The prostate is an area of the body that men often don’t think about unless something is wrong with it. An important part of the reproductive system, the prostate is a small gland that is located between the penis and the rectum. Without this gland, it would be impossible for pregnancy to happen, because the special liquid that this gland secretes (called seminal fluid) is what allows the sperm to get where it needs to go and do what it needs to do.
Most of the time, this gland just sits nestled in its protected position, unassuming and functioning as it should–that is, allowing reproduction to happen largely without a hitch. And, most of the time, this very essential gland goes unnoticed because unlike other more visible parts, it’s more internal. Unfortunately, like most body parts, there are plenty of things that can go wrong.
Also known as benign prostatic hyperplasia or BPH, an enlarged prostate is a non-cancerous condition that most often happens to men in the 50+ age range. As men age, an increase in the cells that make up the prostate cause it to grow to an abnormal size. But as a result of its growth, it infringes on the urethra, making that body part narrower than it should be, which causes problems when you try to urinate. These problems can include things like dribbling after you urinate, getting up to urinate during the night two or more times, pain with urination, bloody urine, and/or straining to urinate.
Problems urinating are bad enough. But that’s not all–if you don’t work on reducing the size of your prostate, you can get a complete urinary blockage, meaning that you can’t urinate at all and you’ll need to use a catheter to empty your bladder, at least temporarily. And not regularly emptying your bladder completely can lead to urinary tract infections and bladder and kidney damage.
But don’t despair! The American Urological Association has developed a questionnaire to help you determine the severity of your symptoms and how much they are affecting your life so you can figure out just how enlarged your prostate is. Depending on the symptoms you experience (though not all men have any symptoms at all or have symptoms that don’t disrupt their life), there are various treatment options your urologist may suggest at your appointment.
If you find yourself under a lot of stress that causes you to go more frequently, but you don’t completely empty your bladder, your urologist may suggest regular exercise and other stress reduction techniques like meditation. This will help relax the muscles and prevent frequent urination while hopefully aiding more complete emptying.
Taking Your Time
Even without stress reduction, you can reduce your anxiety about emptying your bladder by taking your time in the bathroom and letting yourself empty completely. This will also help prevent the need for more frequent trips and reduce your time spent in the bathroom. To aid less frequent bathroom runs at night, it’s a good idea to avoid drinking in the evening, particularly caffeinated or alcoholic drinks. These drinks in particular can stimulate the kidneys, which may lead to more urination. But make sure you’re drinking plenty of water and consuming fiber–constipation can also affect urination.
As always, tell your urologist about any medications you might be taking. While an exam will still be needed to confirm the condition, it may be possible that your problem will be easily solved. It is well known that some medications have certain side effects attached to them and while they may be great at solving the original problem, your urologist may suggest switching them out to something that will have less of an effect on your prostate. Even over-the-counter medications, such as cold medications, can affect your prostate.
Often, treating an enlarged prostate involves taking prostate-specific medications. One of the safest and most effective medications for BPH is tadalafil. One of tadalafil’s brand names is Cialis. Many men are familiar with using Cialis for erectile dysfunction, but it is also helpful for BPH. It’s important to keep in mind that without sexual stimulation taking this drug is unlikely to result in an erection.
Alpha blockers are another class of medication that help relax the muscles, and while they may not cure the problem entirely, they can help relieve symptoms, making it easier to urinate. 5-alpha-reductase inhibitors (5ARIs) may be offered as treatment. These work by reducing the size of the prostate enough so that it stops encroaching on the urethra. Depending on the exact nature of your problems and the symptoms you’re experiencing, you may be given a combination of these (and other) medications, or you might be advised to try one at a time to see if that helps. It may also be necessary to try one or more medications in conjunction with a lifestyle change.
As with all medications, there will be side effects. Some of the most common are headache, upset stomach, back or muscle pain, nasal congestion, and/or dizziness. If these become troublesome, make sure to let your urologist know.
If your symptoms don’t improve at all with the above treatments, your urologist may suggest a minimally invasive procedure as the next possible fix. There are several types offered, and your urologist can discuss the pros and cons of each to help you decide if one is right for you.
While discussing the prostate can be embarrassing for many men, it is nothing compared to the problems that could happen by not talking about it at all. If you feel that something isn’t working the way it should be, don’t hesitate to make an appointment with a urologist.