From the age of 40, the prostate begins a growth that in most cases is benign in nature and that we know as prostate adenoma. About 10% of this growth can be malignant (cancer).
What is the prostate?
The prostate is an internal secretion gland that is anatomically located under the bladder and surrounding the urethra (the tube through which urine passes from the inside of the bladder to the outside). One of the most important functions of this exclusive male gland is to provide nutrients for the maturation of sperm.
What causes an enlarged prostate?
Prostate growth, whether benign or malignant, can cause symptoms currently known as LUTS (Lower Tract Urynary Simptoms) or lower urinary tract symptoms. These can be of variable intensity (mild, moderate or severe) and expressed as bladder, irritative or filling symptoms of the bladder and urethral, obstructive or bladder emptying symptoms.
People with lower urinary tract symptoms have:
- Urinate more frequently
- Getting up at night to urinate.
- Urge to urinate that often causes involuntary loss of urine.
- Delay in starting urination.
- Weak and / or choppy jet.
- Feeling of incomplete emptying of the bladder.
- Post voiding drip.
When and how should the prostate be evaluated?
It is recommended to start a prostate evaluation from the age of 50 or from the age of 40 in the case of a direct family history of prostate cancer.
When we carry out the prostate evaluation we take into account 2 aspects:
- The type of gland growth (benign or malignant).
- The alteration in the quality of urination (urinary obstruction) that generates LUTS.
The evaluation of the prostate growth is carried out with a rectal examination, which allows to evaluate the size, the sensitivity, the presence of nodules and fundamentally the consistency and by the determination of a marker present in the blood called prostate specific antigen (PSA or PSA in English). ). According to the results of the digital rectal examination and the PSA value, a control or a prostate biopsy will be suggested.
To evaluate the alteration in the quality of urination, the following are used:
- Self-response questionnaires such as the index of prostate symptom score (IPPS in English) (add link that leads to the questionnaire).
- Urinary flowmetry, a method that consists of the emission of urine into a container connected to a computer that produces a urination record or curve that can infer the possibility of abnormal urination.
- Renal and abdominal vesicoprostatic ultrasound to evaluate the anatomy of the upper and lower urinary tree, the prostate volume, the presence of stones, cysts, tumors, and postvoid residue.
What can be the results of a prostate evaluation?
Faced with the diagnosis of a benign prostatic growth (prostate adenoma), the indication for annual periodic control, medical treatment or prostate surgery (removal of the prostate adenoma) will arise.
It is important to clarify that the removal of the prostate adenoma does not prevent the development of prostate cancer, so that all patients operated on for prostate adenoma should continue with their periodic controls.
If the evaluation shows the presence of prostate cancer, there will be a need to determine if the process is localized to the gland or has already exceeded its limits to carry out a treatment that may be surgical, with rays or with medication that blocks the effect of hormones. male.
What are the risks of not having a prostate evaluation?
The risks are not to detect early a cancer of the gland which reduces the possibilities of radical treatment.
When the prostate is enlarged and without treatment, the risks of obstruction can generate complications such as recurrent urinary infections, bleeding, bladder stones, urinary retention, deterioration of bladder function, dilation of the kidneys and in more cases severe kidney failure.