The prostate gland is only found in men. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra (the tube which passes urine from the bladder) runs through the middle of the prostate. The prostate helps to make semen, but most semen is made by the seminal vesicle. The prostate gland commonly becomes larger in older men. This is called Adenoma of Prostate or Benign Prostatic Hyperplasia. It can cause problems with passing urine. The prostate gets bigger ('enlarges') gradually after the age of about 50. By the age of 70, about 8 of 10 men have an enlarged prostate.
The Adenoma of Prostate affects the quality of life of about a third of men over 50 years, the numbers increasing markedly with years. Histological evidence of an Adenoma of prostate occurs in up to 90% of men by the age of 80. It is unusual before the age of 50 and affects men of Afro-Caribbean origin at a slightly earlier age. Between the ages of 50 and 59, 60% of men already have an enlarged prostrate gland. In men near the age of 60, 75% of them had this illness. At the age of 80 years only one in five men does not have the expressed adenoma. Recently this illness has strongly rejuvenated. It is unusual now for thirty year old men to have an enlarged prostate. The majority of patients turn to a doctor only when they begin to note the stagnation of the urine (the bladder is not completely emptied, it leaks urine, or there is a constant smell of urine). In such neglected cases, almost always there will be problems.
Some scientists and doctors consider the prostate adenoma to be the first stage of prostate cancer. On the contrary, other scientists do not consider these illnesses to be connected to each other, since in the majority of cases they affect different divisions of the prostate gland. However, the leading role in the development of adenomas and prostate cancer is played by the man's sexual hormones. A high level stimulates the prostate enlargement.
The symptoms of the disease:
About 1 in 3 men aged over 50 have some symptoms due to an enlarged prostate. As the prostate enlarges it may cause a narrowing in the first part of the urethra. This may partially obstruct the flow of urine from the bladder. This can lead to obstructive symptoms such as:
- Poor stream. The flow of urine is weaker, and it takes longer to empty your bladder.
- Hesitancy. You may have to wait for a while before urine starts to flow.
- Dribbling. Some urine may trickle out and stain underpants soon after finishing urination
- Emptying. You may have a feeling of not quite emptying your bladder.
The Adenoma of prostate may also 'irritate' the urethra and lower bladder which may cause:
- Frequency (passing urine more often than normal). This can be most irritating if it happens at night. Getting up several times a night is a common symptom and is called 'nocturia'.
- Urgency. This means you have to urinate quickly when it is needed.
Usually the symptoms are mild to begin with. Perhaps a slight reduced urine flow, or having to wait a few seconds to start passing urine. Over months or years the symptoms may become more troublesome and severe. Complications develop in some cases.
An Adenoma of prostate does not always cause symptoms. Also, the severity of the symptoms is not always related to the size of the prostate. It depends on how much the prostate press on the urethra and lower bladder. Not all urinary symptoms in men are due to an Adenoma of prostate. In particular, if you pass blood or have pain it may be due to bladder, kidney, or other prostate conditions. You should see a doctor if these symptoms occur, or if there is a change from your usual prostate symptoms.
The complications of the disease:
The anatomical situation of the prostate explains why the adenoma can resound, by decreasing the gauge of the urethra, on the bladder and even on the ureters and the kidneys. Adenoma will have very few consequences. On the other hand it will obstruct the bladder and the high apparatus.
Repercussion on the urethra: The prostate surrounds the urethra under the bladder and, while increasing volume, thus will stretch it and decrease its gauge, thus obstructing the evacuation of the urine. This embarrassment will be at the origin of the repercussion of the adenoma on the bladder and the remainder of the urinary tract (ureters and kidneys).
Repercussion on the bladder: The bladder is not a urine bag but a hollow muscle intended to collect the urine secreted continuously by the kidneys and to voluntarily evacuate it with regular interval. The urethra is finer, the effort required to evacuate the urine thus will be larger, and as any muscle which works against an increased resistance, the bladder will thicken from 3 to 4 mm in normal cases, it can thicken up to 1 or several cm. It is a muscular bladder.The bladder cannot fight indefinitely, between the fascicule of muscle fibrosis on the level of the more weak cells; the vesicle mucous membrane will make hernia covering out of the bladder.
The retention supplements of urine: The urethra, at the time of an inflammatory push of the adenoma or in case of an increase in its volume, can be completely blocked, and then the bladder cannot be emptied more. It is the complete retention of urine which is often the circumstance of discovered adenoma because the patient will then come to consult you in urgency to be relieved of this desire for urinating impossible to relieve.
Incomplete retention of urine: The bladder is emptied, but incompletely, the urethral resistance exceeds the force of the bladder and at the end of the micturition, there will remain permanently a more or less important volume (300cc, 1 liter, and sometimes more). The bladder is distended, lost its normal capacity and will not recover a force of normal contraction after treatment.
At the end it is necessary and urgent to prevent and fight the Adenoma of prostate because it can become dangerous if nor treated, and it may lead to a cancer.
