Monday, May 11, 2009

ENLARGED PROSTATE AND IT'S COMPLICATIONS

In the right side is an image of urinary bladder(brick red colored)And the yellowish one is the enlarged prostate projecting into the bladder.Urethra is seen as a narrow
passage passing through the prostate.
 



The innocent enlargement of prostate is called benign enlargement of  prostate(BEP).This is a gland somewhat the shape of an apple(Not size) usually 15 grams to 20 grams in weight .Through it passes the urethra starting from the urinary bladder called the bladder neck.It's function is not very clear but believed to facilitate and nourish the sperm during their travel inside female reproductive system.
  Though there are various postulates forwarded, the most commonly accepted one is the imbalance in male and female hormones after the age of forty.As it grows in size pushes itself up, elevating the bladder neck and narrowing and squeezing the urethra passing through it, to cause symptoms of urinary obstruction.This enlargement being natural phenomena one need not worry if is not getting any symptoms.That is an asymptomatic persons need not worry except periodical ultrasonological  evaluation.
 A few symptoms had already been described last time.An apparently asymptomatic person may get a retention of urine after taking alcohol and long bed ridden patients may also get it .This is an urgency and has to be relieved by catheterization .
Other complications are more serious in nature.There is back pressure of stocked urine inside  the bladder on the total urinary system above i.e. bladder itself,ureters,kidneys to create problems .And once kidneys are affected  systemic disorders like impairment of brain function occurs.Infection in the stocked urine is a constant problem and gives rise to stone formation .There may be out pouching of bladder at places creating additional pockets in the bladder called diverticula, constantly keeping infected urine inside it and promoting stone formation.The ureters and kidneys may get dilated from minimal extent to a great extent jeopardizing the kidney function. And that may lead to most dreaded kidney failure.There may occur bleeding inside the bladder.
  Very good treatment options are available .I think if the patient is not frail and not unfit for anaesthesia transurethral resection of prostate (TURP) is a very good option.And if frail, medical treatment and catheterization are to be followed with treating physician's advice only.

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