CO, a 52 year old rig worker, noticed poor flow of urine occasionally in the last 6 months. He has had to strain to ‘pee’ at those times. He wet himself twice when he didn’t get to the convenience in time. He feared he had contracted gonorrhea again, an infection he treated in his university days…. ……….
Among other examinations, CO should have evaluation of his prostate gland.
This compendium describes the common experiences of men with prostate gland enlargement. Enlargement of the prostate comes with aging. Commoner among persons of black descent and men above the age of 40, prostate gland enlargement could be debilitating if not managed in time and appropriately.
The major role of the prostate gland is to add a fluid (prostatic fluid) to the sperm in its travel through the penis just before ejaculation. The prostatic fluid and other additives nourish the sperm in the semen till it performs it’s role of fertilizing the egg.
Most men have no symptoms as a result of enlargement of the prostate gland in the early stages of the disease until pressure increases around the urethra-the conducting tube of urine in the penis. The prostate gland is located below the urinary bladder with the first part of the urethra passing through it before entering the penis. This explains why enlargement of the prostate gland may give urinary complaints. These include, but not limited to, the following
- Frequent urination more than one’s usual habit.
- Poor flow of urine
- Straining while urinating
- A feel as if you will pee on yourself if you don’t get to the convenience in time when pressed
- Occasional involuntary passage of urine on self when pressed
- Waking up at night to urinate 3 or more times.
- Feeling of incomplete emptying of bladder despite just urinating.
The above experiences when combined raise the suspicion that the prostate gland might be enlarged. The enlarged prostate may, however, not give some men any concern. In such persons, it is detected during regular medical evaluation. In addition to the above manifestations of prostate enlargement, some men may experience painful sensation while urinating which is highly suggestive of infection. Overtime, urine pools back in the bladder due to incomplete emptying. The residual urine is a fertile environment for bacteria to grow. Some men may also notice blood in urine. In such situation, cancer of the prostate gland must be screened for immediately.
Enlarged prostate could be cancerous or not cancerous. This is reliably confirmed by a biopsy examination of a sample of the prostate gland. Removal of the prostate in early stages of cancer saves lives. In Benign Prostatic Enlargement ( non-cancerous prostate enlargement), removal of the prostate in some individuals improves their quality of life. In other individuals, the family doctor or urologist recommends medications which reduce the size of the enlarged prostate gland.
A yearly rectal examination (see picture) is a reliable evaluation in addition to a blood test for PSA (prostate specific antigen) when screening for prostate enlargement (cancerous or non-cancerous). Normal values of PSA are within 0 to 4 ng/ml. Highly elevated values raise the concern for probability of cancer.
Early detection with appropriate management is key…
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the chief editor of The Family Doctors. He can be contacted via firstname.lastname@example.org