Prostate Health and Life as We Age
By: Dr Mudassir Hussain
Tags: Sexual Health, Life, Elderly, Health, Healthcare

Prostate Health and Life as We Age

The epicenter of sexual health and continence

Photo by Katarzyna Grabowska on Unsplash

The prostate is a small gland lying deep in the lower part of your body, known as the pelvis. It sits comfortably at the outlet of the bladder and ducts which drain your body fluids at the time of orgasm. It's not more than the size of almond, but can get bigger as you age. They have attributed this mysterious increase in size to multiple etiologies. However, no single aetiology can fully explain the problem.

Why the prostate is important

The function of the prostate is vitally important in the life of men. Most patients attribute its role in voiding and storage of urine and keeping them dry between voids. However, its central role in sexual function is less appreciated. It is involved in maintaining fertility and erectile function in men. This means the diseases of the prostate will have deleterious effects on social and sexual wellbeing of the elderly men.

The increase in size of prostate is central to all bad things it causes in later life.

What is prostatic enlargement?

As the size of the gland increase, it blocks the outlet (exit path) of the bladder. That means urine cannot pass easily out of the body as it uses to pass in the past. This gives rise to the feeling of hesitancy, so you will have to wait for some time before urine flows. This subtle change in voiding (the act of micturition) is usually the first symptom, followed by more obvious problems as the disease progress. With time, you feel that the urinary stream is thin, weak and intermittent. You have to use force from lower abdominal muscles to get urine to pass out of the bladder, we know this as Straining.

Beside these obstructing voiding symptoms, there will be another set of symptoms which we call as storage symptoms. Your bladder will give you a sense of filling earlier than before, known as urgency. It will be difficult to postpone the act of micturition once you feel the urge to void. You will void only a small volume of urine more frequently than before. We know this as frequency. At night, you have to wake up several times to void. We know this as Nocturia.

Nocturia is the most bothersome symptom among the several others brought up the enlarging prostate. This symptom alone has the most deleterious effect on the health of men after fifties. The biggest effect of nocturia is on sleep quality. The interruption of sleep brought up by the frequent need to void affects the quality of daytime energy. It also increased the risk of a fall in bathrooms owing to low light, frequent visits, and slippery floor. Men with this problem are lethargic and less productive during the daytime and at higher risk of accidents.

Is there any preventive strategy?

Till date, there is no acceptable prevention strategy to avoid this sequence of events as you get old. All you can do it to make sure you don’t ignore the development of these symptoms and consult your doctor early to avoid the harmful consequence of obstructed bladder and voiding. There are effective treatments available ranging from medications to minimally invasive surgery.

What is Prostate Cancer?

Most of these enlargements of the prostate are what we call, benign enlargements. This means that the increase in the size of gland is induced by non-cancerous growth of cells within the gland. So, the only problem benign enlargement cause is the obstruction to urine flow. It has no ability to come out of its coverings and spread to distant organs of the body.

But sometimes the growth is cancerous. We call it prostatic cancer. This is less common than Benign prostate enlargement, but still common enough to caution men in this age group. The behaviour of such cancers in the prostate is unpredictable.

Most men die with prostate cancer, rather than of prostate cancer.

Although several men have this cancer in their prostate glands, however, the slow growth of it means that it will not be a threat to life during their lifetime. This creates a perplexing situation for both patients and doctors. The actual goal is to diagnose only clinically significant cancer, i.e. only those who are going to grow quickly and threaten to shorten the life span of a patient. But in reality, we hit several slow-growing lesions as well. The tests and imaging studies available to us cannot reliably differentiate between the dangerous and relatively harmless type of cancers.

What are prostatic infections?

The third common condition is related to infections, which affect this vital tiny organ. The prostate is an ideal site for bacteria to hide. Most antibiotics given for a short duration cannot kill all bacteria living in this secure shelter. The infection in prostate known as Prostatitis can be an acute or chronic event. In both cases, bacteria seep into the gland and cause inflammation or simple words a situation where normal body cells are damaged along with bacteria. The ultimate winner is usually the immune system, but not without the support of antibiotics prescribed by your doctor.