Today I thought I would talk about Prostate Disease, because with increasing longevity in our country, more men are living to that ripe old age when they are more likely to develop diseases of the prostate gland.

Lower urinary tract symptoms (commonly called LUTS) such as straining to pass urine, difficulty in initiating the passage of urine, a poor urinary stream, a frequent desire to pas urine, especially at night, could all be caused by enlergement of the Prostate gland. Incidentally, the correct spelling is PROSTATE – and not "prostrate" as some people pronounce the word.

Situated at the base of the bladder, where the bladder outlet opens into the urethra (the tube that passes through the penis to the outside), the gland tends to enlarge gradually as men get older - and by the time a man reaches his fifties, the enlarging gland has begun to compress the first part of the urethra.

The term Benign Prostatic Hypertrophy (BPH) is used to describe the condition - Benign indicating that the condition is NOT cancerous. BPH is quite common - research studies in many populations have shown that approximately forty percent of men over 60 suffer from BPH.

We now know that BPH is not necessarily progressive. Symptoms may stay the same, they may regress with medication - or even in some cases get better without any active treatment. Moreover, the impact of the symptoms varies - and in many cases, all that a doctor needs to do is to reassure the patient and review from time to time to monitor symptoms

What is important in deciding whether active treatment is indicated is the ‘Degree of Bother’ which the symptoms are causing the patient. If they are not troublesome enough to cause distress, most physicians would adopt a "wait and see’ policy today. Should symptoms deteriorate, medication in the form of 5? reductase inhibitors (finasteride, duasteride) or ? blockers (prazosin, terazosin) can be helpful. A few studies have shown that some men experiencing symptoms of BPH have had an improvement in their symptoms by using herbs for prostate health such as Saw palmetto extract or Soy products. Where medications tried over a period of time prove ineffective, surgery may be recommended. Although various modifications of the basic procedure of removing prostate tissue and "widening" the urinary channel are available, Transurethral resection of the prostate (TURP) - where the prostate is removed endoscopically via an instrument inserted under general anaesthesia through the penis - is still the most common procedure. TURP usually proves effective for most men.

The importance of understanding BPH is that it this type of prostatic enlargement is NOT caused by prostate cancer. It is a non-malignant condition, often requiring no active therapy - and even in the cases where treatment is indicated, medications or a simple surgical operation usually relieve the problem.

If you have access to the inernet, you can get some useful information at http://www.andrologyaustralia.org/pageContent.asp.

The response I received to my idea last week of starting to write health information articles again was most gratifying. For those who are interested in having a more permanent record of these health information articles but don’t want to cut up their Sunday Island to make a collection of newspaper cuttings, may I suggest getting on the internet and going to Suite 101, a Canadian internet magazine where some of my health articles can be found. Just type http://patient-health-education.suite101.com/article.cfm/understanding_high_blood_pressure, which web address will take you to the relevant articles.