In young men, the prostate or prostate gland is about the size of a walnut. It surrounds the upper urethra and contributes the seminal fluid in which the sperm cells swim during orgasm. As we age, the prostate tissue produces more and more cells. This not only increases the entire diameter of the gland, but also increasingly narrows the urethra within it. Benign (benign) hyperplasia (enlargement) of the prostate occurs. This triggers various symptoms, which are summarized under the term benign prostate syndrome (BPS). This is not a malignant cancer.
Men over the age of five are most often affected by benign prostate enlargement. 20 to 45 percent of all men between the ages of 50 and 59 have an enlarged prostate. For those over 70, the proportion rises to up to 70 percent. Whether and when problems arise varies from man to man. For individual sufferers, even a slight enlargement of the gland has unpleasant consequences. Conversely, there are men with a severely enlarged prostate who do not experience any symptoms. Apparently there is also a genetic predisposition to prostate syndrome: “I have already treated three generations, grandfather, father and son from the same family,” says Dr. Matthias Bauermeister, urologist from Pinneberg near Hamburg.
An enlarged prostate increasingly narrows the urethra. This has different consequences. Since the urine cannot flow optimally, those affected often suffer from frequent and strong urges to urinate. This is associated with problems with urination – it takes a long time until the urine can flow out. The urine stream is usually weak and often interrupted. “Dribbling after urinating is also common,” says Bauermeister. Another typical symptom of a pathologically enlarged prostate is the urge to urinate at night. Many people probably know the keyword from advertising for corresponding products.
For many of those affected, the first step is to go to the pharmacy: “They then take herbal ingredients, such as pumpkin seed extract,” says Bauermeister. They often only go to the urologist when the symptoms have a massive impact on everyday life, says Bauermeister: “Anyone who constantly has trouble sleeping at night because they often have to go to the toilet or feels a constant urge to urinate while working, suffers from it.” Doctors generally differentiate between non-surgical ones and operational methods. The simplest method is observational waiting. In other words, the doctor and patient assess whether the symptoms worsen over time and how much the quality of life suffers as a result. Together they then consider what needs to be done.
There are now various medications that provide relief. Alpha blockers relax the smooth muscles of the bladder and prostate and relieve pressure on the urethra. This allows the urine to flow better again. They work very quickly within hours or days. They do not affect the size of the prostate. 5-alpha-reductase inhibitors, on the other hand, reduce the growth of the gland and can even make it smaller. The doctor often prescribes both active ingredients in combination.
If medication doesn’t produce the desired result, surgery is often the only option: “Nowadays, no one has to worry about becoming incontinent as a result,” the urologist reassures. The procedure is usually carried out endoscopically. A laser or a so-called electric loop is usually advanced through the urethra to the gland in order to remove excess tissue from the inside. The gland as a whole is preserved. In this way, the prostate can be reduced in size by up to 30 percent. Unfortunately, the tissue continues to grow even after such an operation, so it often has to be repeated after a few years. Bauermeister knows a common consequence of such an intervention: “During orgasm, semen no longer escapes to the outside, but instead ends up in the bladder.”
It becomes problematic when, as a result of the narrowing, more and more urine cannot flow out and builds up in the bladder. “This can lead to urinary tract infections and prostate infections, even with fever,” warns urologist Bauermeister. It becomes really dangerous when the backlog extends into the ureter and kidneys. “Then kidney failure can occur.”
Regardless of whether you are a man who has difficulty urinating or other of the symptoms mentioned above, you should consult a urologist regularly from the age of 45 for early cancer detection. Because prostate cancer does not have to be announced by pain. However, if it is discovered in time, it can usually be treated well.
