By way of anatomy, the
urethra
pierces thru the prostate after leaving the bladder before traversing
the penile shaft. Aging enlarges the prostate causing it to press
against the urethral segment passing thru it and making it harder to
urinate. Symptoms are divided into Irritative and Obstructive.
Irritative symptoms include urgency, and frequency . Obstructive
symptoms include slow stream, pressure above the pubis and night time
urination. Patients with enlarged prostate often have both irritative
and obstructive symptoms. The most useful symptom is night time
urination due to its impact on the sleep and general wellbeing of the
patient. Initial therapy consists of an Alpha Blocker which causes
dilatation of the urethra, and 5-Alpha Reductase inhibitor which causes
reduction in the size of the prostate. Using an Alpha Blocker alone
will lead to rapid improvement of symptoms but the unabated growth of
the prostate will eventually overcome the effectiveness of the Alpha
Blocker. This is the reason to also treat with prostate size reducing
agent 5-Alpha Reductase Inhibitor. Alpha blockers can interact with
Erectile Drugs causing heart problems. 5-Alpha Reductase Inhibitors
cause a lowering of the PSA ( Prostate Specific Antigen ) leading to
delayed diagnosis of prostate Cancer. Please see the newsletter titled
