Enlarged prostate: from diagnosis to treatment
An enlarged prostate (in medical terms benign prostatic hyperplasia) can be a progressive condition, especially if left untreated
In severe cases it can cause urinary tract infections, bladder stones and urine retention.
Tests to diagnose an enlarged prostate
How can an enlarged prostate be detected?
A proper history and rectal examination can reveal a marked enlargement of the prostate or the presence of other lesions:
To ascertain increased prostate volume and prevent prostatic hyperplasia, it is useful to have periodic check-ups such as:
- a complete urine test;
- examinations to assess kidney function.
A fundamental index for investigating the state of health of the prostate is the P.S.A. value, i.e. the prostate specific antigen: this value makes it possible to estimate the possibility of progression of benign prostatic hyperplasia.
In addition, the PSA value indicates whether further investigations are necessary to detect prostate neoplasia.
Other tests to identify p. disease include:
- suprapubic and transrectal ultrasound: these allow the prostate volume to be assessed, as well as the post-mineral residue, i.e. the residue of urine that remains in the bladder after urination. The amount of urine remaining in the bladder is often an important symptom that the hyperplasia is worsening.
- uroflowmetry: a useful, albeit limited, way of assessing the urine flow both diagnostically and in monitoring the effectiveness of treatment.
Medications to treat an enlarged prostate
Drug therapy to combat an enlarged p. and alleviate urination disorders involves the use of various drugs taken individually or in combination.
Alpha blockers have an immediate effect and improve the opening of the bladder neck and thus the flow of urine.
However, as a contraindication, they can sometimes cause retrograde ejaculation.
5α-reductase inhibitors work by reducing the volume of the prostate gland, but they take time to work.
Anticholinergic and b3 agonist 5-phosphodiesterase inhibitors also have an effect on symptoms.
The main indication for these drugs is erectile dysfunction as their function is to relax smooth muscles.
In addition, certain phytotherapies can be used, such as Serenoa repens, Hypoxis rooperi and Pygeumda, which produce good results without side effects when symptoms are mild.
If drug therapy does not have the desired effect, surgery is recommended.