Virtually no man who lives long enough gets around it: benign enlargement of the prostate. It begins as early as age 30 and progresses slowly. Complaints do not develop until years (tens of years) later. Shaped like a chestnut, the prostate lies under the bladder and encloses the urethra like a fist. Before puberty, it is small and largely inactive; at about age 20, it reaches its normal size.
Cause of an enlarged prostate
The trigger of enlargement of the prostate gland is a hormonal imbalance: from the age of 50, the male sex hormone testosterone is increasingly converted in the prostate into the breakdown product dihydrotestosterone (DHT), which probably stimulates tissue remodeling.
Consequences of enlargement of the prostate
From the age of 40 to 50, the prostate tissue changes. The layers of muscle and connective tissue around the urethra increase, and the benign growth can even grow into the bladder. This is called benign prostatic hyperplasia (BPH) or prostatic adenoma. The enlargement of the prostate narrows the urethra, like a fist slowly squeezing a straw.
The consequences are easy to imagine – urine can no longer flow freely: The pressure increases when urinating; to apply this pressure, the muscle pulls in the bladder (bar bladder) increase. These in turn constrict the ureteral orifices, and the urine backs up into the kidneys.
After urination, a residue of urine remains in the bladder (residual urine), which increases the risk of bladder infection. If the prostate is so large that the bladder outlet does not open at all, painful urinary retention occurs.
Who is affected by prostatic hyperplasia?
BPH is very common in older men, so much so that it is uncharmingly referred to as old man’s disease.
Doctors believe that microscopic changes in the prostate gland are detectable in about 50 percent of men over the age of 50. In half of these, the enlargement can already be felt. In those in their seventies, 70 percent are already affected, and in those in their 80s, 90 percent are affected.
How does prostate enlargement manifest itself?
Whether and how severe symptoms occur varies greatly. Some men have no symptoms despite enlarged prostate tissue, while others show significant symptoms without detectable enlargement.
Typical signs of prostate enlargement include:
- Post-drip and thus wet laundry, residual urine feeling.
- Weakened urine stream, frequent urination with small amounts of urine.
- Difficulty starting or interruption of the jet when urinating
By the way, even though the prostate and its secretions perform important functions during sexual intercourse, a BHP does not mean that impotence must be associated with it.
It is not always prostate problems
Many men believe they have a prostate problem because they have to go to the bathroom at night. Not infrequently false alarm, because very few men are awakened by urge to urinate, but go to the toilet because they are just awake anyway. The reason? With age, the sleep structure changes – without disease value, one wakes up four to five times at night.
Apart from that, the capacity of the urinary bladder also decreases in old age independently of BPH, which results in more frequent urination.
