$Unique_ID{BRK01471}
$Pretitle{Genitourinary System}
$Title{A Discussion of the Prostate}
$Subject{prostate enlargement}
$Volume{J-15}
$Log{
Reproductive Anatomy of the Male*0006001.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


A Discussion of the Prostate


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QUESTION:  It is certainly a sign of advancing years when we sit around and
all we talk about is our prostates.  Although one of us has already had an
operation it is amazing how little we understand about the condition, where it
comes from and the treatment.  Would it be too much to ask you to provide us
with a discussion of the problem?  Surely there must be many other readers of
your column who would profit from the information.

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ANSWER:  You must referring to a most common problem of older men, called
"Benign Prostatic Hyperplasia" (BPH), and it most certainly is of interest to
many of my readers.  While the condition is rarely seen before age 40, it seen
with increasing frequency in men over the age of fifty, and by age eighty, 75
percent of all men are affected.  About a third of the affected men will
require some type of treatment.  The prostate is an organ that is located at
the neck of the bladder, and the tube that carries urine from the bladder
through the penis (the urethra) runs through the gland.  In benign
hyperplasia, the tissues of the gland begin to grow larger, and start to
compress the urethra.  It is thought that certain male hormones (androgens)
play a role in this growth.  As the urethra becomes compressed, the symptoms
of BPH become more pronounced.  They include:  a reduction in the force of the
urinary stream, hesitancy in starting urination, post voiding dribbling, and
nocturia (excessive urination at night).  The diagnosis can be made by the
infamous but most important rectal examination, during which the enlarged
gland can be palpated.  A variety of other laboratory tests and analysis
including a tissue needle biopsy are sometimes performed to clinch the
diagnosis.  In many cases no treatment is necessary except for close and
regular observation.  Certain medications that help voiding, such as
terazosin, prazosin and phenoxybenzamine are available and useful in some
cases.  A number of surgical techniques have been developed to correct the
problem including the insertion of a balloon catheter through the urethra to
dilate the channel and push back the overgrowth of prostatic tissue.  Other
techniques cut through the urethra and remove a portion of the gland
(trans-urethral prostatectomy or TUR) or open surgery through the abdomen that
removes the growth may also be employed.  The results of all these procedures
are generally good with improvement in symptoms for most patients.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
