Plumbing problems

What say you on the issue below?

Big prostates can cause urination problems. However, simple steps can be taken to improve symptoms.

I RECENTLY travelled to Langkawi to give a talk about men’s health. The flight was delayed and I had a rare opportunity to browse through some magazines in the news-stand.

When I was going through some foreign magazines, I discovered an interesting study on men’s health carried out in the United Kingdom. The aim of the survey was to identify men’s knowledge of their own body. One of the questions of the survey read: “Do you think women have smaller prostates, therefore they have less problems with urination?”

I was completely astonished to find out that an astounding 60% of men answered “yes” to that question! I don’t think this was a reflection of British male humour, but showed a lack of knowledge of their own health.

Unlike any other organ in the body, the size of the prostate will increase with age. As a result, men may experience problems such as slow stream, difficulties initiating urination, dribbling, and urgency.– Photo courtesy of InnoHerb

The worrying thing was the survey was actually done on well-educated British Telecom engineers. I often wonder how the answer would differ if the survey were conducted in Malaysia.

In fact, the prostate is an organ that is situated between the bladder and penis. Unlike any other organ in the body, the size of the prostate will increase with age. As a result, a man from the age of 40 may begin to have problems such as slow stream, difficulties initiating urination, dribbling, and urgency. For many men, this can be both embarrassing and distressing.

Many studies have revealed that night time urination can be bothersome as many men find it difficult to get back to sleep. This has significant impact on their quality of lives. Moreover, many men also tend to wake up their partners when going to the toilet at night. This certainly can be a source of marital disharmony.

Apart from the bothersome symptoms affecting quality of life, many men actually worry about the association of such symptoms with prostate cancer. Instead of seeking help from a doctor, many of these men suffer in anxious silence. In fact, the vast majority of such urination symptoms are caused by a condition called benign prostate hyperplasia. This condition can affect 50% of men at the age of 50, and 80% of the men at the age of 80! In a way, like grey hair, perhaps this is a natural process of getting old.

As an urologist, I often reassure the patient after a thorough medical history, examination, a simple blood test, PSA (Prostate Specific Antigen), and a flow study. Most men do not need any treatment apart from lifestyle changes such as avoiding drinking fluids at night, especially coffee and tea.

If the lifestyle changes are ineffective and the symptoms are bothersome, I often suggest a trial of medications such as alpha blockers or 5-alpha reductase inhibitors. The former is a medication that is very efficacious in relaxing the prostate, and the latter has the effect of shrinking the prostate over a period of time.

Just like plumbing, when the prostate is relaxed or shrunken, the obstruction in the urinary flow will significantly improve. The alpha blocker is very effective in nearly 80% of men with such problems, resulting in significant reduction in the numbers of men requiring surgery for the obstructive prostate.

Apart from relaxing the prostatic tissues, the alpha blockers can also relax the blood vessels. As a result, blood pressure may also be controlled at the same time.

Increasingly, many men are also looking for more natural products to ease their urination problems. Recent studies have demonstrated that a healthy diet with fruits and vegetables such as tomatoes have significant protective effects on the prostate. Some men also experience symptom relief from herbal and natural medications such as saw palmetto. Although the effect is encouraging, the scientific data available perhaps is not as robust.

Unlike grey hair, prostate enlargement may result in complications to health. For certain men, the enlargement of the prostate can potentially result in acute retention of urine (inability to pass urine), recurrent urine infections, bladder stone formation and even kidney failure.

Sadly, one recent study done in Asia revealed that men in Asia tend to leave the urination problems untreated until the conditions have become serious. For some, the damage may be irreversible.

For those who fail to improve with medical treatment, surgery may be the next treatment option. There has been great strides made in surgical technology. In the sixties, men with benign enlargement of the prostate required open operations to remove the prostate.

In the seventies, the introduction of endoscopic operations such as TURP (Trans Urethral Resection of Prostate) had revolutionalised the treatment of prostate conditions.

In the 21st century, the utilisation of laser to surgically treat benign enlargement of the prostate is also widely available, with less complications and faster recovery.

So guys, the mystery of the enlarged prostate is now revealed. Why suffer in silence? Have a simple check-up, change your lifestyle, and take a pill if necessary. After all, there is light at the end of the tunnel.

Dr George Lee is a consultant urologist. This article is courtesy of sanofi-aventis. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.