Prostate
gland enlargement
MALE DISORDERS – Prostate gland enlargement
The gifts that God has given specially to a man
may by itself turn to be a burden like the inflammation caused in the prostate
gland named Prostatis. Even though Prostatis is a common condition for aged
men, the frustration caused by it to the patients and clinicians are more.
The topic speaks of aggravated urinary complaints and sexual problems
at night. The prostate
gland is present only in men. This gland is located just below a male’s
bladder and surrounds the top portion of the urethra. It is very close to the
muscles which control the uretric sphincter and the duct which controls
ejaculation during sexual activity.
So, any problem with the prostate will affect urine flow and sexual
activity. Behind the prostate is the rectum. The prostrate gland’s primary
function is to produce most of the fluids in semen that nourishes and
transports sperm. The fluid is added to the semen at the time of ejaculation.
The fluid released from the prostate is made up of alkaline phosphatase, citric
acid, proteins, enzymes, fat and sugar to feed the sperm and also form a
swimming media for sperm to reach the egg.
The normal prostate in young men is about the size of a small plum. From
birth to young adulthood, the prostate grows from about the size of a pea to
the size of a plum. Most men experience a second period of prostate growth in
their 40s. Prostate enlargement affects about half of men in their 60s and up
to 90 per cent of men in their 70s and 80s. When prostatis is caught at an
early stage, there is a good chance it can be cured. It can be a danger to
health if it is recurrent or progressive.
The prostate enlargement is usually named BPH – Benign prostatic
hypertrophy. In BPH, the normal elements of the prostate gland grow in size and
number. The problem starts with the reproduction of the cells rapidly in the
central portion of the gland, so the tissues enlarge, and often compress the
urethra, totally or partially blocking urine flow. This urethral compression
leads to urine retention and the need for frequent urination, adding to
infection and complications.
BPH is not a forerunner to prostate cancer. The presence or absence of
prostate gland enlargement is not related to the development of prostate
cancer. Prostate cancer is the second most common cancer in men, though it
mainly affects older men. Cancer develops as a result of a breakdown, leading
to cells growing in an uncontrolled way. The mass of excess cells form a tumour
(growth), which may be benign or malignant. The tumour is described as
malignant if it is able to invade other healthy tissue.
Complications – Renal complications arise from prolonged obstruction. They
can include hydronephrosis, renal infection, renal calculi, uremia and renal
failure.
CAUSES
The causative factor for prostate enlargement is unknown but predisposing
factors are:
1. Male hormones (androgens) influence the enlargement of the
prostate. It is rare to see enlargement of the prostate in men whose male
hormone levels are very low. Only a few men with enlarged prostate have
significant symptoms or require treatment.
2. The prostate gland may get infected by many organisms, including
the one that causes gonorrhea. Infections elsewhere in the body may also be
carried to the prostate gland through the bloodstream. Sometimes the prostate
may become inflamed simply by enlargement of the gland or by excessive sexual
activity.
3. Another important cause of prostate enlargement is overproduction of a
hormone metabolite called DHT, which is the prime culprit in the development of
BPH and possibly prostate cancer. The prostate enlargement is directly
dependent on increased dihydrotestosterone (DHT) production, the principal
androgen hormone in the prostate which increases as age advances.
4. Zinc has long been associated with male sexual health. This is because
zinc is an integral part of hormone structures and a major constituent of
seminal fluid and is involved in the production of sperm. As age increases,
deficiency leads to impotence and prostate enlargement because the prostate
tissue grows to collect more zinc to maintain its health.
SYMPTOMS FOR BPH
Normal urination should have a time period gap of more than 2 hours during
the day unless large amounts of liquids such as water, coffee, tea are
consumed. During the night, urinating once can be admitted as normal. The BPH
patient faces symptoms such as:
·
Inconvenient, painful and debilitating urination
·
Waiting for a long time for the urinary flow to start up
·
A slow flow of the urine stream with a decreased strength
and force is felt while urinating.
·
Inability to empty bladder fully. This is due to bladder
outlet compression made by BPH. Due to this, stagnation occurs which favours
infection. As the bladder cannot empty fully, urine may need to be passed quite
frequently.
·
Frequent night urination and urgency – due to irritated
bladder from infection.
·
Straining is required to force urine through the
constricted urethra. This causes thickened bladder muscles. Constant straining
may also cause the bladder muscles to weaken. Many men wake up in the morning
with an erection and with an urge to urinate which cannot be implemented due to
the erection. The bladder sphincter is designed to remain closed in the
presence of an erection. This prevents any ejaculation that occurs from entering
the bladder. When the valve gets damaged and an ejaculation occurs, the semen
takes the shorter route into the bladder. This is called retrograde emission.
·
Sometimes there is a strong desire to pass urine but only
leakage of urine occurs without any continuity, leading to great discomfort and
embarrassment.
·
Occasionally, an enlarged prostate will cause blood to
appear in the urine. The urine may look bloody or cloudy.
·
Prostate enlargement can cause a complete blockage to
urine flow. This then requires emergency treatment.
·
In case of prostatis, fever may be present with lower
abdominal pain and distention. There is also loss of appetite and fear to take
water due to fear of urination. A hard lump in the angle of the thighs or
rectum is felt which becomes painful when pressed.
ALARMING SIGNS OF BPH
1. A slow flow of urine – even though there is urgency
2. Leaking after the initial stream subsides.
3. Frequent urination by getting up more times in the night
4. Feeling of fullness in the bladder very frequently
5. Inability to empty the bladder
6. Total inability to urinate due to blockage of the urethra
7. Painful urination and painful ejaculation
8. Impotence
DIAGNOSIS OF BPH
Behind the prostate is the rectum. So prostate can be easily detected by a
physician by rectal examination. During a rectal examination, the prostate
should be free, smooth and pliable. If there is any difference in the soft tissue
of BPH with irregularities, patients should go for all other lab tests. A
standard recommendation is to avoid vigorous digital examination of the
prostate, because it may induce bacterial infection or worsen it.
Diagnostic tests also include blood test to detect prostate specific antigen
(PSA), a cell surface protein normally found on prostate cells. Elevated PSA
levels indicate an enlarged prostate, which may be caused by a benign or
cancerous growth.
·
Ultrasound scanning may provide detailed information.
·
Cultures and microscopic examination of urine and
prostatic secretions will also give a clear picture.
TYPES OF PROSTATE PROBLEMS
There are three main types of prostate problems
1) Prostatis (infections and inflammation)
2) Enlargement (benign prostatic hypertrophy)
3) Cancer
1.
Prostatis – Inflammation in the prostate is
common and the easiest complaint to diagnose and treat. This form of prostatis
leads to a range of very uncomfortable and painful symptoms, including chills,
fever, pain in the lower back and genital area, urinary frequency and urgency
often at night, burning or painful urination and body aches. There is also a
clear infection of the urinary tract, with white blood cells and bacteria in
the urine. Culture and sensitivity test will also guide for treatment. Early
treatment is good to control and prevent recurrences.
2. Enlargement- This can be due to
Acute bacterial prostatitis – Acute bacterial prostatis may be considered
as a type of urinary tract infection. The disease causing organisms are
primarily gram-negative, coliform bacteria. The most commonly found organism
are E-coli, Klebsiella, Proteus, Enterococci and Pseudomonas. Sometimes
cultures grow Staphylococcus aureus, Streptococcus faecalis, and Chlamydia
species. Patients usually have fever, chills, low back pain, perineal or
ejaculatory pain, dysuria, urinary frequency, urgency, myalgias and
obstruction. The duration of therapy will sometimes be long.
Chronic bacterial prostatis – This form of prostatis is
associated with an underlying defect in the prostate. Symptoms can be similar
to those of acute bacterial prostatis, and there are also signs of infection.
Patients have recurrent urinary tract infections with persistence of the same
strain of pathogenic bacteria in prostatic fluid or urine. Symptoms can be
quite varying, but many men experiences irritating voiding symptoms, possibly
with pain in the back, testes, epididymis or penis, low-grade fever,
arthralgias and myalgias
2.
Prostate cancer – Prostate
cancer is the second most common cancer among men next to lung cancer. The
peripheral (outer) zone of the prostate is the area most susceptible to
developing cancer. BPH is an excessive growth of normal prostate cells. In
prostate cancer, a tumour consisting of abnormal cells is the culprit behind
the disease. At first the tumour is small, but a tumour may eventually grow so
large that it infiltrates and occupies the entire prostate. Another difference
is that a prostate with BPH will be fairly soft and pliable. A cancer tumour
can be made up of very tightly packed cells. Here prostate gland is tender and
warm, swollen, firm and irregular.
GENERAL TREATMENT FOR BPH:
BPH affects each man differently. Each man is different and each
manifestation of the disease is different, there is no single treatment for all
men. The type of treatment can be chosen depending on how much the symptoms
bother. Often the symptoms gradually or suddenly worsen. The bladder may hardly
empty at all or may cause back pressure on the kidneys, causing kidney failure.
Such a complication may produce general sickness, but may get advanced
condition without giving any symptoms at all.
The first line of treatment is usually conservative with tablets. Medicines
are chosen for the muscles in the prostate to relax and to reduce the size of
the prostate. This will give a significant improvement in symptoms. Nowadays,
allopathic doctors use medicines like Hytrin, which belongs to a class of drugs
called alpha-1 blockers and relax the smooth muscle of the prostate and the
bladder neck. Relaxing these muscles helps relieve the urinary obstruction
caused by the enlarged prostate. Also, they are using anti-androgens, which
stop the action of male hormone levels on this gland (finasteride). These are
useful if the gland is quite large.
Side-effects for these drugs are very much annoying. They include erectile
dysfunction, fatigue, dizziness, heart palpitations, sinus congestion and, in
some cases, severe low blood pressure. For patients taking alpha blocker drugs,
the most common side-effects are feeling dizzy and tired and having headaches
Side-effects of finasteride include less interest in having sex, decreased
erection, and problems with ejaculation. Alpha-antagonists or hormonal agents
to reduce the prostate’s size may cause erectile dysfunction, loss of libido,
feminisation and thromboembolism.
Surgical options
Surgery has more risk than the other treatments. But for any serious
complication of BPH, surgery is the only choice. Surgery is recommended when
complaints are out of control.
There are three main types of surgery for BPH:
·
Transurethral resection of the prostate
·
Transurethral incision of the prostate
·
Open prostatectomy
A new line of treatments for BPH appear every year. Examples are laser
surgery, microwave thermal therapy and new drugs.
Side-effects of these surgeries are that bloody urine is likely for several
days. Also, recurrence of blocks, urine incontinence and erection dysfunction
is common. One other problem is retrograde ejaculation. Men with this problem
may not be able to father children. But it does not affect the ability to get
an erection or have sex. This is common with surgery and rare with alpha
blocker drug treatment.
HOMEOPATHIC APPROACH FOR BPH
First of all, the patient should accept that they are ageing, i.e. in childhood
they run for everything and in the adult stage they walk for everything and
when aged, they walk slowly even for urgent matters. Likewise as they grow
older, the passing of urine should also to be done in a very relaxed manner,
i.e. if they are straining more they cannot expel even a drop since the muscles
around the bladder get tightened and close the urethral orifice more tightly
instead of relaxing them to pass urine. So, the first thing to be followed is
go to the urinal
1) Before the bladder gets filled up and
2) Go in a relaxed manner; wait for a minute or two for the bladder to
empty the urine voluntarily, without any force. If the bladder empties
voluntarily, there will not be any residual urine.
As a natural phenomenon, we should treat the enlarged prostate by the way
which restricts its growth. Usually, it gets worse by drinking alcohol, tea, or
tension, urgency or full bladder, so first of all avoid all these things. Some
persons will try to urinate in different positions like sitting, standing,
leaning forward or backward, with leg apart whichever they feel comfortable to
pass urine. As positioning and passing method differ from one another, the
medicine selection also differs, since in Homoeopathy the patient’s comfort is
given more importance than the disease’s common symptoms.
There are several medicines in Homoeopathy for enlarged prostate, urinary
complaints, frequent urination at night and erection disorders. Medicines
frequently used are Belladona, Cantharis, Nux vom, Staphysagria, Apis mel,
Thuja, Sabal serrulata, Ferrum picricum, Equisetum, C.F 6x, C.P6x, Gelsemium,
acid phos, Causticum, Acid phos, Baryta mur, etc. These Medicines should be
taken under the advice and diagnosis of a qualified Homeopath.
Homoeopathy is the best treatment without dangerous surgeries, injections
and hormone therapies. You can discover a new, relaxed, comfortable life.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer: The contents of this column are for informational
purpose only. The content is not intended to be a substitute for professional
healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare
professional for any health problem or medical condition.)