Many times enlargement of the prostate does not pose a problem.
Prostate. The prostate gland, approximately the size of a walnut, is located at the base of the urinary bladder. This gland literally encircles the urethra, the tube emptying the bladder, which is the only exit for urine from the bladder. Because of the intimate anatomic relationship between the prostate, the bladder neck, and the urethra, a benign enlargement of the prostate poses a concern regarding various degrees of bladder outflow obstruction. As we age, the prostate enlarges so that a man in his sixties and seventies will generally have a prostate two to three times the size of a man in his twenties and thirties. Due to the benign enlargement of the prostate, the amount of sperm often decreases and becomes more watery in consistency. In addition, the ejaculate exits the penis with much less force than in younger men.
A small amount of local anesthetic is injected into the skin of the scrotum before the incision is made. This operation is usually performed in the physician's office.
Many times enlargement of the prostate does not pose a problem. If the size of the prostate is such that the outflow tract, the urethra, is compressed, however, there will be varying degrees of urinary symptoms, such as a decreased stream and decreased frequency and urgency of urination. For most of this century this condition was treated with surgery, a prostatectomy (removal of the prostate gland). Within the last several years, however, there are several medications that are extremely effective in minimizing voiding symptoms. These medications often preclude the need for surgery. Nevertheless, sometimes surgery is required and this is often done through the penis, an operation called transurethral resection of the prostate (TURP). Very often, after this operation, the man will experience a dry ejaculate. This happens because much of the seminal fluid comes from secretions of the prostate gland and during the TURP procedure, the gland is literally cored out so there is much less tissue to produce seminal fluid. In addition, the bladder neck region is resected and the seminal fluid that does enter the urethra will first enter the bladder in a retrograde fashion, rather than exiting directly through the penis. This will not interfere with the individual’s ability to obtain an erection or experience orgasm; however, it will generally render a man sterile.
Pregnancies may be achieved through retrieval of sperm sequestered in the bladder following intercourse. Erectile dysfunction or impotence is very rare following transurethral surgery of the prostate and is more common following radical removal of the prostate, which is reserved for cancer of the prostate. Recent surgical techniques, however, have allowed the preservation of potency in 60 to 70 percent of the cases undergoing radical prostatectomy.
Prostatitis is an inflammatory condition of the prostate that can be caused by bacteria and nonbacterial agents. Often this will cause a temporary decrease in sex drive and in erectile ability. The bacterial prostatitis may require several months of antibiotic therapy to eradicate. Symptoms include low back pain, pelvic pressure, urethral discharge, and diminished libido (sexual desire). The prostate is tense and very tender, and often the male feels like he’s “sitting on a hot potato.” Conservative treatment measures are appropriate, consisting of antibiotics, very hot Sitz baths, and more frequent intercourse in an attempt to milk the prostate gland. Passive congestion of the prostate due to a buildup of seminal fluid because of prolonged intervals between emissions can produce prostatitis and its associated symptoms.
Prostate cancer generally has no symptoms and is discovered during the course of a digital-rectal examination and/or a peripheral blood sample that shows an elevation in prostate-specific antigen (PSA).
The condition called hematospermia, which is blood in the semen, is generally a benign condition due to small calcifications occurring in the prostate gland and generally is not the harbinger of anything serious.
Posted in Understanding the Basics
To Ed Wheat Sr. and Gladys Gibson Wheat, whose commitment, devotion, warmth, generosity, and integrity stood for fifty years as a beautiful picture of genuine agape love.