Men, usually elderly, with diseases of prostate may suddenly be unable to urinate at all. This condition is known as acute urinary retention (AUR). So, relief should be prompt, so that the urine doesn't continue to accumulate, stretch the bladder, and perhaps even back up into the kidneys, causing them to fail. AUR is usually treated by carefully inserting a tube, called a catheter, through the penis or directly through the belly using a large needle. There it will remain until the natural passage can be opened up, usually by surgery.

What is the prostate gland and how does it function?

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The prostate is a gland about the size of a walnut that is situated below the urinary bladder and in front of the rectum. The urethra (a long tube that carries urine out of the body) passes through the prostate. The prostate gland produces a fluid that serves as the vehicle for sperm. Although there will be implications if the prostate gland is removed, it is not an essential organ and the body can function without it.

Are all prostate tumors cancerous?

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Several things never stop growing until they die --trees, reptiles, the hair in ears and the prostate. Between the ages of 20 and 45, the prostate gland doesn't grow much, but after that there's no stopping it. Symptoms of this continuing growth don't usually show up before age 60. At times, this tissue overgrowth is benign, meaning that the cells do not contain cancer. This prostate condition is called benign prostatic hypertrophy or BPH. Other times, abnormal cancerous cells characterize the overgrowth of tissue and this is referred to as a malignancy or cancer of the prostate.

How can a person know that he has benign prostatic hypertrophy or BPH?

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The main symptom of BPH is a decrease in the flow of urine. Other symptoms of BPH include: Hesitation in starting the urine flow Dribbling after emptying as much as a person can get out Feeling a great urgency to urinate (This is also a symptom of a urine infection) Urinating many times during the night (The medical term for this is- 'nocturia' and this can also be a symptom of heart failure) Feeling as if all the urine hasn't come out Rarely the prostate will grow in such a way as to impinge upon the rectum and cause constipation.

What are the traditional treatments of BPH?

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Medical treatments Proven medicinal treatments for BPH are alpha-adrenergic blockers or alpha-blockers and finasteride. Alpha-blockers relax the muscles that hold the urine in, while at the same time strengthening the muscles that pump the urine out. They can improve the urine flow, but they don't slow down the prostate's growth. Finasteride is a drug that interferes with the body's manufacturing of male hormones. It has been shown to shrink the prostate by about 25% and to keep it shrunk for up to three years, if a person keeps taking it. Longer studies are not yet available. These studies also showed that finasteride reduced the need for prostate surgery by over half. Two percent of men have sexual problems when taking finasteride. Surgery There are two surgical approaches for treating BPH - from the inside (through the penis) and from the outside. Transurethral resection of the prostate (TURP). The most common and easiest route for prostate surgery for both the surgeon and the patient is through the penis. Because the urine tube from the bladder to the outside world is called a urethra, this procedure is known as a transurethral resection of the prostate or TURP. TURP is simple and safe enough that it can often be done in an outpatient setting. After numbing, the urologist will insert a thin, rigid metal instrument called a cystoscope into the penis. This instrument is both a telescope and a cutting tool. Looking through it, the doctor can see the inside of the urethra, the prostate and the bladder. He will look for tumors and other abnormalities before beginning to cut away the prostate from the inside, a process that can be likened to coring an apple. After the procedure a catheter will remain in place until healing is under way. The main complication from a TURP is that many men during orgasm will find their semen going back into the bladder instead of coming out the way it used to. This is called retrograde ejaculation. A few men have impotence or an inability to hold their urine (incontinence) after prostate surgery. Approaching the prostate from the outside is conventional surgery through an incision somewhere in the skin. Only very large benign prostates, cancerous ones and a few other special conditions require this approach. There are several ways to get at it; but the surgeon's choice which one he uses is much pretty. This requires hospitalization and carries a higher risk of complications, including impotence and incontinence.

Who is at risk for developing prostate cancer?

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Researchers still do not know what causes prostate cancer. They have, however, been able to identify risk factors that have consistently been associated with prostate cancer. The role that some of the identified risk factors play in the development of prostate cancer is less clear, because research studies have provided conflicting results in some areas. Age: After age 50, the chance of developing prostate cancer begins to increase. Over 80% of all prostate cancers occur in men 65 years and older. Race: Prostate cancer is twice as prevalent among African-American males as it is among their Caucasian-American counterparts. Ethnicity: Prostate cancer is most common in North America and northwestern Europe. It occurs less frequently in Asia, Africa, Central America, and South America. Diet: The results of most studies show that men who eat a high fat diet have an increased chance of developing prostate cancer. Some research has shown that men who eat higher fat diets tend to eat less fruits and vegetables and more dairy products. These factors may also play a part in the development of prostate cancer. Recent studies have shown that a diet high in lycopenes (found in higher levels in fruits and vegetables) and selenium, may lower the risk of developing prostate cancer. Exercise: Maintaining a healthy weight along with regular physical activity may reduce the risk of prostate cancer. Family history: Prostate cancer appears to have a genetic link. Having a father or brother with the disease doubles a man's risk of developing it. The risk gets even higher if several relatives have been affected, especially if they were young at the time of diagnosis. The recent discovery of the HPC1 gene will soon give more information about the inherited risk of prostate cancer. Vasectomy: Men who have undergone vasectomy (a surgical procedure that renders them sterile) may have an increased risk of getting prostate cancer, according to some studies. Findings in this area have been inconsistent; while some studies have shown an increased risk after vasectomy, others have not.

What is the best way to screen for prostate cancer?

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Prostate cancer screening recommendations vary widely. Some organizations believe that prostate cancer screening has not been proven to reduce the number of overall deaths attributed to the disease. Other organizations, like the American Cancer Society and the American Urological Association, believe that the majority of evidence supports the view that prostate cancer screening can save lives. Digital rectal examination (DRE) A digital rectal examination can be performed to screen for prostate cancer as part of an annual physical examination in men age 50 or above (and in younger men who are at increased risk). During this test, a doctor inserts a gloved and lubricated finger into the rectum to feel for any abnormally firm or irregularly shaped area of the prostate that might be cancer. The prostate gland is located near the rectum and many prostate tumors begin in an area that can be felt on rectal examination. While the rectal examination may be a bit unpleasant, it can be performed quickly. Prostate specific antigen (PSA) test The PSA test is a blood test, which measures a protein that is manufactured by prostate cells. The American Cancer Society recommends that this test be offered each year to men 50 and older with a life expectancy of at least 10 years, and to younger men with higher prostate cancer risk. The PSA test results are reported as nanograms per milliliter or ng/ml. Results under 4 ng/ml are usually considered normal. Results above 10 ng/ml are high and values between 4 and 10 are considered borderline. The greater the PSA level, the greater the chance that prostate cancer exists. It is important to realize that the PSA is a screening tool and not a diagnostic indicator for prostate cancer; PSA is used to estimate the likelihood of prostate cancer. The level can be elevated in benign conditions of the prostate and at times it may appear normal when prostate cancer is present. PSA levels are also useful in monitoring men who have had prostate cancer. Often a rising PSA level can provide an early warning sign that the prostate cancer is returning and early intervention can then be instituted. Transrectal ultrasound Transrectal ultrasound (TRUS) may be suggested if the digital rectal exam or PSA levels are abnormal. The test involves the insertion of a probe into the rectum. Pictures are then recorded using sound waves that create an image of the prostate gland. During the TRUS, a biopsy may be obtained if a suspicious area of the prostate is identified. The test is generally performed in a doctor's office or outpatient setting. It usually takes less than 30 minutes to perform.

How is the diagnosis of prostate cancer confirmed?

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Since most early cases of prostate cancer produce no symptoms, it may first be suspected after one of the screening tools is implemented. Other signs may include difficulty in starting or maintaining a flow of urine, increase in the urge to urinate, or blood in the urine. Symptoms of advanced prostate cancer can include pain in the pelvis, hips, spine or ribs, weight loss, weakness, and swelling of the lymph nodes in the groin. Once the suspicion of prostate cancer exists, a biopsy will be needed to confirm the diagnosis and plan the best course of treatment. A biopsy can be performed via the TRUS, whereby a selection of tissue is removed from several areas of the prostate gland to get an adequate sampling and determine how invasive the disease has become. The biopsy can be performed in a doctor's office or outpatient setting. After a biopsy is obtained, the tissue is sent to a laboratory and examined by a pathologist. A report will be available in about 1 week. If the biopsy is positive, meaning that cancer cells have been identified, a grading system will be used to estimate the aggressiveness of the tumor cells and the likelihood that the cancer will proliferate. If the biopsy report indicates the presence of cancer, additional testing will be needed to find out if the disease has spread beyond the prostate gland to surrounding organs. This is referred to as staging. The stage of cancer is the most important factor in determining treatment options. Tests that may be necessary to determine the stage of prostate cancer include a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, bone scan, and lymph node biopsy.

How often a person will need to visit a doctor will depend on various factors such as how close to normal the blood glucose levels are, what symptoms a person may be experiencing, what other health conditions are being treated for, and how comfortable the person is with current treatment plan for managing diabetes. The American Diabetes Association recommends that all patients with type 2 diabetes should visit their doctor at least 2 to 4 times per year. If the patient is newly diagnosed or experiencing symptoms he/she may need to visit the doctor more often. During each doctor visit the patient should be prepared to discuss about blood glucose readings. The doctor will record the weight and blood pressure at each visit. As part of routine physical examination the doctor will also check the eyes and feet to screen for diabetic complications. An annual examination by an eye doctor is also recommended. Several blood tests to check cholesterol, lipids, and glycosylated hemoglobin (a blood test that gives information about how well controlled the blood sugars have been during the last 2 to 3 months) may also be done. A urine test should also be performed to check for protein. During each office visit, the patient should have an opportunity to review treatment plan and set goals together with physician. It should be remembered that diabetes management is a joint effort that will only produce good results when both the patient and doctor work together cooperatively.

The commonest manifestation is an itchy rash that develops over a few days, after skin contact with a substance. The affected area first becomes itchy, then red and swollen with vesicles (water bubbles). Although usually confined to the area of contact, sometimes strikingly so the rash can spread to other parts of the body. occasionally the rash is more chronic, manifesting as an itchy patch that does not heal for weeks or even months. This usually occurs when there is frequent contact with the substance e.g. a watch strap. The rash resulting from contact allergy is called allergic contact dermatitis.

A substance that can cause contact allergy is called a contact allergen. Common contact allergens are: metals e.g. nickel in watch straps, chrome in cement skin care products e.g. fragrances, lanolin medication e.g. flavine, neomycin. A skin test called a patch test is used to confirm contact allergy. The upper back is used as a test site. A small amount of the suspected contact allergen (diluted to a non-irritant concentration) is applied onto the skin in an aluminium chamber and sealed with hypoallergenic tape. Usually, several suspected allergens are tested simultaneously. They are left on the skin for 48 hours and read at 48 and 96 hours. A positive reaction indicates that he patient is allergic to the test substance. This is a very safe procedure.

Very often it is. An example of the need for a patch test is when a skin rash has persisted for a long time. Many skin care products and medication would have been tried. It is necessary to identify the cause of contact allergy. A patch test will help to ascertain the cause. Another situation whereby a patch test is important is when a dermatitis is suspected to be due to work. There are many substances in the workplace that may cause contact allergy.

In many cases, removing the cause i.e. the allergen from skin contact will result in a cure. Usually, once allergy to a substance has developed, it remains for life. That is to say, future contact with the substance will result in an allergic contact dermatitis again. This is exactly like a drug allergy. It is advisable for patients to carry a card to remind themselves and their doctors of their contact allergy.