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Prostate Problem Guide
Should I Have Prostate Surgery?
For a few men the arrival of middle age brings with it increasing urinary difficulty caused by an enlargement of the prostate gland. Instances of urinary difficulty increase with age so that by the time that most men reach retirement there's a better than 50/50 change they'll be experiencing difficulties and, if they're lucky enough to reach the age of 80, then they'll almost certainly run into difficulty as prostate problems affect about 90% of the male population by this age.
While enlargement of the prostate is extremely common it is also a benign condition that is confined to the prostate gland and for many men it will develop very slowly over a period of years. There are a variety of symptoms, almost all associated with problems in passing water, and these can range from the quite mild which are really not too bothersome and which you can certainly live with as just another sign of the ageing process, to more severe symptoms which are sufficiently annoying to warrant treatment.
In addition to the common problem of an enlarged prostate, which will affect almost all men at some point, a significant number of men will also develop prostate cancer which, while it starts life in the prostate gland, can eventually spread throughout the body and is an extremely dangerous condition and the second most common form of cancer death in the United States today.
An enlarged prostate and prostate cancer are two quite separate conditions and, despite what you may have heard, an enlarged prostate does not cause prostate cancer. The two conditions can however exist side-by-side and one problem with prostate cancer is that the symptoms of an enlarged prostate can mask the presence of a growing cancer.
The first step therefore is to call in and see your doctor as soon as you start to experience any sort of problems passing water and get him to establish the root of the problem.
If you consult your doctor at the first sign of trouble and he diagnoses prostate cancer then it is very likely to be at early stage of development and confined to the prostate gland, in which case your doctor will almost certainly suggest prostate surgery. In this particular case, unless there is a very good reason why you should not have surgery (such as the presence of other medical conditions that you place you at risk from surgery) then the answer to whether or not you should have prostate surgery is invariably going to be "yes".
CYPROTERONE: an anti-androgen with progestational activity.
HISTOLOGY: the study of the appearance and behavior of tissue, usually carried out under a microscope by a pathologist (who is aphysician) or a histologist (who is not necessarily a physician).
OSTEOCLAST: cell that breaks down bone; osteoclasts are in bone tissue and resorb bone leading to bone loss or osteopenia or osteoporosis.
SPECIFICITY: the probability that a diagnostic test can correctly identify the absence of a particular disease assuming the proper conduct ofthe test; specifically, the number of true negative results divided by thesum of the true negative results and the false positive results; a methodthat detects 95% of true prostate cancera cases is highly sensitive, but if it also falsely indicates that 40% of those who do not have prostate cancera do have prostate cancera thenits specificity is 60%, rather poor
There can be no question that the best way to deal with cancer is to remove it altogether and, when it is confined to the prostate gland, the easiest and best way to do that is to have it surgically removed.
If, however, your doctor diagnoses nothing more than an enlarged prostate the question of whether or not you should have surgery become a bit more complicated and you will need to discuss your options with your doctor.
There are a range of treatments available for an enlarged prostate including drug therapy and non-surgical treatments, as well as several different surgical treatments and each has its own advantages, disadvantage and risks.
The major difference in the case of an enlarged prostate is that the vast majority of treatments are not designed to cure the problem but are aimed at reducing symptoms so that it does not unduly interfere with your quality of life.
The question of whether or not you should have prostate surgery is very much dependent upon the cause of your problems. If you have prostate cancer and prostate surgery is the recommended option then, unless there is a good reason for deciding otherwise, you should almost certainly accept your doctor's recommendation. If, however, prostate surgery is being considered for an enlarged prostate, then there will be a range of other options open to you and you will need to make a very personal decision, in consultation with your doctor, about whether or not prostate surgery is the choice you feel would be most appropriate.
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