The ‘unspoken’ health problem afflicting millions of men

It’s that time of year when men leave their mo to grow in the name of men’s health. And while prostate cancer is a big focus of Movember, there’s another prostate condition that has a significant impact on men’s lives.

Like scores of Australian men, rushing to the toilet throughout the night began to take a toll on Peter Tornaros.

Not only did he become tired and irritable, but the hourly calls of nature began affecting his marriage.

“My constant visits to the toilet also disturbed my wife’s sleep and as a result we were grumpy and argued more,” recalls Peter, from Wollongong.

“Beyond that, it had a real impact on my mood. I was down and didn’t want to meet up with friends and family, I became very insular.”

Too embarrassed to go to the doctor, he wrote it off as a sign of ageing.

But Peter was suffering benign prostatic hyperplasia (BPH), or enlarged prostate, a little-talked-about but common urological disease affecting half of men by the age of 50.

While prostate cancer is a big focus of Men’s Health Awareness Month – as evidenced by the emergence of wild and woolly moustaches for Movember – this year experts also want to help men better understand BPH, and how they can get help.

What is enlarged prostate and what are the symptoms?

Benign prostatic hyperplasia, or enlarged prostate, is the non-cancerous growth of the prostate gland.

By the age of 80, about 80 per cent of men will suffer it.

The biggest symptoms are:

  • A frequent, urgent need to urinate;
  • Difficulties starting urination;
  • An inability to empty the bladder.

It can also cause bladder, urinary tract or kidney problems.

I was down and didn’t want to meet up with friends and family, I became very insular.

What causes enlarged prostate?

As the prostate expands, it puts pressure on the urethra, the tube that transports urine out of the penis.

“The prostate grows as men age. The cause of BPH is not entirely clear, but it’s believed to be due to a change in the balance of male and female hormones,” says Dr Jon Emery, Professor of Primary Care Cancer Research at University of Melbourne’s Department of General Practice.

“As men get older, their male hormone levels start to fall.”

He says symptoms may be indicative of other issues and advises visiting a GP for evaluation.

The GPA may recommend at PSA (prostate specific antigen) blood test, which also screens for prostate cancer.

How is enlarged prostate treated?

The severity of the condition varies in men and treatment can range from behavioural changes to medication and surgery.

Dr Emery says simple measures include abstaining from diuretics like alcohol, coffee and tea at night, and taking regular toilet breaks to ward off feelings of urgency.

Dr Peter Chin, a urologist at Wollongong’s Graduate School of Medicine, says medication can come with side effects, while the risks of surgery to remove part of the prostate tissue include catherisation, sexual dysfunction and an extended recovery.

“Unfortunately for many men who have seen a doctor, the BPH treatments provide insufficient relief or bothersome side effects, making the symptoms sometimes more appealing to live with than the treatment options,” he says.

“Men often wait until the last minute to do something and by that time there are a lot of changes to the bladder that can’t be changed.”

Dr Chin performs a minimally invasive day procedure called a prostatic urethral lift, where the prostate is pulled away from the bladder using implants to help the urine flow more freely.

Written by Elissa Doherty