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Prostate complaints
Enlarged prostate is an ailment that almost every man has to deal with later in life. However, this should not cause any problems.
An enlarged prostate is often benign and is also called BPH: benign prostatic hyperplasia (or benign prostate enlargement). In only a few, the prostate retains its original size, but it is still unclear why this is so.
The prostate
The prostate is a small organ that only men have. It is located at the bottom of the bladder and lies around the beginning of the urethra. It also lies at the front against the pubic bone, while at the back of the prostate is the rectum. The prostate is a collection of glands that produce seminal fluid. This seminal fluid is the main component of semen.
The prostate is already present at birth, but is still very small. During puberty, the gland grows to adult size under the influence of the male sex hormone testosterone. From the age of 25, the prostate begins to grow slowly again, which does not stop. It is this second period of growth that ultimately causes the enlarged prostate. If no testosterone is made in the body, such as after a castration, the prostate will not grow. If castration takes place at a later age, the prostate will shrink again.
Frequent urination
An enlarged prostate does not necessarily lead to complaints. Discomfort occurs in only 30 percent of cases. Symptoms of an enlarged prostate are almost never seen in men under 40, while more than half of men in their 60s, and even up to 90 percent of men between the ages of 70 and 90 have symptoms of BPH. It is said that every man will suffer from an enlarged prostate in his lifetime, if he lives long enough.
When there are complaints, it is often difficulty urinating. Because the prostate surrounds the urethra, it slowly but surely pushes the urethra shut. As a result, the complaints often start with a weakening of the urine stream. It takes some time for the pee to come out. And it takes longer for you to pass urine, because the urine stream is thinner or drops.
Complications
The enlarged prostate can also irritate the bladder, so that some men have the urge to urinate more frequently and have to get out of bed at night. At some point, the enlargement can narrow the urethra so much that the bladder is no longer completely emptied after urinating. The amount of urine left behind can get bigger and bigger, until you can no longer urinate at all. The residual urine can also cause complications such as bladder infections, prostate infections, bladder stones and even kidney problems. It is striking that some men already suffer from complaints with a small enlargement of the prostate, while other men with a large enlargement have no difficulty at all when urinating.
Testosterone
The reason for the growth is not entirely clear, but there are some complicated theories about it. The prostate grows under the influence of the male hormone testosterone. However, it is not the case that men with a higher testosterone level in the blood are more likely to suffer from BPH.
The body produces less and less testosterone with age. This causes another hormone, estrogen, to increase in proportion. This would ensure that the growth-stimulating substances in the prostate become increasingly active and the prostate grows as a result.
A second theory is that the substance dihydrotestosterone (DHT), which is made from testosterone, accumulates in the prostate in older men and stimulates cell growth. This sounds plausible, because men who don’t produce DHT don’t get an enlarged prostate.
BPH or cancer?
In 80 percent of men who have difficulty urinating, the complaints are caused by BHP. In some cases, however, the complaints are caused by other, much more serious diseases, which must be treated immediately.
One of those diseases could be prostate cancer, but a benign swelling doesn’t cause cancer. Prostate cancer only gives symptoms when the disease is already in an advanced stage. It is therefore important to go to the doctor immediately in case of complaints. Only this can rule out whether the complaints are caused by BPH, prostate cancer or another condition.
Sources:
www.urolog.nl
www.prostaat.nl
www.nlm.nih.gov
kidney.niddk.nih.gov
www.medicinenet.com