Practically no man who lives long enough comes around them: the benign enlargement of the prostate. It starts at the age of 30 and progresses slowly. Complaints do not develop until year (ten) e later. Shaped like a chestnut, the prostate - called the prostate gland in German - lies under the bladder and surrounds the urethra like a fist. Before puberty, she is small and largely inactive, at about twenty, she reaches her normal size.
Consequences of enlargement of the prostate
From the 40th to the 50th year the prostate tissue changes. The muscular and connective tissue layers around the urethra multiply, the benign tumor can even grow into the bladder. This is called benign prostatic hyperplasia (BPH) or a prostate adenoma. The enlargement of the prostate narrows the urethra, like a fist slowly closing a straw. The consequences are easy to imagine - the urine can not flow away unhindered:
- The pressure during urination increases; To apply this, the muscle pulls up in the bladder. These in turn narrow the ureter, the urine accumulates in the kidneys.
- After urination remains a urine residue in the bladder (residual urine); This increases the risk of cystitis. If the prostate is so large that the bladder outlet does not open at all, it creates a painful urinary retention.
Who is affected by prostate hyperplasia?
The BPH is very common in older men, so they are little charmingly called Altherrenkrankheit. Doctors assume that microscopic changes in the prostate are detectable in about 50% of men over the age of 50 years. In half of the magnification is already palpable. Seventy-five year-olds are already affected, and 9 out of 10 men in the 80-year-olds. The cause is a hormonal imbalance - from the age of 50, the male sex hormone testosterone in the prostate is increasingly being converted into the breakdown product dihydrotestosterone (DHT) - which probably stimulates tissue remodeling. By the way, even though the prostate and its secretions play important roles in sexual intercourse, a BHP does not mean that impotence needs to be involved.
How is a prostate enlargement expressed?
Whether and how severe symptoms occur is very different - some men have no complaints despite enlarged prostate tissue, others show a clear symptomatology without detectable enlargement. Typical characters are:
- Dribbling and thus wet laundry, residual urine
- Muted urinary stream, frequent urinary urgency with small amounts of urine
- Starting difficulties or beam interruption
Not always prostate problems
Many men believe they have a prostate problem because they have to go to the bathroom at night. Not infrequently blind alarm, because the few men are awakened by urination, but go to the bathroom, because they are just awake anyway. The reason? In old age, the structure of the sleep changes - without illness, you wake up four to five times a night. Apart from this, the capacity of the bladder also decreases with age, irrespective of BPH - resulting in more frequent urination.