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Overview | Treatment | Surgery | Precautions | After Surgery Care
Prostate Enlargement (BPH)
Prostate Enlargement (BPH)
OVERVIEW
Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To choose the best option, you and your urologist doctor will consider your symptoms, the size of your prostate, other health conditions you might have and your preferences.
Signs and Symptoms of Prostate Enlargement (BPH)
The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:
- Frequent or urgent need to urinate
- Increased frequency of urination at night (nocturia)
- Difficulty starting urination
- Weak urine stream or a stream that stops and starts
- Dribbling at the end of urination
- Inability to completely empty the bladder
Less common signs and symptoms include:
- Urinary tract infection
- Inability to urinate
- Blood in the urine
The size of your prostate doesn’t necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.
In some men, symptoms eventually stabilize and might even improve over time.
Factors that increase your risk of developing Prostate Enlargement (BPH)
BPH has been found to run in families, which means that if you have a family relative affected by the condition you are more likely to have it.
Age is another risk factor of BPH and one-third of men in between the ages 40 to 60 years may have moderate to mild symptoms. Around half the male population at the age of 80 and above has the symptoms of BPH.
Diseases including heart disease and diabetes may increase the risk of BPH.
Those having higher body mass index (BMI) or suffering from obesity are more exposed to the risk of BPH while those who exercise regularly have a reduced risk.
Diagnosis of Prostate Enlargement (BPH)
Your doctor will start by asking detailed questions about your symptoms and doing a physical exam. This initial exam is likely to include:
- Digital rectal exam.
- Urine test.
- Prostate-specific antigen (PSA) blood test.
PSA Test
The prostate-specific antigen (PSA) blood test, tests the level of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland. The PSA test can be done in a lab, hospital or health care provider’s office. There is no special preparation. Ejaculation can raise the PSA level for 24 to 48 hours. So the patient should not ejaculate for two days before a PSA test.
Very little PSA is found in the blood of a man with a healthy prostate. A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. One possible cause of a high PSA level is benign (non-cancer) enlargement of the prostate. Inflammation of the prostate, called prostatitis is one more common cause of high PSA levels.
DRE
The digital rectal examination (DRE) is done with the man bending over or lying curled on his side. The health care provider puts a lubricated gloved finger into the rectum. The health care provider will feel the prostate. They will be looking for abnormal shape or thickness in the prostate. The DRE can help your health care provider find prostate problems.
Treatment of (BPH)
A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. The best treatment choice for you depends on several factors, including:
- The size of your prostate
- Your age
- Your overall health
- The amount of discomfort or bother you are experiencing
If your symptoms are tolerable, you might decide to postpone treatment and simply monitor your symptoms. For some men, symptoms can ease without treatment
Medication
It is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include
- Alpha-blockers. These medications relax the bladder neck muscles and muscle fibres in the prostate, making urination easier. Alpha-blockers — which include alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax) and silodosin (Rapaflo) — usually work quickly in men with relatively small prostates. Side effects might include dizziness and a harmless condition in which semen goes back into the bladder instead of out the tip of the penis (retrograde ejaculation).
- 5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.
- Combination drug therapy. Your doctor might recommend taking an alpha-blocker and a 5-alpha reductase inhibitor at the same time if either medication alone isn’t effective.
Tadalafil (Cialis). Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement.
Minimally invasive or surgical therapy
Minimally invasive or surgical therapy might be recommended if:
- Your symptoms are moderate to severe
- Medication hasn’t relieved your symptoms
- You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems
- You prefer definitive treatment
Minimally invasive or surgical therapy might not be an option if you have:
- An untreated urinary tract infection
- Urethral stricture disease
- A history of prostate radiation therapy or urinary tract surgery
- A neurological disorder, such as Parkinson’s disease or multiple sclerosis
FAQ
What is the role of the prostate gland??
Makes fluid that nourishes sperm. The prostate gland makes a fluid that helps to nourish sperm. Scientists do not know all of the prostate’s functions. One of its main roles is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm and makes the vaginal canal less acidic.
What are symptoms of an enlarged prostate?
The medical term for enlarged prostate is benign prostatic hyperplasia (BPH). BPH causes the prostate gland to grow in size, which may compress the urethra that courses through the centre of the prostate. This can impede the flow of urine from the bladder through the urethra to the outside. It can cause urine to back up in the bladder (urinary retention) and increase the need to urinate frequently during the day and night. Other common symptoms include a slow flow of urine, the need to urinate urgently, and difficulty starting the urinary stream. More serious problems include urinary tract infections and complete blockage of the urethra, which may be a medical emergency and can lead to injury of the kidneys.
An enlarged prostate indicates prostate cancer. True or False?
False. An enlarged prostate (benign prostatic hyperplasia or BPH) is completely benign. It is not a precursor to prostate cancer. In addition to BPH, there are other prostate problems that have nothing to do with cancer, such as acute and chronic prostatitis.
How Can BPH Affect Your Life?
In most men, BPH gets worse with age. It can lead to bladder damage and infection. It can cause blood in the urine and cause kidney damage.
Is BPH (Enlarged Prostate) a serious problem?
In most cases, an enlarged prostate does not possess a serious threat or problem to health and is a normal ageing process. In other cases, it may lead to serious conditions including urinary retention and kidney damage. Hence, it is important to get the condition diagnosed at an expert clinic or hospital.
What is the best treatment for BPH?
There is no one-size-fits-all or best treatment for enlarged prostate and benign prostate hyperplasia. The extent of prostate enlargement, the effect of the condition on other organs, symptoms and their gravity and other aspects are evaluated for choosing the best treatment course for BPH, for a given individual or patient.
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When to see a Urologist Doctor
An enlarged prostate (bph) is mostly having the symptoms related to difficulty in urination, as stated earlier. It is important to see the doctor if you have any of the symptoms as these will worsen over time and may also impact the health of other organs that are part of the urinary system.
As the symptoms of BPH / enlarged prostate are similar to other grave and fatal diseases, it is very important for you to reach out to an expert to diagnose the condition in the best way and with the most reliable results. A grave or more complete obstruction of the urinary tract may also occur if the condition is not treated in time.