Prostatism
Many men think that as they get older they have no choice but to suffer the irritating and embarrassing problems their growing prostate gland brings.
However, they're mistaken. They don't have to spend most of the night in and out of the toilet and all day developing a knowledge of local lavatories that betters any tourist guide.
Treatment for the most common cause of this problem, the non-cancerous condition benign prostatic hyperplasia (BPH), is available and doesn't always involve having an operation.
What is it?
The prostate gland makes the liquid that carries sperm on ejaculation, the semen. It's about the size of a walnut and sits at the base of the bladder around the tube that urine passes through (the urethra).
What happens?
Once men reach their 40s the prostate gland starts to enlarge. For some men this doesn't cause any problems, for others it's like putting a kink in a hosepipe and causes difficulties with the flow of urine.
Possible symptoms include: difficulty passing urine, a weak stream that may take a while to get going and when it does it just stops and starts, having to get up throughout the night to pass water, having to find a bathroom urgently when out and about, feeling the bladder isn't empty and needing to go to the toilet again and again, and dribbling after passing urine. Men with an enlarged prostate can suffer some or all of these symptoms.
Often they find they have to run to the bathroom urgently, sometimes not making it in time. It may be just an inconvenience for some but for others it can cause extreme discomfort and take over their lives. Many men become frightened to go out and if they do they make sure they know the locations of every toilet in the area.
Although women don't have a prostate gland many also suffer disturbed sleep or interrupted outings because of their husband's problem.
Why does it happen?
It's estimated that one in four men in their 50s and one in two men over 60 will be troubled to some degree by this enlargement of the prostate gland. However, it's not entirely clear why the prostate enlarges as men get older.
Can I stop it?
Taking the herb saw palmetto appears to help reduce the symptoms of an enlarged prostate and some believe that taken regularly it may prevent the prostate enlarging in the first place.
Should I see a doctor?
It's important to remember that these prostate-related problems aren't something that men just have to put up with. There are many treatments available and so seeing the doctor to establish the diagnosis is a good idea.
The doctor will examine the prostate gland by feeling it in the back passage and may arrange for blood tests and a scan of the prostate to be performed.
The tests you have will depend on what your doctor thinks is appropriate.
If the symptoms are only minor then lifestyle changes - such as eating a low-fat diet with plenty of red tomatoes and soya foods, and cutting down the amount of caffeine and alcohol - may be all that's needed.
More troublesome symptoms can be treated with medicines or an operation which reduces the size of the prostate gland and improves the flow of urine.
The doctor can prescribe effective medication to shrink the size of the prostate and relieve the symptoms.
When symptoms persist despite this treatment or if the gland is very large then an operation to reduce its size may be advised.
This article was last medically reviewed by Dr Rob Hicks in May 2005.
First published in October 1997.
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