The prostate is located at the exit of the urinary bladder.
The prostate is a gland of 18-20 grams that is involved in reproduction.
The urinary canal passes through it, and as they age, this organ begins to grow in most men.
In some men, the prostate enlarges into the urethra that runs through it.
Since the prostate grows inwards, it grows less, but patients apply to the doctor with very serious complaints.
The outward enlargement of the prostate does not cause any complaints in patients, but the outward enlarged prostate grows more than the inward enlarged prostate.
The prostate is a gland in the anterior part of the intestines that surrounds the exit of the urinary bladder.
The main task of this organ, which is a part of the male reproductive system, is to produce the fluid that protects the sperm and to store the sperm in this fluid in a healthy way.
In addition, this organ prevents urinary incontinence by squeezing the mouth of the bladder.
Table of Contents
Why Prostate Enlarges
The prostate begins to grow in early adolescence (2 times faster).
In men in their 30s, this organ begins to grow in different shapes and continues until the end of life.
The cause of prostate enlargement is not known exactly, but male hormone (testosterone) and estrogen are thought to have a serious role in this growth.
While 50% of people over the age of 50 have prostate enlargement, this rate rises to 65% at the age of 60.
When men reach the age of 80, this growth rate exceeds 90%.
Especially in elderly patients, prostate problems should be carefully monitored.
What Complaints Does Prostate Enlargement Cause?
The prostate grows slowly over the years, which begins to compress the urethra.
The organ that enables urination is the urinary bladder and has a structure made up of muscles.
The prostate compresses the urinary canal, which causes the muscles of the bladder to expand and the bladder begins to contract more strongly.
At this stage, sometimes the patient does not have complaints.
Sometimes, complaints such as going to the toilet frequently, getting up to urinate at night, rushing to the toilet after feeling the need to go to the toilet, and sometimes urinary incontinence may occur due to excessive activity of the urinary bladder.
Over time, the prostate begins to grow and tires the bladder.
In this case, urinary problems begin to occur (urine flow slows down, forked urination, dripping during urination, intermittent urination, the feeling of the presence of urine still inside after urination)
In patients who do not receive treatment, the bladder muscles melt, and the high pressure in the bladder begins to disrupt the kidneys.
Even if the patient receives treatment after this stage, the urinary bladder and kidney functions often do not return to their original state.
How Is Prostate Diagnosed?
The diagnosis of prostate enlargement is usually made with blood and urine tests, ultrasonography, urine flow test, and tests and analyzes that will not disturb the patient in any way.
A treatment plan is applied according to the degree of growth detected and the complaints caused by the patient.
Benign Prostate Treatment
If prostate enlargement is benign, it is treated with lifestyle changes, monitoring the patient, drug administration and surgery.
The prostate is a naturally growing organ and it is not possible to prevent it.
However, there are some treatment ways to minimize the patient’s complaints and increase the quality of life.
Several treatment methods are used to eliminate the patient’s complaints about urination.
Immediate surgery is not recommended in patients with enlarged prostate.
Depending on the patient’s complaint and the severity of the disease, the treatment method is chosen.
In the first stage of the treatment, arrangements are made regarding the toilet habits and lifestyle of the patient.
If necessary, drug treatment can be started by leaving the second step.
Such drugs are drugs called “alpha-blockers” that relieve the congestion caused by the prostate most quickly (for example, prostreat etc.).
As the medical world developed, over time, types of drugs with less side effects for prostate began to be found.
In some cases (in patients with a prostate size over 35 grams), drug types called “5 alpha-reductase inhibitors” can be used, which stop the growth of the prostate and reduce its size.
If these drugs are used regularly, they begin to take effect after 9 months.
If the patient has been diagnosed with an overactive bladder or goes to the toilet frequently, then “anti-cholinergic group” drugs are added to the treatment.
In addition, it has been proven that the “Phosphodiesterase 5 inhibitor” group drugs, which are effective on the erection problem, regulate urination complaints in regular use.
There are special medications available for patients who urinate frequently at night.
Surgery may be considered if voiding problems persist despite treatment, recurrent urinary tract infections and severe bleeding in the urine, or if the patient had to insert a catheter because he or she could not urinate.
If patients who do not care about all these problems do not seek treatment, kidney problems will arise and the patient will face the problem of kidney failure.
How Is Prostate Surgery Performed?
There are different types of prostate surgery.
The first type of surgery is the surgeries in which the prostate is cut from the inside by entering through the urinary tract.
In this surgery, the growing part of the prostate is cut and removed using an electrical wire at the end of the instrument.
Since the electrical energy used in the surgery may cause side effects on the erection functions, different energies called bipolar or plasmakinetic are used in prostate surgeries today and very successful results are obtained.
There are also surgical methods that are performed by entering through the urinary canal and vaporize the prostate.
Different energy sources such as greenlight or diode laser are used in these types of surgery.
For patients with a large prostate, the “Holmium enucleation” method, in which the prostate is peeled like an orange peel, can be used.
One of the types of surgery is prostate surgeries performed through the abdomen.
These types of surgery are open prostatectomy, laparoscopic simple prostatectomy and robotic simple prostatectomy.
In abdominal surgeries, the bladder is cut in addition to the prostate, and bleeding may be more than in surgeries performed through the urinary canal.
Therefore, this type of surgery is not recommended unless necessary.
Prostate surgeries have features that shorten the recovery period of the patient and provide life comfort with advancing medicine.
Patients with benign prostatic enlargement are evaluated by urology specialists and the appropriate type of surgery is selected for the patient.
In prostate surgery, the size of the prostate is taken into account.
For example, prostate weighing up to 80 grams can be operated with many systems without any problems.
If patients use blood thinners, laser treatments should be considered in the foreground.
In some cases, patients cannot receive anesthesia, and in such cases, surgeries that can be performed with local anesthesia should be preferred.
Surgery experience of the surgeon is also important in prostate surgery.
For example, in Transurethral Prostatectomy surgery, an experienced surgeon can treat prostates weighing up to 120 grams.
Prostate surgeries called “Plasmakinetic” come to the fore in patients with prostate less than 120 grams and in patients who do not use blood thinners during the surgery.
If the patient’s prostate is more than 120 grams, prostate enucleation surgery with Holmium laser can be considered.
If a disorder in the bladder and prostate needs to be treated at the same time, then using robotic surgery provides successful results.
