From the size of
an almond in puberty, due to hormonal signals, it grows in size. It
has three lobes or sections, enclosed side by side in a capsule. The
small urinary tube that empties the bladder, passes over the middle
lobe. Anything that happens there to swell the prostate — infection,
inflammation, cancer, hypertrophy – can enlarge these lobes and thus
obstruct the flow of urine , causing a wide spectrum of misery. With
partial obstruction, urine backs up in the bladder and becomes a
stagnant pool; bacteria often invade the pool, multiply and cause
serious infection, retention, hydronephrosis etc.
In an adult
male, the prostate usually weighs about 20 grams. Almost all of this
mass develops during puberty in response to hormonal changes
associated with maturation. The prostate literally doubles in size
during puberty. If a man is lucky, and some are, the prostate never
again undergoes any changes in size. Unfortunately, for men between
the age of 40 and 59, nearly 60% can be shown to already be
suffering from benign prostatic hyperplasia. This usually does not
present a noticeable problem until after the age of 50.
By the age of
80, however, some 85% of all men suffer from one or more symptoms of
BPH. As the prostate enlarges, the layer of tissue surrounding it
stops it from expanding, causing the gland to press against the
urethra like a clamp on a garden hose. The bladder wall becomes
thicker and irritable. The bladder begins to contract even when it
contains small amounts of urine, causing more frequent urination.
Eventually, the bladder weakens and loses the ability to empty
itself and urine remains in the bladder. The narrowing of the
urethra and partial emptying of the bladder cause many of the
problems associated with BPH.
Benign prostatic
hyperplasia (formerly called hypertrophy) in some ways is the male
equivalent of menopause. The primary effect of BPH is a progressive
decrease in the ability to empty the bladder as the prostate
enlarges and applies pressure to the urethra. Retained urine from
this obstruction at first can interfere with sleep as the sufferer
wakes up in the middle of the night. At other times, pressure may
make it impossible to properly control urine flow (incontinence).
Retained urine in the bladder can allow bacterial growth and
infection. Urine may flow back up the tubules to the kidneys and
cause infection there. In severe cases of retention, urine even can
find its way into the blood (uremia) with toxic consequences.
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