Prostate diseases generally fall into three categories: infectious, malignant,
and hypertrophy. The first two categories are dealt with under the chapter
on Immunity. This discussion will focus on benign prostatic hypertrophy.
Benign Prostatic Hypertrophy
Benign adenomatous hyperplasia of the periurethral prostrate
gland commonly seen in men over age 50, causing variable degrees of bladder
outlet obstruction.
The prostate gland is present in all men from birth, and assumes importance
when fertility is achieved. It produces the fluid which accompanies the
sperm during ejaculation. Located deep within the pelvis, it sits on top
of the urethra, the tube connection the penis to the bladder. As it achieves
adult size, the prostate wraps itself around the urethra, into which its
secretions empty. The gland is normally about the size of a chestnut, but
because of its location, if it becomes inflamed or enlarged, it may exert
pressure on the urethra, or block the outlet to the bladder, so obstructing
the flow of urine. This can cause interrupted or difficult urination (dribbling
incontinence), urgent or frequent urination, especially at night. There
may also be dysuria. Urine trapped in the bladder may become infected and
cause cystitis, and backward pressure can lead to kidney infection.
Congestion and overgrowth of the prostate gland is virtually universal in
men over the age of 60. Why this happens is not understood, but theories
suggest hormonal responses of glandular cells as androgen and other hormone
levels vary with age. This does not cause problems for many older men, although
the others who are not so lucky take little consolation in that fact!
As the swelling progresses, flow through the urethra decreases, and the
bladder grows thicker and stronger to compensate for the increased resistance
it has to overcome. Eventually, the bladder is no longer able to overcome
such forces completely, and emptying becomes incomplete; urine thus stagnates
in the bladder. If the obstruction becomes severe, pressure backs up to
the kidneys causing damage. When the bladder is unable to empty itself of
all its contents, the occasional bacteria present in the urinary tract are
able to multiply, and urinary infection occurs. This in turn can worsen
the swelling already present in the prostate.
The earliest symptoms are usually urinary hesitancy, weakening of the urinary
stream and incomplete emptying with urination. Dribbling of urine may occur.
If infection sets in, burning, blood, and fever may occur. In the severest
cases total inability to urinate occurs, sometimes with massive enlargement
of the bladder.
A small number of enlarged or inflamed prostates may be cancerous. This
fact underlies the need for a proper medical investigation.
One possible prescription for Benign Prostatic Hypertrophy: Internal medications
Serenoa serrulata 2 parts
Hydrangea 2 parts
Smilax 1 part
Turnera diffusa 1 part
Zea mays 1 part
Arctostaphylos uva-ursi 1 part to 5 ml of tincture taken three times
a day
One possible prescription for Benign Prostatic Hypertrophy: Strong infusion
for Sitz Bath
Equisetum arvense
Agropyron repens
Arctostaphylos uva-ursi Equal parts of dried herb
Use 2 oz of the mixture to each 1 pt of water.
Broader Context of Treatment:
If the symptoms are not markedly impairing the patient's life-style, and
if recurrent, serious, or resistant infections or kidney damage are not
present conservative therapy may be adequate for long periods of time. This
consists of:
- treat any infection
- occasional massage of the gland through a rectal exam to relieve excessive
congestion
- frequent ejaculations on the patient's part for the same purpose.
- avoid drugs which reduce bladder tone. These include antidepressants,
certain tranquilizers and antihistamines.