Prostate enlargement - diagnosis and therapy

How is the diagnosis made?

First, the doctor will raise the medical history (including medications taken) and ask about the symptoms and the frequency of urination during the day and at night. In many cases, a standardized questionnaire is used for this. This is followed by a palpation of the prostate via the rectum, often coupled with an ultrasound - both the rectum and the abdominal wall. Thus, at the same time the kidneys and bladder can be assessed and the residual urine can be determined. For this purpose, the blood and urine are examined, also to rule out malignant changes. Depending on requirements, further tests are included, such as cystoscopy, an X-ray examination (excretory urogram). When measuring the urinary stream, the doctor checks the strength of the urinary stream.

Which therapy is there?

The treatment depends on the symptoms and the examination findings, especially the measurement of the urinary stream. For only mild symptoms "watchful waiting" (wait and check regularly) is indicated - in about one third of the men they improve spontaneously over time. In the second third, prostate problems remain constant, with the remainder worsening noticeably.

Herbal preparations without a prescription: In the case of mild symptoms, low-herbal herbal medicines, which are available over the counter in the pharmacy, have their place. These include extracts of stinging nettle root, saw palmetto fruits, pumpkin seeds and rye pollen. The plant extracts have a decongestant and anti-inflammatory, but do not prevent the growth of the prostate. However, they can postpone the timing of an operation where the excess prostate tissue is shed. Suggested use: The preparations do not work immediately, but must be taken over several weeks to achieve an effect. In any case, regular checks with the urologist are important.

Prescription Remedies: For obvious symptoms, the doctor will prescribe alpha-blockers (with the active ingredients doxazosin, prazosin, terazosin or tamsulosin). These act on the bladder neck, the urethra and the muscles in the prostate relaxing and thus facilitate the urination. Your advantage: The effect sets in immediately. Circulatory disorders and dizziness are known as side effects of the drugs. If the prostate tissue is significantly enlarged, finasteride is used. This interferes with the hormone metabolism of the prostate - it prevents the conversion of the hormone testosterone into dihydrotestosterone. The symptoms are significantly improved after at least six months of use; However, only about half of men respond to the therapy.

Operation of the prostate

If the medication stops and the symptoms become very stressful, surgery is inevitable; in case of urinary retention, overflow bladder, kidney congestion and damage, it is absolutely necessary. The goal is to remove the proliferating tissue, the actual prostate capsule is preserved. It can be imagined as an orange: the pulp is peeled, the shell remains. There are a number of different surgical methods; which is suitable, the expert must decide. Transurethral resection (TURP), in which the tissue is shaved off by an electrical sling introduced through the urethra, is most frequently performed. A newer method is the gentler vaporization of the prostate tissue by means of a laser in the green light range (Greenlight laser). Surgery should be performed in large specialist clinics to minimize risks. Still, BPH surgery is a routine intervention today.

What can I do myself?

Some studies suggest a connection between diet and prostate enlargement. Especially certain phytochemicals should be able to prevent enlargement (polyphenols, eg in grapes, pomegranates, spices) or even prostate cancer (phytoestrogens, eg in spinach, broccoli, soybeans and carotenoids eg in carrots, tomatoes, green vegetables).

If you are already suffering from mild discomfort, the following tips can alleviate this:

  • Wear comfortable underwear made from natural fibers.
  • Give in to frequent urination - otherwise there is a risk that the bladder will become overfilled and overstretched, thus aggravating the symptoms.
  • Watch out for regular bowel movements - so there is no additional pressure on the urinary tract.
  • Do not sit too long, stand and walk in between times.

Enlargement and cancer - risk increased?

According to previous findings, there is no direct correlation between the development of a benign enlargement and a malignant cancer of the prostate. Benign growth usually proceeds from the inner parts of the prostate, while the germ cell of prostate cancer sits in the outer glandular lobes. It is possible, however, that both diseases occur at the same time or coincidentally. Although prostate cancer is much less common than benign BPH, it is important to identify and clarify it early on. It is therefore important to regularly take care of the annual check-ups after the age of 45 years. This allows early damage to be detected in good time. The costs are covered by the statutory health insurance.

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