Treat Your Enlarged Prostate Right!
One of the challenges of getting older for most men is the enlargement of the prostate. While every man cringes at the thought of the annual “finger wave” exam, dealing with the health of your prostate is crucial for not only your health but also your quality of life.
What Are The Signs You Have A Prostate Problem?
While some men know they have a problem, others are clueless until the doctor says “Houston, we have a problem.” According to Temple University Hospital, the following are signs you will want to keep an eye open for to be sure you know if a problem is developing:
- Trouble urinating.
- Dribbling when you are done urinating.
- Slow or weak urination.
- Sudden urge to urinate.
- Having to urinate multiple times overnight.
- Blood or pain while urinating.
If you are experiencing any of these problems, you may want to talk with your physician and see if you have a prostate problem.
What Causes An Enlarged Prostate?
By age 60, over 50% of men have BPH or the benign enlargement of the prostate. By age 85, that increases to 90%. The specific issue with the enlargement of the prostate is an increase in the number of cells, which is an increase in actual mass. This is different from enlargement due to inflammation, where an anti-inflammatory regimen may prove beneficial.
According to Dr. Kahled Fareed, the actual cause of prostate enlargement is not fully understood; however, there are some theories about what contributes to it. This includes:
- Androgens or male hormones.
- Excess estrogen in the body.
- Disruption of cell-to-cell communication.
Should You Really Be Concerned About An Enlarged Prostate?
While the initial stages of an enlarged prostate may be a little annoying, they likely will not cause any major complications or disruptions to your life. However, in advanced stages of BPH, there are serious health problems that can result.
For instance, during later stages, the urethra can become so constricted that you cannot urinate all, resulting in the need for a catheter, kidney failure, bladder stones and more. Catching prostate problems early is important to prevent them from becoming major problems later.
What Are The Treatment Options?
According to WebMD, there are several treatment options for an enlarged prostate, depending on the degree of the problem, the severity of symptoms, and other health considerations for an individual. The options all fall into three primary categories: medications, surgical options, and naturopathic options.
As you explore the options, be sure to discuss with your doctor the short-term benefits of each, and the potential for long-term complications, as well as the time needed to see an effect on your symptoms or the time to recover in the case of surgical options.
Medication Treatment Options
According to Dr. Westney, Director of Urology at the University of Texas Medical School at Houston, medications are very effective for many patients. There are two primary classifications of medications used to treat an enlarged prostate.
Alpha blockers are used to help relieve the symptoms of BPH but do not actually reduce the size of the prostate. They work to relax the muscles around the prostate and the bladder neck so urine can flow unrestricted. These are most effective early on, with normal to moderately enlarged prostates.
5-Alpha Reductase Inhibitors
These drugs work to help actually reduce the size of the prostate by reducing the levels of the male hormone DHT, which contributes to the growth of the prostate.
While these medications can be very effective, they can take several months to have a noticeable effect. Patience is necessary, as many patients will need to take them for six to twelve months to see if they are going to work.
When medications are ineffective for dealing with the symptoms of the enlarged prostate, surgical intervention may be needed. With the advance in technology, there are now many options for urologists to consider, depending on your particular situation.
Minimally Invasive Options
There are now several options for minimally invasive procedures that can usually be done right in your urologist’s office. Generally, these options use some form of heat to reduce the size of the prostate, which means that you should see an effect on your symptoms nearly immediately.
TUMT – Technically known as transurethral microwave thermotherapy, uses computer-regulated microwaves to destroy some of the excess prostate tissue.
This specific procedure can help reduce how frequently or urgently you need to urinate, as well as reducing straining and intermittent flow problems. This requires only local anesthesia and medication to help manage pain.
Keep in mind that this is generally a procedure that will need to be repeated because symptoms do return over time.
Additionally, there can some minor complications such as a temporary increase in frequency and urgency to urinate and may lead to less semen being ejaculated.
TUNA – This does not refer to the seafood, but rather transurethral radiofrequency needle ablation. Similar to TUMT, this procedure uses heat to destroy some of the prostate tissue, but this time using needles inserted directly into the targeted tissue.
Some anesthesia is used, but a hospital stay is not required. Similar to TUMT, this may lead to a temporary increase in painful, urgent or frequent urination.
Prostatic Stents – While not widely used, stents are an option that can be considered. These are small metal coils that are inserted into the urethra to help keep it open. Generally, these are only considered as options for men who are unwilling or unable to consider medications or other non-invasive or surgical options.
The reason these are not more widely used is that they are expensive, and can cause side effects such as frequent urinary tract infections. Further, many patients report they do not help relieve their symptoms, and if the stent shifts, can actually make them worse.
PAE – According to a Fox News Report in 2016, this is a new procedure being tested in several hospitals across the country in which interventional radiologists inject submillimeter particles into the arteries of the prostate to obstruct the blood flow to the organ, causing it to soften and shrink.
When medications and non-invasive options are not effective, surgery may be required. Your urologist will consider several options to determine what is going to be best for you. Be sure to discuss both the expected benefits, as well as the risks as you consider your options.
TURP – or transurethral resection of the prostate is the most common surgical option used to treat enlarged prostates, in part because it has seen the greatest positive effect on symptoms.
In this surgery, a small electrical wire loop is used to cut off the excess tissue that is pressing against the urethra and restricting urinary flow. As the loop makes the cut, it also carries blood vessels, leading to minimal bleeding.
One consideration about the TURP procedure is that men can usually expect retrograde ejaculation after recovery. With this condition, semen is expelled back into the bladder rather than out through the urethra. While not generally painful, this can cause fertility issues.
TUIP – Transurethral incision of the prostate is a procedure where tissue is not actually removed, but cuts are made in the prostate to help relieve the pressure on the urethra. Patients usually go home the same day and may need to wear a catheter for a couple of days.
Laser Surgery – This requires general anesthesia and uses a laser to destroy prostate tissue, and usually an overnight stay in the hospital. Surgeons have several procedures that utilize a laser, including resectioning and more.
Open Prostate Surgery – Open prostate surgery, or prostatectomy, is usually reserved for when the prostate is greatly enlarged, the bladder is damaged, the patient has bladder stones, or if the urethra is narrowed.
The surgeon will make an incision in the abdomen, allowing the surgeon to see the whole prostate, and remove necessary tissue. Given the invasiveness of the procedure, it is performed under general or spinal anesthesia and can take up to several months to recover.
Some people prefer to look at natural options for improving health and solving problems. These options can include various exercises, changes to diet and habits, and user of supplements.
Many physicians are reluctant to recommend these options because of the variation possible, not providing consistent results.
However, many people are moving more toward naturopathic solutions as the first course of action, leaving medication and surgical options for more severe cases, or when naturopathic treatments are ineffective.
According to Dr. Joshua Axe, a certified doctor of natural medicine, a doctor of chiropractic, and a clinical nutritionist, there are several options for dealing with the symptoms of an enlarged prostate without resorting to medication.
1. Diet and habit changes – The first step is to look at your lifestyle and see if you can improve your symptoms by making small tweaks. Dr. Axe recommends:
- Limiting alcohol and caffeine.
- Limiting the number of fluids consumed in the evening.
- Try urinating regularly at least every three hours.
- Increase physical activity.
- Maintain a healthy weight.
- Increase the number of healthy fats, such as Omega-3 rich foods.
2. Try Kegel exercises – While this is normally something people hear recommended for women, these exercises can actually be very effective for helping men support their bladder and close the sphincter. The recommendation is to practice these exercises three to five times every day.
3. Herbal supplements – While some physicians are cautious about supplements because of variation from one batch to another, they can still be very effective for helping the body function properly. Dr. Axe recommends Saw Palmetto, Stinging Nettle Root, and Pumpkin Seed Oil.
Which One Option Is Best For You?
This answer is completely dependent on how much work you want to put into treating your enlarged prostate, your specific symptoms and severity, and the speed at which you need to see results. Discuss all the options with your physician, and then follow your instincts on where to start.