Awareness Programme on Prostate Care: Frequent Urination Might be a Sign of Prostate Disease!
Chennai
28th August 2019 :
- Urination problems: Embarrassing today; Dangerous tomorrow
Prostatic diseases are common among aging men causing
significant morbidity. Most chalk-up the problem of the prostate to the current
circumstances, some blame aging, weather change, travel-related stress, the
water of different places, etc. However, due to the sedentary lifestyle, the
age factor is blurring the line. The quality of life gets hampered as the
prostate enlargement can cause “lower urinary tract symptoms.” Benign
Prostatic Hyperplasia (BPH) is defined by at least microscopic
excessive growth, which over a period, translates into the gross enlargement of
the gland visible to the naked eye.
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| (L to R) Dr. M.G RAJAMANICKAM, Sr. Consultant, Bharathiraja Hospital, Dr. P.B. SIVARAMAN, Sr. Consultant, Chennai Urology Research Institute |
It begins before 40 years and approximately 8% of men at
least microscopic BPH by 45 years, 50% by 60 years and
90% by 90 years of age. The prevalence of BPH range from 14% to 30% for men
aged 50 or older, depending on the definition used. While BPH prevalence in
India is by 25% for 40–49; 37% for 50–59; 37% for 60–69; 50% for 70–79.
Approximately 2 out of every 5 Indian men have bothersome lower urinary tract symptoms
due to BPH. However, most will not present to a doctor and seek treatment, as
many will normalize it, linking it with aging, the weather, travel-related to
stress, change in water, etc. They will cope with the bother of the disease
until it becomes too severe and causes all sorts of complications.
The prostate goes through two main growth period with
age. The first occurs early in puberty when the prostate doubles in
size. The second phase of growth begins around age 25 and continues
during most of a man’s life. BPH often occurs with the second growth phase.
Patients with BPH commonly complain of frequent urination at night,
difficulty
in passing urine, incomplete emptying of the bladder. The
quality of life gets hampered as the prostate enlargement can cause “lower
urinary tract symptoms”. To cope with these symptoms, the patient starts
restricting water and other fluid intake and being conscious of his urination,
for example, being on the look-out of toilet location wherever he goes,
urinating before going on long trips outdoors, where he might not have access
to loos such as on a long-distance bus journey. These coping strategies further
restrict the patient’s quality of life.
It is also important to note that the size of the
prostate doesn't necessarily determine the severity of your symptoms. Some men
with slightly enlarged prostates can have significant symptoms, while other men
with enlarged prostates can have minor urinary symptoms. And if left untreated,
the urinary problems might lead to obstruction of the urinary tract and affect
prostate health. It is critical to consult your doctor and not shy away from
the issue. Your doctor can help you choose the best care based on your age,
health, and how the condition affects you. Also, important to note is the fact
that the symptoms of BPH are like those produced by more lethal diseases, such
as prostate cancer. Therefore, it is vital to visit a doctor or specialist to
understand what and how severe the actual problem is.
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| (L to R) Dr. M.G RAJAMANICKAM, Sr. Consultant, Bharathiraja Hospital, Dr. P.B. SIVARAMAN, Sr. Consultant, Chennai Urology Research Institute |
Adding to this Dr. M.G RAJAMANICKAM, Sr. Consultant,
Bharathiraja Hospital, highlights that, “It revolves around the home, the office and places
nearby the home. During a weekday, apart from commuting to and from office,
there seems to be less movement to other places. Weekends are limited to the
home or places near the home. While they do not articulate it, their behaviour
reveals that they protect themselves by not straying too far and always
remaining accessible to a bathroom. This is especially true for patients who
are not being treated. Those who are treated also have a similar lifestyle but
are more open and confident to move out of this perimeter should the need arise”.
Diagnosis of BPH is made by a mixture of physical,
radiographic examinations and a few lab tests. Physical examination includes DRE
(digital rectal examination), which involves a physical examination of prostate
by a Urologist. Abdominal and pelvic ultrasound also indicates the size of the
prostate gland. Lab tests include PSA (Prostate-specific antigen). PSA
is a protein that is made only by the prostate. When the prostate is healthy,
very little PSA is found in the blood.
According to Dr. P.B. SIVARAMAN, Sr. Consultant,
Chennai Urology Research Institute, “Patients are largely unaware of
this condition despite high prevalence rates as they consider it a normal part
of aging, which can be rectified through a targeted patient awareness campaign.
BPH is diagnosed through a combination of methods including patient history,
IPSS scorecard, ultrasound, and PSA tests”.
Dr. M.G RAJAMANICKAM, Sr. Consultant, Bharathiraja
Hospital further added that “Most realized
there was a problem when the frequency of washroom visits increased seemingly
sudden and quick onset – not a gradual increase. This is how it started for
most, described as the first symptom”.
BPH management involves management of symptoms through
medications like Alpha-blockers, most commonly tamsulosin. BPH symptoms are
measured by using IPSS (International Prostate
symptom Score). If symptoms are uncontrolled, a combination treatment is
offered. Surgical removal of prostatic tissue is the last step if symptoms are
uncontrolled on medication. Since alpha-blockers are chronic treatments, there
are different molecules available with alpha-blockers for comorbid patients,
sexually active patients, and the general population. BPH symptoms are usually
neglected until they become very bothersome, which should not be the case.
Prostate health month, observed in the month of
September, is a movement to create awareness of men's health. Intending to
provide easily accessible prostate health www.whatarelief.in is a digital
asset created for patient awareness and education.
Reference:
- Globocan 2018
- International Journal of Biological & Medical Research; Int J Biol Med Res. 2012; 3(3): 1895-1898
- The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: A system; www.nature.com/scientificreports
- A Study of Relationship of Prostate Volume, Prostate Specific Antigen and age in Benign Prostatic Hyperplasia; www.ijcmr.com 💢💢
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