The prostate, it's man thing. This normally walnut sized gland is located above a man's rectum and just below the bladder and wraps around the urethra, the tube used to expel urine and semen from the male. It performs an important role in sexual reproduction. A man's ejaculation consists of sperm produced by the testicles and semen, a protective liquid that is partly produced by the prostate. Until around middle age this gland usually gives us no bother, However, in later life it makes its presence known as an enlarged prostate.

Although changes can begin as early as the thirties, actual enlargement of the prostate doesn't tend to appear until beyond fifty years of age. Also known as benign prostatic hyperplasia, or bph, this condition affects most males over the age of 40, and more commonly over the age of 60. Beyond 60, over half of men have bph and by the age of 85 the number climbs to 90%. An enlarged prostate is an inevitable development of getting older but doesn't automatically indicate cancer as many men fear.

Benign Prostatic Hyperplasia, is part of a group of symptoms known as, Benign Prostatic Syndrome or bps. The term "benign" means that, although it is a growth, it is not cancerous, while "hyperplasia" means "enlargement". In the ageing male, prostate cells gradually multiply, creating an enlargement. Because the gland surrounds the urethra, it squeezes and strangles it slowing the flow of urine and the function of the muscles of the bladder. If the condition worsens and becomes severe it prevents the bladder from emptying completely at each urination. Urine that collects in the bladder can become infected and lead to stone formation or kidney damage. A sufferer tends to urinate more often, perhaps two or three times at night. This need to urinate gradually becomes more urgent over time. Other symptoms of bph are a weak and sometimes split urine stream and possibly an ache in the area between the scrotum and anus. Science does not know what causes the prostate gland to enlarge, but it's thought it may be linked to hormones.

When a man's symptoms point to bph, a doctor should conduct a digital rectal examination. This examination involves the physician inserting a finger into the anus to feel if and how much the prostate has enlarged. Generally a smooth prostate surface suggests bph but a lump in the gland might indicate prostate cancer but not always. Should a man be diagnosed with prostate cancer symptoms and BPH it is purely coincidental as the two conditions are quite independent of each other. Often the next step is a blood test for a check of prostate-specific antigen or psa levels. Although higher than normal levels of psa point to the possibility of cancer being present, it is not definite and there are many factors that can affect an increase in psa levels.

A lot of men affected by an prostate problems will never think to seek medical help. They just accept it as part of getting older or perhaps through fear it might be linked to cancer. However, some men have a greatly enlarged prostate but few symptoms, while others may have completely the reverse situation. The severity of the symptoms is critical to the decisions around whether or not to have treatment and, if so, which kind of treatment to choose. With milder symptoms, it may not be necessary to do more than wait and see called 'watchful waiting' or 'active monitoring to see how things develop. Medication is the most common kind of treatment for mild to moderate symptoms. Medications may be prescribed to relax the muscle inside the prostate, making it easier for the urethra to open while others block the action of testosterone which causes the prostate to shrink.

When the situation is severe enough some form of surgery maybe required to reduce the size of the prostate to improve urine flow. There are several procedures available some of which are minor enough to be carried out at clinics as a day patient. These procedures involve removing prostate tissue around the urethra allowing space rather like a tunnel and relieving the constriction. Partial or complete removal of the gland may be recommended even for BPH as well as when cancer has been detected. This kind of procedure is major surgery requiring a hospital stay as it would be done under general anaesthetic. Added complications for this treatment is the risk of impotence and incontinence. More often these are temporary problems and are resolved within a year but they can be permanent in a percentage of cases.

Some men decide to self medicate with over-the-counter herbal treatments and there are a great many on the market. One of the best known treatments being the saw palmetto berry, a shrub native to some parts of the USA and West Indies. This remedy is said to be very effective for relieving inflammation and enlargement of the prostate. While it has proven to be helpful in this condition caution should be observed because clinical reports suggest the herb can cause a fall in prostate PSA levels. This may lead to false reporting of raised PSA readings which could be indicative of prostate cancer. As such, in some cases a prostate cancer test may be misled by these falsely represented levels. The consequence is the cancer could be missed and urgent treatment delayed or even missed.

All men are not created equal. We are all individual and as such any treatment must be tailored to our needs and with the best outcome in mind.

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