Dubai — The prostate is a walnut-sized gland in men surrounding a tube called the urethra, through which urine and semen pass. The prostate helps in the formation of seminal fluids.
Problems that can affect the prostate are either infection of the prostate, which usually affects young men under 50 years, or prostatic enlargement, which affects almost half of men above 50 years and up to 70 percent of men above 80 years. It is a common issue, explains Dr. Moamen Amin Abdelrahim, Consultant Urologist at Zulekha Hospital, Dubai. The less common issue is prostate cancer, a malignant disease occurring in older men.
The most common prostatic problem in men under 50 years is prostatitis, which is an infection of the prostate commonly caused by bacteria. Symptoms may include burning urination, frequent urination, fever, or general fatigue. Treatment involves antibiotics to kill the bacteria and medications to relieve symptoms.
For men over 50 who have started experiencing urination problems, the reason could be an enlarged prostate (BPH). As men age, their prostate continues to grow, squeezing the urethra. Since urine travels from the bladder through the urethra, pressure from the enlarged prostate may affect urine flow. You may experience one or more of these issues:
• A frequent and urgent need to urinate, possibly requiring multiple trips to the bathroom at night.
• Difficulty starting a urine stream, despite feeling the urge to urinate.
• A weak stream of urine.
• Only a small amount of urine each time.
• The sensation of needing to urinate even after just finishing.
• Urine leakage or dribbling.
• Small amounts of blood in the urine.
The progression of the disease may cause recurrent urinary infections, stone formation, urine retention where the patient can’t pass urine and needs a catheter, and in severe cases, kidney damage.
Treatment options include watchful waiting for mild disease or medications that improve symptoms and decrease prostate size. Surgical treatment may be needed for patients not responding well to medication. Surgery can be performed with minimally invasive procedures (using laser, ultrasound, microwave, or needle ablation) to remove part of the obstructing prostate. This approach is recommended for patients who cannot tolerate major surgery due to other medical conditions.
Alternatively, the standard treatment involves removing the enlarged prostatic tissue either through the urethra using a scope for prostates less than 80 grams or open surgery for prostates over 80 grams. Another option for large prostates is laser enucleation, although it is not yet widely available.
