manner; wait for a minute or two for the bladder to empty the urine voluntarily, without any force. If the bladder empties voluntarily, there will not be any residual urine.

As a natural phenomenon, we should treat the enlarged prostate by the way which restricts its growth. Usually, it gets worse by drinking alcohol, tea, or tension, urgency or full bladder, so first of all avoid all these things. Some persons will try to urinate in different positions like sitting, standing, leaning forward or backward, with leg apart whichever they feel comfortable to pass urine. As positioning and passing method differ from one another, the medicine selection also differs, since in Homoeopathy the patient’s comfort is given more importance than the disease’s common symptoms.

There are several medicines in Homoeopathy for enlarged prostate, urinary complaints, frequent urination at night and erection disorders. Medicines frequently used are Belladona, Cantharis, Nux vom, Staphysagria, Apis mel, Thuja, Sabal serrulata, Ferrum picricum, Equisetum, C.F 6x, C.P6x, Gelsemium, acid phos, Causticum, Acid phos, Baryta mur, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

Homoeopathy is the best treatment without dangerous surgeries, injections and hormone therapies. You can discover a new, relaxed, comfortable life.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com / www.drcheena.in

(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)