In the run up to ‘Movember’, the prostate cancer charity’s month of sponsored moustache growing, Oak’s Hospital Urologist Mr Zaf Maan brings his expertise to bear on the subject of men’s health and prostate disease.
As men get older the prostate can enlarge, causing urinary symptoms. These symptoms interfere with men’s daily activities, disrupting daily routines and sleep patterns. However, treatment in the form of tablets or surgery is readily available, often achieving a dramatic improvement in quality of life.
What is prostate enlargement?
This is by far the most common prostate problem in the ageing man. The prostate is a gland that sits at the base of the bladder. The urethra (or water pipe that leads to the end of the penis) actually passes through the prostate gland. In men over the age of 40, the prostate commonly enlarges, producing a blockage in the urethra. It should be stressed that this enlargement of the prostate is very common in men as they get older and has nothing to do with prostate cancer.
What are the urinary symptoms caused by the prostate increasing in size?
The enlarged prostate slows the flow of urine during urination. Some men complain of a feeling of incomplete bladder emptying after urination, having to stand at the toilet for longer than other men, or going to the toilet more frequently than usual. Other men develop the embarrassing symptom of dribbling urine on to their trousers after they thought they had finished passing water.
Rushing to the toilet (urgency) and passing urine frequently at night (nocturia) are particularly bothersome symptoms, causing loss of sleep in men and their partners as well.
When should I be concerned?
If the symptoms are bothersome enough to be interfering with your daily lifestyle then it’s time to seek advice from your urologist. Men are however well known to be slow when it comes to seeking medical attention, even for quite severe symptoms! Usually it is their partners or wives who notice the gradual worsening in symptoms over time.
There is a well-known association between erectile dysfunction (impotence) and urinary symptoms. Many patients choose to address both of these problems together with their urologist.
Other so-called ‘red-flag’ symptoms include the passing of blood in the urine, bladder infections and urinary incontinence. If you have had any of these symptoms then you should consult your urologist urgently.
What treatments are available other than surgery?
Lifestyle advice can be effective in milder cases. Tablets are available to treat moderate urinary symptoms and are shown to be highly effective in most cases. Side effects with these tablets are uncommon and usually mild. If the symptoms are severe then surgery may be an option.
What kind of surgery might I need?
If you elect to have surgery you will be assessed pre-operatively at the Oaks Hospital. Surgery for an enlarged prostate is usually undertaken using a special narrow endoscope that passes through the natural passageway of the urinary system, the urethra. There are no cuts on the outside of the body. The instrument cores out the centre of the prostate to give a wider channel to pass urine through. Patients typically spend one or two nights in hospital. The operation is called a trans-urethral resection of the prostate (or TURP for short).
Should I be concerned about prostate cancer?
Enlargement of the prostate gland is not usually related to cancer at all. If you have urinary symptoms, your general practitioner or healthcare consultants at private hospitals in Essex, Manchester, Birmingham and the rest of the UK will perform tests to check for prostate cancer too.