Benign Prostate Hyperplasia (BPH)
BPH, or prostate gland enlargement, is a common condition as men get older. The prostate is a small gland that starts out about the size of a walnut. As men age, the gland becomes enlarged.
About half of men with the condition have no symptoms other than the change in size. For others, urinary and sexual issues can result, including impeded of urine flow, leading to bladder, urinary tract or kidney problems.
Symptoms of BPH
The symptoms of BPH are often very mild at first, but they become more serious if they aren’t treated.
Common symptoms include:
- Unable to completely empty the bladder
- Need to urinate two or more times per night
- Straining to urinate
- Sudden urge to urinate
- Weak urine stream
- Dribbling of urine
- Painful urination
- Blood in the urine
As the prostate enlarges, it can partially block the flow of urine from the bladder, causing urine to back up in the bladder. This can increase the frequency of urination and potentially cause urinary tract or kidney problems.
The doctor will review your symptoms and medical history. A rectal examination will be needed for the doctor to assess the size of the prostate.
Diagnostic and assessment tests may include:
- Urinalysis (urine test)
- Ultrasound of the prostate
- Measuring urine left in the bladder after urinating
- Cystoscopy to look at the urethra or bladder with a scope
- Urodynamic pressure to test pressure in the bladder during urinating
Causes of an Enlarged Prostate
BPH is considered a normal condition of male aging. The exact cause is unknown and for some men poses no problem. For others, treatment will be required.
Contributing factors can include:
- Family history of BPH
- Sedentary lifestyle
- Erectile dysfunction
There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have, and your preferences.
An enlarged prostate is not cancerous, but symptoms can mimic more serious conditions. Screening for prostate or bladder cancer is not uncommon in diagnosing BPH.
Alpha Blockers: These pills relax the muscles of the prostate and bladder to improve urine flow. They reduce symptoms of BPH and blockage of the urethra. The pills do not reduce the size of the prostate. Alpha blockers work almost immediately and provide much relief for urinary problems.
Alpha Reductase Inhibitors: These pills block the production of dihydrotestosterone (DHT) which has been considered to be a factor in prostate enlargement. These pills are particularly affective for men with prostates that have grown so large they are imposing on the bladder or urethra.
The UroLift System
Urolift is a minimally invasive approach to treating an enlarged prostate that holds the prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
Clinical data has shown that the UroLift is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function. The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.
If the patient has attempted other treatments without success, is unable to urinate or has bladder stones, surgery may be required.
Transurethral resection of the prostate (TURP): The doctor goes through the urethra with a scope and removes portions of the prostate that are affecting your urinary flow. This is the most common surgical procedure for enlarged prostrate.
Open Prostatectomy: This procedure removes the inner part of the prostate through an abdominal incision. It is applied when the size of the prostate is too large for a TURP.
To help control the symptoms of an enlarged prostate, you can:
- Limit beverages in the evening. Don’t drink anything for an hour or two before bedtime to avoid middle-of-the-night trips to the toilet.
- Limit caffeine and alcohol. They can increase urine production, irritate the bladder and worsen symptoms.
- Limit decongestants or antihistamines. These drugs tighten the band of muscles around the urethra that control urine flow, making it harder to urinate.
- Go when you first feel the urge. Waiting too long might overstretch the bladder muscle and cause damage.
- Schedule bathroom visits. Try to urinate at regular times — such as every four to six hours during the day — to “retrain” the bladder. This can be especially useful if you have severe frequency and urgency.
- Follow a healthy diet. Obesity is associated with enlarged prostate.
- Stay active. Inactivity contributes to urine retention. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.
- Urinate — and then urinate again a few moments later. This practice is known as double voiding.
- Keep warm. Colder temperatures can cause urine retention and increase the urgency to urinate.
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