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Prostate Enlargement Contents Prostate Enlargement Contents At A Glance 04 The Prostate 06 Prostate Enlargement – BPH 10 – DATE REVIEWED: DECEMBER 2017 (5TH EDITION) Symptoms 12 © Healthy Male (Andrology Australia) 2004 Causes and Prevention 16 Health information in this booklet describes PROSTATE ENLARGEMENT. Diagnosis and treatment options are Diagnosis 17 described to help men and their families understand the health problem, make men aware of the available treatment options, and to help make talking with their doctor easier. Treatment 22 The information contained in this booklet is based on up-to- date medical evidence. It has been provided for educational purposes only. It is not intended to take the place of a clinical Lifestyle and Relationships 40 diagnosis or medical advice from a fully qualified health professional. Healthy Male urges readers to seek the services of a qualified health professional for any personal health Support 42 concerns. Although the information in this booklet has been carefully reviewed, Healthy Male does not take any responsibility for Glossary 44 any person using the information or advice available in this booklet. Information is given on the understanding that users take responsibility for checking the relevance and accuracy of Expert Reviewer 47 the information. Healthy Male is supported by funding from the Australian Government Department of Health and is administered by Monash University. At A Glance or other symptoms described as You should talk with your doctor ‘irritative’. Obstructive symptoms and think carefully about the include a delay or straining when risks and benefits before making starting to urinate, and slow or a decision, jointly with the doctor, dribbling flow of urine. Irritative about whether to have treatment, symptoms include urgent or or the type of treatment. frequent urination during the day What is prostate enlargement and night. BPH may also cause other symptoms. Can I do anything to prevent (benign prostatic hyperplasia or BPH)? BPH? BPH is a benign (non-cancerous) enlargement or growth How is BPH diagnosed? As there are no known causes of BPH there are no known ways of the prostate gland. As the prostate surrounds the top If you have urinary symptoms, a to prevent it. However, lifestyle part of the urethra, enlargement of the prostate makes doctor may do a number of things changes may help to stop the to find the cause, including: taking symptoms of BPH getting worse the urethra narrower and puts pressure on the base of the a medical history and description of and may even help to improve bladder. Narrowing of the urethra can affect the passing symptoms, a physical examination, symptoms. blood or urine tests, and sometimes of urine in a number of ways. BPH is not usually life- biopsy or ultrasound. These tests threatening but symptoms can have a major effect on are used to find out the type of prostate disease (to check if it is quality of life. BPH, prostate cancer or prostatitis). BPH is more likely to be the cause of urinary problems than prostate cancer. How common is BPH? What are the symptoms BPH is the most common prostate of BPH? disease. BPH usually starts after A number of men with BPH do not How is BPH treated? the age of 40 years and is more have many or any symptoms. If you have LUTS linked with common in older men; it affects The men who do have BPH BPH, when deciding on the best nearly all men at some time in symptoms usually notice changes treatment it’s important to think their lives. Some men do not have to their urination because BPH about how much the symptoms any symptoms even though their affects the part of the prostate that are bothersome or affect your prostate has grown larger. BPH surrounds the top part of the urethra. quality of life. In some cases of BPH, usually becomes more of a problem when the symptoms are mild, no over time, with symptoms getting LUTS (lower urinary tract treatment may be the best option. worse if they are not treated. symptoms) is a common term Oral medicines (tablets) can help used to describe a range of urinary men with moderate symptoms. symptoms. LUTS linked to BPH Surgery is an option for men whose include a group of symptoms BPH symptoms are severe and have described as ‘obstructive’ and/ a major negative effect on their quality of life. 04 05 1 6 7 12 2 8 11 3 9 The Prostate 1 9 9 6 1 46 7 10 2 12 8 7 12 2 8 5 11 3 11 3 1 Bladder What is the prostate? 2 Vas deferens 9 The prostate is a small but important gland (organ) 3 Urethra 4 4 in the male reproductive system. The main role of 10 4 Penis 10 the prostate is to make fluid that protects and 5 5 Scrotum Bladder 5 gives nutrients to sperm. The prostate makes about 6 Seminal Vesicle Prostatic glands 1 Bladder one third of the fluid that is ejaculated (released) Bladder 1 2 BladderVas deferens 7 Rectum from the penis at orgasm (sexual climax). ProstaticEjaculatory glands ducts 2 3 VasUrethra deferens 8 Prostate gland EjaculatoryUrethra ducts 4 Penis The prostate is made up of a number of small 3 Urethra 9 Epididymis UrethraExternal sphincter muscle 5 Scrotum 4 Penis 10 Testicle glands surrounded by supporting tissue called the 6 External(pelvic sphincter floor musclemuscles) Seminal Vesicle 5 Scrotum 11 Cowper’s gland stroma (the tissue or supporting framework of an (pelvicStroma floor muscles) (interspersed 7 Rectum 6 12 Ejaculatory duct 8 SeminalProstate Vesiclegland organ). The small glands in the prostate make the Stromabetween (interspersed prostatic glands) 7 9 RectumEpididymis fluid. The prostate is surrounded by pelvic floor betweenProstatic prostatic duct glands) 8 10ProstateTesticle gland muscles, which contract during ejaculation to ProstaticInternal duct sphincter 11 Cowper’s gland help move the fluid into the urethra. 9 Epididymis Internal9 Detrusor sphincter muscle 12 Ejaculatory duct 10 Testicle 9 Detrusor muscle 11 Cowper’s gland Cross-section of the prostate gland The male reproductive system Where is the prostate? 12 Ejaculatory duct The male reproductive system is made up of many organs, glands and ducts (tubes). Some of muscles support the bladder and the bowel and these are on the outside of the body, such as the surround the urinary tract and rectum (back penis and the testicles inside the scrotum sac. passage). Other organs and tubes are internal, including the epididymis, vas deferens, seminal vesicles and the The prostate is located near the rectum. Growth prostate gland. of the prostate can be checked by a digital rectal examination (DRE) where a doctor places In young men the prostate is about the size of a a gloved finger into the rectum to check the size, walnut, but it gets bigger with age. The prostate sits shape and feel of the prostate. underneath the bladder, and surrounds the top part of the urethra. Urine passes through the urethra on What does the prostate do? its way from the bladder to the penis. The prostate gland makes fluid that forms a The prostate rests on the pelvic floor muscles major part of semen (mixture of sperm and fluid). that stretch from one side of the pelvis to the The fluid from the prostate helps the sperm flow other, and run from the tailbone at the back to along the ducts (tubes) of the male reproductive the pelvic bone at the front. The pelvic floor system. 06 07 The Prostate Childhood Puberty 1-10 years 11-20 years 1.4g 10.8g The pelvic floor Sperm are made in the testes and then pass muscles help to stop along the highly coiled epididymis, through the urine leaking from vas deferens to the prostate. The prostate gland Adult Later Life the bladder and other glands (the seminal vesicles and 21-50 years 71-80 years Cowper’s gland) make the fluid that mixes with 18.1g the sperm. Semen then travels along the urethra 30.9g to the tip of the penis where it is ejaculated (released) at orgasm. To stop semen flowing backwards into the bladder during ejaculation, an internal sphincter (muscle) at the base of the bladder and the top of the prostate closes. An external sphincter (a Weight of the prostate at different ages pelvic floor muscle) at the end of the prostate relaxes to release the fluid from the prostate into the urethra. What is prostate disease? Prostate disease is any medical problem that How does the prostate gland change affects the prostate gland. Common prostate problems include: with age? The male sex hormone testosterone makes the • benign prostatic hyperplasia or hypertrophy prostate grow in size. As men get older, the prostate (BPH): a benign (non-cancerous) enlargement grows larger. At puberty, testosterone levels in boys of the prostate gland start to increase and the prostate grows to about • prostatitis: inflammation of the prostate eight times its size. It continues to grow, doubling gland, sometimes because of infection in size between the ages of 21 and 50 years, and almost doubles again in size between the ages • prostate cancer: a problem where cells within of 50 and 80 years. The reasons for this ongoing the prostate grow and divide abnormally so growth are not fully understood. that a tumour forms. Most of the growth of the prostate happens in the Only prostate cancer and the uncommon condition central part of the prostate. There is an increase acute bacterial prostatitis can be life-threatening. in both the number of the smaller glands in the However, both inflammation and enlargement of prostate, and the stroma.
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