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Benign Prostatic Hypertrophy

If you are a man who finds it difficult to start your stream, check with your doctor to see if you have an infection or a benign or cancerous enlargement of your prostate.

Your doctor usually examines your prostate for potentially cancerous nodules, orders a PSA blood test and checks your urine for infection. If your doctor finds a nodule, he usually orders an ultrasound test and then cuts out small pieces of the nodules which are then analyzed for cancer. If he finds no cancer, he must check you for infection or benign prostate enlargement. It is so unusual to find bacteria in a man's urine, that it requires further tests to check your entire urinary system. PSA or Prostate Specific Antigen is made by prostate cells and released into the bloodstream. The larger your prostate, the more cells you have to release PSA into your bloodstream. Therefore, PSA is a measure of the size of the prostate gland, rather than just prostate cancer.

A sudden rise in PSA means that the gland is enlarging rapidly which can be a sign of cancer, but it also can mean infection or benign enlargement. If you have an elevated PSA, burning on urination, feeling that you have to urinate all the time and terrible discomfort when your bladder is full, the odds are overwhelming that you have an infection, that can be very difficult to cure. Your doctor then massages your prostate to express semen and looks at it under a microscope. If it is loaded with white blood cells, you probably have an infection and should be treated with antibiotics for at least a month or even much longer. Your doctor can order a semen culture and treat the germ that grows. However, a negative culture does not rule out prostatitis. Frequent infections in men are mycoplasma, chlamydia and ureaplasma. Doctor do not have a dependable test for these bacteria, so they often treat you and your a sexual partner with a long acting erythromycin, a quinolone or a doxycycline antibiotic for several weeks. If you have an enlarged prostate that is neither infected nor cancerous, your doctor may prescribe Proscar which often does not reduce the prostate size adequately; or he may recommend freezing, burning or surgery which can make you impotent or incontinent.

One study shows that the prostate enlarges much faster in men with high blood insulin, high blood cholesterol, lower blood levels of the good HDL cholesterol, diabetes, high blood pressure, or obesity. All these conditions increase your risk for a heart attack. If future studies support this one, you can protect your prostate by eating a plant-based diet, restricting refined carbohydrates such as bakery products, pastas, sugar-added foods, and fruit juices, and checking to see if you have diabetes (1).

1) Hyperinsulinaemia as a risk factor for developing benign prostatic hyperplasia. European Urology, 2001, Vol 39, Iss 2, pp 151-158. J Hammarsten, B Hogstedt. Address Hammarsten J, Varberg Hosp, Dept Surg, Urol Sect, S-43281 Varberg, SWEDEN.

2) V Pansadoro, P Emiliozzi, L Defidio, P Scarpone, G Sabatini, A Brisciani, S Lauretti. Prostate-specific antigen and prostatitis in men under fifty. European Urology 30: 1 (1996):24-27.

Checked  8/4/16

August 19th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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