PROSTATE ENLARGEMENT

As the prostate enlarges, the surrounding capsule stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. As a result, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination and weakening of the bladder. As the bladder weakens, it loses the ability to empty itself, and urine remains behind. This narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. Many people feel uncomfortable talking about the prostate, since the gland plays a role in both sex and urination. However, prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH. In the United States alone, 350,000 operations take place each year for BPH. It is not clear whether certain groups face a greater risk of getting BPH. Studies done over the years have suggested that BPH occurs more often among married men than single men and is more common in the United States and Europe than in other parts of the world. However, these findings have been debated, and no definite information on risk factors exists.

The cause of BPH is not well understood. For centuries, it has been known that BPH occurs mainly in older men and that it doesn't develop in males whose testes were removed before puberty. For this reason, some researchers believe that factors related to aging and the testes may spur the development of BPH.

Throughout their lives, men produce both testosterone, an impor- tant male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in the blood decreases, leaving a higher proportion of estrogen. Studies done with animals have suggested that BPH may occur because the higher amount of estrogen within the gland increases the activity of substances that promote cell growth. Another theory focuses on dihydrotestosterone (DHT), a substance derived from testosterone in the prostate, which may help control its growth. Most animals lose their ability to produce DHT as they age. However, some research has indicated that even with a drop in the blood's testosterone level, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage the growth of cells. Scientists have also noted that men who do not produce DHT do not develop BPH. Some researchers suggest that BPH may develop as a result of "instructions" given to cells early in life. According to this theory, BPH occurs because cells in one section of the gland follow these instructions and "reawaken" later in life. These "reawakened" cells then deliver signals to other cells in the gland, instructing them to grow or making them more sensitive to hormones that influence growth.

Prostate Enlargement Symptoms Many symptoms of BPH are caused by obstruction of the urethra and gradual loss of bladder function which results in incomplete emptying of the bladder. The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as:
1. A hesitant, interrupted, weak stream
2. Urgency and leaking or dribbling
3. More frequent urination, especially at night
4. A sense that the bladder isn't completely empty
5. Having to strain to urinate

The overall size of the prostate does not always determine how severe the obstruction or the symptoms will be. Some men with greatly enlarged glands have little obstruction and few symptoms while others, whose glands are less enlarged, have more blockage and greater problems. In some cases, a man may not know he has any obstruction until he suddenly finds himself unable to urinate at all. This condition, called acute urinary retention, may be triggered by taking over-the-counter cold or allergy medicines. Such medicines contain a decongestant drug, known as a sympathomimetic, which may, as a side effect, prevent the bladder opening from relaxing and allowing urine to empty. When partial obstruction is present, urinary retention can also be brought on by alcohol, cold temperatures, or a long period of immobility. It is important to tell your doctor about urinary problems such as those described above. In eight out of 10 cases, these symptoms suggest BPH, but they can also signal other, more serious conditions that may require prompt treatment. These conditions can be ruled out only by a doctor's exam. Severe BPH can also cause serious problems over time. Urine retention and strain on the bladder can lead to:
1. Urinary tract infections
2. Bladder or kidney damage
3. Bladder stones, and
4. Incontinence

In rare cases, the bladder is permanently damaged.

What is Prostate Cancer?
Cancer of the prostate, a common form of cancer, is a disease in which cancer (malignant) cells are found in the prostate. The prostate is one of the male sex glands and is located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). The prostate is about the size of a walnut. It surrounds part of the urethra, the tube that carries urine from the bladder to the outside of the body. The prostate makes fluid that becomes part of the semen, the white fluid that contains sperm. Cancer of the prostate is found mainly in older men. Three quarters of all reported cases are in men 65 and older, and the risk for developing the disease increases with age.

A positive family history also increases the risk for the disease, as does African American origin. African American men have the highest rates of prostate cancer in the world. Until its late stages, prostate cancer is a relatively symptomless disease. When symptoms do occur, they commonly take the form of urinary problems, such as painful urination or blood in the urine. Pain in the back, hips, or pelvis may also be associated with prostate