TAKE YOUR ENLARGED PROSTATE FOR A STROLL THAT MAY KEEP IT IN SHAPE

There seems to be a very simple activity men can engage in to reduce their risk of discomfort later in life: walking!

Research shows that 2 to 3 hours of walking a week may reduce by 25 per cent a man’s risk of developing common prostate problems. The longer a man lives, the more likely he is to develop these problems. As the years pass, hair thins, muscle wastes and his prostate grows plump with age.

A prostate in a healthy 20-year-old man is the size and shape of a walnut and weighs around 10 grams. A seriously enlarged prostate in a 60-year-old man can be the size of a lemon and weigh 40 grams.

Some men live happily with an enlarged prostate and are never inconvenienced, some bear the discomfort stoically and some find the condition intolerable.

The way a man reacts depends on the extent to which the enlarged prostate interferes with the flow of urine. The lube that carries urine from the bladder to the outside world passes through the centre of the prostate. As the prostate grows, it can constrict the tube with its increased mass, its increased muscle tone or both.

Researchers say that, while it cannot reduce the mass of the prostate, walking can help to reduce its muscle tone. The smooth muscles of the prostate are controlled by the sympathetic nervous system, which regulates the body’s involuntary functions.

The researchers suggest that there is a mechanism by which physical activity causes the sympathetic nervous system to reduce prostatic muscle tone. They base their findings on the experiences of 30 000 men aged between 40 and 75 who are part of an ongoing US prospective study called the Health Professionals Follow-Up Study.

The findings show that those men who are more physically active have fewer symptoms. Inactivity, gauged by the number of hours spent watching television and videos, is associated with more symptoms. While the study shows activity is good for all ages, younger men appear to derive more benefit from high-intensity exercise than from walking.

The prostate has been described as a time bomb ticking away deep in the plumbing of every male. Three main things can go wrong with it: it can become inflamed due to infection, it can become cancerous or it can become enlarged and obstruct the flow of urine. The latter is the most common prostate complaint.

Symptoms caused by enlargement often begin appearing when a man is in his 40s. By the age of 60, most men will have developed some signs of it. Common symptoms include difficulty starting to urinate, a weak urine flow, a urine flow that stops and starts midstream, the need to strain in order to urinate, dribbling, incontinence and water retention.

If the bladder muscles have to work harder to overcome constriction of the urethra, other symptoms may arise, such as discomfort when urinating, urgency, frequency, a need to get up at night to urinate and a feeling of not having emptied the bladder fully.

Drugs that help relax prostate muscle are available in Australia. There is also a drug that can reduce prostate size.

Some say the US research may have been compromised by the placebo effect. (Other studies have shown a placebo response of almost 30 per cent to any treatment for urinary symptoms.) There is also a natural fluctuation in symptoms such as those outlined earlier, and this must be taken into account when considering the effectiveness of treatment.

Many men recover spontaneously. They may, for example, go through a period of dribbling and having to get up at night but find, 3 months later, that their symptoms have resolved themselves without their having taken any action whatsoever.

Perhaps those in the American study who undertook exercise felt better about themselves and this made their prostate symptoms seem less distressing. Perhaps the ones sitting and watching television drank more glasses of beer or cups of tea and as a result had to rush to the toilet more often. There are many possible explanations.

But even if the science is not perfect, it is slill worth doing the walking. Walking confers innumerable other health benefits and, if practised safely and by consenting adults, causes little harm.

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