SCRIPT NUMBER 141
ENLARGEMENT OF PROSTATE - 2
(TWO SPEAKERS)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE:
ENLARGEMENT OF PROSTATE - 2
PROGRAM NUMBER:
SUBJECT:
141
SYMPTOMS, COMPLICATIONS, TREATMENT OF PROSTATIC
ENLARGEMENT
KEY WORDS: DRIBBLING, REPRODUCTIVE GLAND, SPERM, URGENCY,
FREQUENCY, HORMONES, DECONGESTANTS,
ANTIHISTAMINES
DATE OF SCRIPT: DECEMBER 6, 2013
AUTHOR: RICHARD YUKL, MD, FACS
SPEAKER 1:
Men in their adult life often notice symptoms similar to those
that developed in Juan, one of our listeners. Starting at about age 50, Juan
noticed that the number of times he needed to urinate each day increased, and
his need to urinate awakened him from sleep at night on a regular basis. Despite
his feeling of urgent need, he had trouble starting urination, and his urine stream
was weak, starting and stopping frequently, and dribbling at the end.
SPEAKER 2:
Today, we will talk about enlargement of the prostate. The
prostate is a reproductive gland in men that was created to serve two important
functions. It produces the milky-colored fluid that carries sperm during sex, and it
is the main mechanism that keeps men from dribbling between times of urination.
The prostate is like a ring surrounding the tube that carries urine out of the body.
As every man ages, his prostate gland enlarges. As it does, the center of the
ring becomes smaller, and it begins to block the flow of urine.
SPEAKER 1:
What symptoms does the enlarged prostate cause?
SPEAKER 2:
Prostate enlargement rarely causes symptoms in men
younger than age 40, but about half of men over age 60 have some symptoms.
Usual symptoms include a urine stream that starts and stops when you urinate,
incomplete emptying of the urinary bladder, and a dribbling at both the end of
urination and between urination. You may have blood in your urine. Your urine
stream will be weak, and you may need to urinate two or more times a night.
SPEAKER 1:
Aside from the symptoms, what complications can an
enlarged prostate cause?
SPEAKER 2:
You can develop serious complications - problems such as
the sudden inability to pass urine at all. In that case, you will need immediate
medical attention, as your doctor will need to place a tube into your bladder to
allow drainage. Other serious complications include the formation of stones in
your kidneys and bladder that obstruct the flow of urine and cause you to be
unable to empty your bladder completely. Over time, these stones can cause the
muscles of your bladder wall to stretch and weaken so that they cannot function
properly. Also, your constant need to strain during urination can increase your
bladder pressure enough to damage your kidneys. That may require surgery as it
can be life threatening.
SPEAKER 1:
What causes a prostate to enlarge?
SPEAKER 2:
The actual cause is not known, but it is not cancer, and it
does not increase your risk for developing cancer in your prostate.
SPEAKER 1:
When should I see my doctor?
SPEAKER 2:
If you are developing urinary symptoms, you should consult
a doctor for evaluation to make sure the symptoms are not caused by a serious
problem such as an infection in the urinary bladder or prostate cancer.
SPEAKER 1:
What treatment will my doctor prescribe?
SPEAKER 2:
You may not need treatment if your symptoms are mild. The
doctor may allow time to pass to see whether the symptoms worsen. If your
symptoms are moderate, medicines can be used to relax the muscles at the
outlet of the bladder, making it easier to urinate. You should notice an increased
urinary flow and a less frequent need to urinate within one or two days after
starting the medicines. Juan consulted a doctor, and evaluation identified only
moderate enlargement of his prostate. The doctor treated Juan’s moderate
symptoms by prescribing a medicine to relax the muscles at the outlet of his
bladder, and the symptoms resolved completely. Other medicines can block the
effects of male hormones, allowing a man’s prostate gland to shrink in size. At
times, both classes of drugs are given together.
SPEAKER 1:
When will I need surgery?
SPEAKER 2:
Your doctor may recommend surgery if your symptoms are
severe, or if an adequate trial of medicines has not controlled the symptoms.
Several types of surgery are available. In one type, the surgeon places a tube
with a light into your bladder’s drainage tube and uses small cutting instruments
to remove all but the outer part of your prostate gland. Most men will experience
a stronger urine flow. In very large prostates and in patients with bladder
damage, the prostate may be removed completely. A final possible procedure is
the placement of a tiny metal or plastic tube into the bladder’s drainage tube to
keep urine flowing. The tube must be replaced every 4 to 6 weeks, but it can
delay having to undergo a real surgical procedure for a time while other medical
problems are treated, making surgery safer.
SPEAKER 1:
So, how can I lower my risk of developing symptoms of an
enlarged prostate?
SPEAKER 2:
There are lifestyle changes that can help control the
symptoms or prevent them from worsening. Don’t drink too much coffee or
alcohol as these beverages increase your urine production, and don’t drink
anything for an hour or two before bedtime. If you take water pills, talk with your
doctor. He may be able to change their dosing schedule to give the pills only in
the morning. Limit the decongestants or antihistamines you take, as these
medicines tighten the muscles around the bladder’s drainage tube. Go to urinate
when you first feel the urge, as waiting too long can overstretch the muscles of
the bladder. Try to urinate at regular, scheduled intervals. This will help to retrain
your bladder, and it can be very useful if you have severe frequency and
urgency. Finally, stay active. Inactivity causes you to retain urine. Even a small
amount of exercise can help reduce urinary problems caused by an enlarged
prostate.
SPEAKER 1:
Health Nuggets is written by Dr. Richard Yukl, a medical
doctor working in the United States. The medical views expressed in this
program are his and may differ for your particular health needs. If you need
medical advice, please consult a medical professional in your area.