Whitesburg KY

Try medicines first for enlarged prostate



DEAR DR. DONOHUE: I have to trot to the bathroom many times during the day and many more times at night. Is this due to my prostate gland? I’m 74 and wasn’t bothered by bathroom visits a year ago. Does this mean surgery for me? How do I know if this is prostate cancer? — R.R.

ANSWER: Odds are you have benign prostatic hyperplasia, the official name for a large prostate gland. In their 40s, a quarter of males have a gland that’s larger than normal. In their 70s, 80 percent of men have an enlarged gland. Not all these men have symptoms like repeated trips to the bathroom, a hard time starting the urinary stream and a decrease in the force of the stream.

The prostate gland lies directly below the urinary bladder, and the bladder’s drainage tube, the urethra, runs through the gland. A large gland presses on the bladder and obstructs the urethra. That’s why many men with a large gland have to run to the bathroom so often — they cannot completely empty their bladder.

You don’t have to jump to surgery right off the bat. Medicines often solve the problem. One class of medicines stops the forceful bladder contractions that signal an urgent need to void. Uroxatral, Flomax and Rapaflo are examples of this drug family. Their effect is seen within a week. Another family of drugs shrinks the gland. Avodart and Proscar are two such medicines. Their effect isn’t seen for up to six months. Combining both classes of drug is another method of treatment.

If medicine therapy fails, a variety of surgical procedures can remedy the problem.

You don’t know if an enlarged gland has cancer cells in it. The PSA blood test, flawed as it is, provides some evidence for cancer. Biopsy of the gland is the ultimate cancer test. A urologist will solve this problem for you.


DEAR DR. DONOHUE: My son is 43. When he was 20, he started getting lumps, which the doctors called lipomas. He has them on his whole body in varying sizes, except for on his face. No one else in the family has them. What can be done besides cutting them out? — M.F.

ANSWER: Lipomas are mounds of fat encased in a tough covering material. They range in size from a golf ball to two or three times that size. They’re soft, and they are not painful.

Surgical removal, at present, provides the best results. If your son has too many for total removal, a select few, the most bothersome ones, can be excised.

©2013 North America Synd.

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