The prostate, part of the male reproductive system, is a walnut-sized gland located in front of the rectum and
just below the bladder where urine is stored. The prostate also surrounds the urethra, the canal through which urine passes
out of the body.
Scientists do not know all the prostate's functions but one of its main roles is to squeeze
fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm
and makes the vaginal canal less acidic.
The prostate goes through two main periods of growth throughout the course
of a man’s life. The first occurs early in puberty when the prostate doubles in size. The gland begins to grow again
around age 25 and continues to grow during most of a man’s life. The enlargement doesn’t usually cause problems
until later in life and when it does, the condition is called benign prostatic hyperplasia (BPH). BPH rarely occurs before
age 40 but, more than half of men in their 60s and 90 percent in their 70s and 80s have some symptoms of BPH.
The
symptoms of BPH include frequent urination, urgency to urinate, a hesitant, interrupted or weak stream of urine or the inability
to completely empty the bladder. This is a result of the fact that as the prostate enlarges, the layer of tissue surrounding
it stops it from expanding causing the gland to press against the urethra like a clamp. The bladder wall becomes thicker and
irritable and begins to contract even when it only contains a small amount of urine thus the need to urinate frequently. Eventually
the bladder will weaken and lose its ability to empty itself.
The size of the prostate does not always determine
how severe the obstruction or the symptoms will be. Some men whose prostates are greatly enlarged have little obstruction
and few symptoms while others whose glands are less enlarged have more blockage and more problems. Sometimes a man may not
even know he has any enlargement or obstruction until he suddenly finds himself unable to urinate at all. This condition is
known as acute urinary retention and may be triggered by a variety of factors including over-the-counter cold medicines, cold
temperatures, alcohol or long periods of immobility.
It is important for men to consult their physician immediately
when they experience the symptoms of BPH because in some cases, the symptoms may indicate a more serious condition such as
prostate cancer. Or, if left untreated, BPH can lead to urinary tract infections, bladder or kidney damage, bladder stones
or incontinence. If the bladder is permanently damaged, treatment for BPH can be ineffective.
As life expectancy
rises, so does the occurrence of BPH. In 2000, there were some 4.5 million doctor visits for BPH in the United States. But,
the cause of BPH is not well understood and no definite information on risk factors exists. Researchers have questioned the
possibility that the proportions of testosterone to estrogen in older men may be a factor because as men age, their testosterone
production decreases leaving a higher proportion of estrogen in the body. It is thought that estrogen may increase the activity
of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone (DHT), a substance
derived from testosterone in the prostate which may help control its growth. While the production of testosterone decreases
with age, older men continue to accumulate high levels of DHT in the prostate which may encourage the growth of cells there.
Research has shown that men who do not produce DHT do not develop BHP - another reason it is thought to be a factor.
One other theory suggests that BHP develops as a result of "instructions" given to cells early in life.
Men who have BHP symptoms usually need some kind of treatment at some time however a number of recent studies have questioned
the need for early intervention when the gland is just mildly enlarged. The studies suggest that early treatment may not be
needed because the symptoms of BHP clear up without treatment in as many as one third of all mild cases. Instead of treatment,
researchers suggest regular checkups to monitor and watch for problems and if conditions persist or pose a health threat,
treatment can commence.
Treatment for BHP can involve drug therapy, minimally-invasive procedures or full-blown
surgery.
