Prostate

The prostate is a fairly small gland (about the size of a nut) which is in the man’s pelvis, adjacent to the urine bladder and he rectum, participating in the production and storage of semen. Many men, throughout life, will deal with a phenomenon called enlarged prostate – a condition in which for certain reasons, the volume of the gland increases significantly gradually.

In fact, an enlarged prostate will characterize most men in a certain stage of life. For example, among men who are 50, it occurs at a rate of about 50% – a rate that increase up to almost 100% among 90 year olds or more.

It’s very important to note that the mean growth of the prostate doesn’t necessarily require treatment: when the enlarged prostate is benign and doesn’t cause any symptoms, only medical monitoring would be required. Only if the condition causes symptoms – difficulty urinating, a sensation of urgency in urinating, difficulty in obtaining an erection and so on – would require medical intervention.

Alongside that, there is a condition that will require immediate treatment, of course, and that is the grown of  the prostate due to a cancerous tumor. In this case, the enlarged prostate will be treated either way, as the cancer might spread at a certain point to other organs and adjacent bones.

Treatment of enlarged prostate

As can be understood, we need to distinguish between 2 cases of an enlarged prostate – benign or malignant tumor. Naturally, the access and ways of treatment in the two conditions will be different in certain ways. Either way, it’s important to remember that an enlarged prostate, whether benign or malignant, might not cause symptoms (at least not in the early stages of the disease). Therefore it’s recommended to periodically undergo various survey tests to discover prostate cancer starting at the age of 50.

An enlarged prostate for benign reasons will not be life threatening in the great majority of cases, but it might cause many symptoms, several of which were noted earlier. These are the treatments offered today for benign enlarged prostate:

• Monitoring: the simplest treatment, monitoring the growth rate of the gland, its shape and various features. The monitoring includes, among else, various tests that are also considered survey test, like a rectal exam of the gland and testing the PSA protein level in the blood. If a change or suspicious finding is discovered, the doctor would consider switching to a more significant treatment.
• Medications to treat the symptoms: there are medications today that allow relief of the symptoms via relaxation of the organs’ muscles whose functioning was damaged (for example, those relaxing the urine bladder muscle or the prostate muscle). These medications don’t treat the prostate’s growth directly, but can definitely aid in relieving the symptoms and thus improve the patient’s life.
• Medications to reduce the prostate’s volume: these are medications that reduce the activity of testosterone, which leads to a reduction in the prostate’s volume, sometimes up to 30%.
• Prostate resection surgery: if the various treatments don’t help, and the symptoms continue to appear in the same intensity, a Prostate resection surgery will usually be decided upon.

An enlarged prostate for malignant reasons must be treated promptly: early discover of the disease has great importance here, since the later the cancer is discovered, there more likely it is that it sent metastasis to adjacent organs.

Treatment of prostate cancer focuses on destroying the cancerous cells, even at the cost of hurting the entire prostate (since a man can function without it). Treatment will be in one of these ways:

• Brachytherapy: Inserting tiny radioactive crystals into the gland, killing the cancerous cells
• Cryotherapy: freezing treatment – by freezing the cancerous cells, they can be destroyed and the development of the disease can be prevented
• Ultrasound waves heating: like freezing, here too there is a focused damage to the cancerous cells, using high heat, which kills them
• Removing the prostate with laser: this is in fact a procedure that uses “vaporization” of the prostate with laser rays
• Prostate resection: this surgery is done in several ways – the open approach, the minimally invasive approach or through the urethra opening (TURP surgery during which the whole prostate is removed).

side effects

The side effects and risks relate mostly to Prostate resection. Until recently, it was considered a high risk surgery for impotence, retrograde ejaculation and narrowing of the urethra. With time, these surgeries became more precise, so those side effects are now considered relatively rare.