What you can do for this common aging-male condition
As they age, many men may experience unusual and unwelcome changes in the part of their reproductive system known as the prostate gland.
Sometimes, they suddenly and urgently need to urinate—often many times a night. Other times, they may have trouble starting to urinate or only produce a dribble rather than a normal stream. Even worse, sometimes a loss of bladder control means urinary incontinence—urinating before making it to a toilet in time.
Signs of the Condition
When Dr. Manhar Gandhi was in his mid-60s, he had some of these common symptoms of an enlarged prostate. A Memphis, Tenn., pediatrician for the past 38 years, Dr. Gandhi knew he needed help.
"A couple of years ago, I began having trouble with an increase in the frequency of my need to urinate. Especially during the night," he says. "At the same time, the stream of urine was low—a dribble. I realized from these symptoms that I was not able to empty my bladder completely when I urinated."
His primary care physician had been following these symptoms, as well as the results of annual PSA tests. PSA (prostate-specific antigen) is a protein produced by cells in the prostate. Dr. Gandhi's PSA results had been up and down. This suggested that all was not right with his prostate.
Seeing a Specialist
It was time to bring in a urologist—a doctor who specializes in urinary tract and male reproductive system conditions. A biopsy of tissue from the prostate ruled out cancer. Dr. Gandhi's physician diagnosed the condition as a non-cancerous enlarged prostate, or benign prostatic hyperplasia (BPH).
Dr. Gandhi was prepared. One of his best friends is a urologist, as is his son, who practices in Virginia.
Dr. Gandhi started taking Flomax (tamsulosin), an often-prescribed medication that relaxes the muscles in the prostate, making it easier to urinate.
But Dr. Gandhi's symptoms worsened. He experienced complete urinary blockage and multiple trips to the emergency room to use a catheter to release the trapped urine.
- The prostate is a walnut-shaped gland that is part of the male reproductive system.
- Benign prostatic hyperplasia—also called BPH—is a condition in which the prostate gland is enlarged and not cancerous.
- BPH is the most common prostate problem for men older than age 50.
- As many as 14 million men have BPH.
- Lower urinary tract symptoms associated with benign prostatic hyperplasia may include frequent and urgent urination, trouble starting a urine stream, urinary incontinence, and other symptoms.
After considering another medication, both urologists agreed it was time for TURP—a minimally invasive surgery used to remove the inside part of the prostate and allow a restored free flow of urine. Carried out in early October 2016, the TURP surgery has so far been effective for Dr. Gandhi.
"I already have a strong flow during urination," he says. "I can feel that I am able to empty the whole bladder. Now, I'm fine."
"Every man should go to his primary care provider once a year to be checked," Dr. Gandhi says. "And, if called for, go to a urologist. Don't put it off."