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Hello and welcome today's presentation and large prostate Causes Symptoms and treatment is presented by Doctor Mark Hsu. He specializes in diagnosing and treating conditions of the urinary tract and the male reproductive system without further ado.
Please welcome Doctor Mark Hsu. Good evening everyone. Thank you for joining me today on this educational talk about the prostate and and how it's can cause urinary issues in a large prostate is one of the most common issues that an older man can deal with in their golden years and very likely if you have a urinary issue at that time, prostate size chart than likely not, it's the prostate.
To give you an overview of our talk tonight first talk about the prostate, it's anatomical considerations and the role in the urinary system. Next Next we'll about how it's enlargement can cause urinary bother and we'll call that PPH from here on out just to simplify things and finally we'll go over some of the treatment options that Urologist can offer for traditionally we've been we've talked about medications and surgery as a traditional options that I've been offered but in the.
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Five to 10 years, there have been a couple of pretty exciting. There are kind of like a niche in the in between of medications and surgery, and we'll talk about a couple of them today, both of which we offer here in our clinic. So what is the prostate? It's typically a walnut sized gland and it sits at the base of the bladder and there's a channel within the prostate and I'll show you right here.
There's a there's a there's a hole that goes through the prostate and we call that the prosthetic urethra and that's the area that the and the bladder has to exit through this area before is able to come out to the urethra and so that's there. Focus I will will prostate size chart referring to quite a bit and otherwise a prostate produces about a third of the volume of the ejaculate and there's two main stages of growth one and it it reaches as adult size in the 20s in your 20s and then it prostate size chart continue to grow from your mid 40s onwards through the rest of your life.
And so there are several problems that can happen prostata psa 8 the prostate that will lead one to seek medical attention and here are three of the most common conditions that the prostate can and one can encounter and the first one is is BPH, which is the one we're going to be talking about today, but there's also other conditions like prostate in the middle there, which is basically an infection or inflammatory condition of the prostate and then there's also prostate cancer.
There can be some. Overlap and and this and this and Prostate size chart between these three conditions, so it's important for the Urologist to to to be able to evaluate you and through the work of kind of figure out which one it is.
I'll get from men will be well if my prostate larger will I have an increased risk of prostate cancer and the answer is no there. People who have small Prostate or large prostate that can get prostate cancer, so that's not a. So let's focus on what BPH stands for because it's pretty aptly named. So if we look at the B, it stands for benign so again that's non cancerous.
We're not talking about cancer in this situation. P is referring to the prostate and H is hyperplasia. Bigger prostate size chart know when anatomically it can cause what's a phenomena We call a medicine and bladder outlet obstruction and and that can then lead to to urinary symptoms, which we also call lower urinary tract symptoms or simply Lutz.
So BPH is the most common reason for what we call this bladder. So if we look at the left side here in the normal Prostate anatomy diagram again, we have the bladder here and the prostate here and that channel that prostate we are going through.
Also inwards towards the middle and so you imagine that prostate size chart hole is getting smaller because that that tube in the process is becoming tighter so over time that bladders gotta work really hard to squeeze that urine through this tight little channel and you can imagine now the bladder is actually a muscle so if the muscle's going to squeeze really hard work overtime for many years, you can imagine what's going to happen.
It's starting to become very thick.
It's what we call a tribe. Bladder it'll it will look. So what are the symptoms of BP? You may not feel completely empty. I got to go all the time you feel like you, you can't hold you can't hold it for very long. And these are all. I mean we can hear any any combination of these symptoms when we talk to patients. So this slide just goes over some statistics of service a quality of life service, a man with BPH that have had the you know that talk about how their their their urinary symptoms affect their quality of life.
So you know patients come to see me. I've heard a lot of different stories. I mean most common ones. I'll mention here will be like golfers who will tell me they have to find a restroom every few holes and you know that's array of just you know. Self-conscious guys at the urinal who are hearing all these young whipper snappers next to them with like laying loose with their good streams and then there's other people who like know exactly where the every single bathroom is on their their prostate size chart, you know to and from work or to their to their errands.
So so this this is this is kind of what what we will hear in the clinic and it's not just you know the patients themselves that have to go through these issues but also their significant others or their loved ones or people around them that also get to vicariously go through these issues as well. Intervention for BP and there's some there's some link that potentially obesity and lack of exercise may increase the risk of progressive BP. So you know just like what all the doctors will say that the importance of a good diet and exercise and stress management all these things you know play to many parts of one's health and and that, and that definitely includes the prostate.
So if you were to come to the the Urologist clinic, this a typically the arsenal of the work that we have first, we will take a detailed history, kind of understand what kind of symptoms that are going on and we have prostate size chart surveys that we can do to kind of quantify to get some objective numbers about prostate size chart bothered one is we'll do a prostate exam where we'll we'll take a feel Prostatitis klaritromicin the size of the prostate and the texture of how it feels and then and then we also will typically also conduct some urine studies to make sure there's no obvious infection and there's no blood in the urine that requires for work.
One of. Test that we also offer. How how Prostatitis 17 éves tightly the screen for it and this could be really it's own lecture and you know it's right. There's so much to talk about with that. It's a good screening tool. I would say and definitely Urologist needs to be available to interpret that.
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Over time, you know the PSA can have some false positives and false negatives that can go up with things like prostate cancer, which we definitely will have to evaluate for if that was a high end of suspicion, but also PSA can also go up with enlarging Prostate because actually at the end of the day, the prostate is what makes the Psa.
UFO is basically a simple thing where I have a man urinate to. Funnel that has a speedometer on it and then we can basically chart prostate size chart time and the velocity so that way we can kind of get a nice curve and see the efficiency of how well when urinate and then there are some procedural things that we can also do one being being a cspan.
You know it's like so so hogyan kell otthoni prosztata adenomát kezelni what extent that has been working for. Try to prostate size chart that urine through the through the prostate Népi jogorvoslat a krónikus prosztatitis kezelésére also we have what's called a trans rectal ultrasound of the prostate where we can do that get a little bit more anatomic detail and also to measure the prostate size.
So most of the time when patients come see me, it's it's mainly quality of life issues that we address and then and you know again.
That doesn't drive me to do something sooner.
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There are a few situations that are listed here that if the the Enlarged Prostate untreated can really lead to significant medical problems that can affect one's health. I think the worst case would be if you know you weren't able to empty at all that the buyer is so weak that it can't squeeze any urine pass prostate size chart prostate. So it's just you have a distended bladder.
That is what we call urinary retention, so you're not able to pee you need to have something like a prostate size chart, for example, which is the most common prostate size chart to be able to sufficiently empty the bladder.
Now this is this.
Undetected this this can lead to what's called real failure, so basically that urine has nowhere else to go because you can't make it through the process so it basically goes backward backwards up into the kidney and basically the the kidneys drown in their own urine and that can cause what's called renal failure and prostate size chart definitely very bad. That's a nice medium for bacteria to grow in and.
Problems that way and there's also a lot of calcium salts in urine that if it's just stays there for a long time, not not able to empty well that can come together over time and form bladder stones and that doesn't sound like fun either right so. And finally the the bottom thing is called bladder dysfunction.
I wanted to show you guys in this diagram here so when I talk about the tred bladder, there's a schematic here about how that can progress over time.
So here is is what we call a healthy bladder where the the bladder wall looks very smooth. I would say smooth like a baby's bottom, but as you kind of get to like a medium kind of sized. Is to get this basically this big thick cobweb of bladder muscle fibers, and this can really show the bladder.
That's just going to be squeezing so very prostate size chart, and this can sometimes be a permanent situation despite what you do to the process at that point. We want to consider early intervention much more aggressively earlier on. So now, we'll go over the last part of the last section of the top. We're talking about BPH treatment options and there's a huge spectrum here so we can go from what's called wash for waiting or you know, making sure that everything in the lifestyle is as optimized as possible.
prostate size chart Prostate size chart then there's like first line therapies. The boss and you, you know you, you dictate what what we want to do and I'm your counselor in a way and basically prostate size chart you all the pros and cons of the options and making sure that there's nothing medically you know, dangerous or threatening that's going on with me to make a stronger recommendation towards a more aggressive therapy.
So the first treatment option is watchful waiting so this is basically where we're fájdalmas pisilés at your lifestyle and making sure that everything is optimized as possible in in one's daily habits and one of the most common things I like to do Prostatitis profilja my patients is get what's called a void diary and so this basically is very simple.
I just have somebody treat chart what they drink, you know, basically the amounts and what they're drinking and what time and then when they pee.
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I have them into a container and measure how much comes out and then they write down you know and that's coming out what is coming out so that way I can see you know there's something adjustments to be made in terms of how much like, for example, caffeine or alcohol, they're drinking. Sometimes people are drinking lots of caffeine tea, you say, and you see a cluster of frequency go along with that.
On the other side, you're like okay, well, maybe try to cut down on the coffee and tea in this part of the day and see if that might help you with your symptoms.
Other things we can do, for example, like like watching how much you you know, making sure that you don't drink that much before you go to bed that can also potentially reduce how much how many episodes you wake up at prostate size chart. There are other things We can also check to like you know medication review. So we don't want we can try to avoid that and we want to be able to catch that.
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That we can offer to patients like kegel exercises or we call purposeful double voiding for select patients where you can, you know in some situations if someone's really bothered by frequency and urgency that they can try to strengthen their pelvic muscles so they can resist that initial urgency to pee or for someone who's not emptying very well, you tell him to pee and then wait about fifteen to 20 seconds and then try to pee again.
So if patients are bothered despite you prostate size chart trying to optimize their lifestyle, Krónikus prosztatitis DGPH 1 we can offer a medical therapy and the most common medication that we'll start with is what's called an Alpha blocker and what this does is that it tries to relax that that area in the process that prostate we talk about that donut hole there's receptors in in the in the prosthetic urethra that can respond to this medication and cause that muscle prostate size chart relax and open out to the side so that don't know relaxes.
A little bigger it Prostatitis puffadás it easier for that urine to come from the bladder to the prostate. He knows okay, so and then one of the considerations with an Alpha blocker is that it can be associated with a phenomenon called retrograde ejaculation and this is a kind of a sexual side effects so usually when you have an orgasm when a man has an orgasm, there's there's fluid that comes out in the semen right so but if it's if this area is really relaxed, then that that semen can actually go backwards through that that prostate into the bladder.
It's nothing dangerous. That urine and semen mix and then later on prostate size chart pee it, It's basically a mix of urine and sperm and semen. There are some there are some drawbacks though, and and and the side effect profiles typically in the the sexual arena where there there can be a phenomenon called Post Finesse syndrome that some people can get from taking this medication and that can manifest with like you know.
It's just that we have to take that into account when we're following your PSA on that medication. So now, we'll talk about some of the minimally invasive prostate size chart that we offer here and and and also it has been become more popular in the last several years, The first one is called zoom zoom is an prostate size chart clinic based therapy where we basically inject water vapor into those obstructive parts of the prosthetic urethra and to the prostate tissue and that heat energy is absorbed by the prostate and after several weeks, you'll get a regression effect where the prostate tissue on the inside recedes out to the sides so again making that.
A whole bigger that's all that's the whole goal of all these therapies. It's a it's a quick procedure I usually takes several minutes Honestly, once we get started a lot of the work actually comes in the preparation and then cleaning up but the procedure time is actually relatively short on the span of several minutes and we'll leave a catheter for a few days and then we'll tell people to wait, usually about two to 4 weeks for the effects to take place as that again that that prostate tissue recovers from the heat, so there prostate size chart be some side effects like some blood in the urine, some frequency some urgency, some burning in with urination.
Are common as as the process recovers from that it's been it has been a pretty well validated procedure and you know they've come out the Az orvos kinevezte a prosztatitis kezelésében company that sponsors resumed to prostate size chart five-year data so the vast majority of people are still satisfied with symptoms that you know 4.