Benign prostatic hyperplasia
Overview of benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH) is a condition in which the prostate gland begins to enlarge gradually causing difficulty in urination. The prostate gland is found between the bladder and urethra. Prostate glands tend to enlarge during the middle age in adults and this is especially noted in individuals above the age of 50 years. Increase in the size of these prostate glands can compress the urethra leading to reduced flow and force of urine.
The terms ’benign’ refers to the enlargement of glands which is not caused by cancer or infection and ‘hyperplasia’ refers to enlargement.1 Treatment include watchful waiting, lifestyle modification, medication and surgery. Complication leads to inability to urinate and urinary infection. Prolong urinary obstruction also leads to kidney damage in certain cases.2
What are the signs and symptoms of benign prostatic hyperplasia
Occurrence is common in men at the age above 50 years.
Common signs such as
- Slow urine flow
- Difficulty in starting urination is observed
- Dribbling at the end of urine
- Increased urine frequency at night and urgency to urinate occurs
- Unable to empty the urinary bladder
Blood is also observed in urine which may indicate urinary tract infection.3
What are causes for benign prostatic hyperplasia
Causes are not clear but studies show that it may be due to changes induced by hormones, especially testosterone.
Testicles play a vital role in the growth of the gland and abnormalities in the functioning of these organs can lead to increased growth of the prostate. Disease relies on the aging factor also. 2
Risk factors include
Aging; wherein men who are above 60 are more likely to suffer from BPH. Heredity factors increase the odds of developing this condition. Prostate enlargement is commonly more in whites and black than in Asian men.
How is of benign prostatic hyperplasia diagnosised?
Rectal examination is carried out to confirm the prostate enlargement. Digital rectal exam is generally carried out, wherein the doctor inserts a gloved and lubricated finger into the rectum to feel for enlargement of the prostate gland.
Additional tests are advised if the diagnosis is not confirmed by this test and also to rule out the presence of other conditions such as infections or cancer.
Urine sample is examined if blood is present in the urine or if any infection is suspected.
prostate-specific antigen (PSA) test
A specialized blood test known as prostate-specific antigen (PSA) may also be advised to confirm the presence of prostate enlargement and also to screen for prostate cancer. Elevation of PSA levels is seen in men who have enlarged prostate.
Uroflowmetry is another test that is carried out to measure the volume and rate of urine flow. Additional tests such as urodynamic pressure-flow studies to measure the pressure of the bladder may be advised in certain instances.
Ultrasound examination of the prostate may be advised to evaluate bladder emptying and also to grade the severity of the enlargement.
Cystoscopy wherein a thin tube with a lens is inserted into the urethra is sometimes advised. This procedure allows the physician to see inside the urethra and bladder and confirm its compression.
Intravenous pyelogram or CT urogram is carried out by taking X-ray images of the bladder and the urethra; these images show the obstruction and the other abnormalities.3, 4
What is the treatment for benign prostatic hyperplasia
Choice of the treatment depends upon the severity of the symptoms and the presence of other complications.
Self care measures include certain practices such as urinating as soon as you feel the urge. Alcohol and caffeine should be avoided after dinner. Fluids should be avoided 2 hours before going to bed. Fluids should not be drunk all at once. Lack of physical activity and exercise worsen the symptoms, hence physical activity is advised.
Over the counter drugs for cold that contain decongestants should be avoided as it increases the symptoms. Stress, nervousness and tension should be avoided as it may lead to frequent urination. Pelvic strengthening exercise is recommended.
When the home care measures fail to relieve the symptoms, medications are advised.
Surgery is done in severe cases, especially in case of urinary tract infections, bladder stone, kidney infections, recurrent blood in the urine. Depending upon the severity, the type of surgery is selected.
Transurethral resection of the prostate which involves removing the prostate piece by piece through a small tube inserted into the penis is the most common surgical treatment. Transurethral incision of the prostate is sometimes done to enlarge the opening of urethra and bladder outlet.
Simple prostatectomy is conducted to remove the inner layer of the prostate gland.
Several invasive procedures are also conducted to destroy the prostate tissue by heat.
Below are the some of the methods carried out.2
- Water induced thermotherapy (WIT)
- transurethral needle ablation (TUNA)
- transurethral electrovaporization (TUVP)
- interstitial laser coagulation (ILC)
- holmium laser enucleation of the prostate (HoLEP)
- transurethral microwave thermotherapy (TUMT)
Complications for benign prostatic hyperplasia
Untreated cases can lead to a sudden inability to urinate.
Individuals may develop urinary tract infections due to the blockage which can further lead to kidney damage. Urinary stones may form due to the blockage and blood may be noted in the urine.2
1. Family Doctor.org. Benign Prostatic Hyperplasia. [updated: December 3006; cited: November2009].Available at: http://familydoctor.org/online/famdocen/home/men/prostate/148.html.
2.Medline Plus. Enlarged prostate.[updated: October 2009;cited: November 2009].Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm
3.Mayoclinic.com. Prostate gland enlargement.[updated: December 2007;cited:November 2009]Available at: .http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027
4.The Merck Manual Online Medical Library. Benign Prostatic Hyperplasia (BPH). [updated: October 2008; cited: November 2009]. Available at : http://www.merck.com/mmhe/sec21/ch239/ch239b.html
Written by: healthplus24.com team
Date last updated: December 23, 2014