Abstract
This article discusses the symptoms, treatments, and complications of benign prostatic hyperplasia.
Contents
Published on May 13, 2017 and last reviewed on Feb 09, 2022 - 4 min read
Abstract
This article discusses the symptoms, treatments, and complications of benign prostatic hyperplasia.
The prostate is a gland in the male reproductive system. The prostate gland’s size resembles a walnut, and it is exactly located between the penis and the bladder. It secretes a fluid that constitutes 30% of the seminal fluid. This fluid is necessary for maintaining the health of the sperms. The prostate surrounds the urethra, which is the outlet for urine.
Benign Prostatic Hyperplasia (BPH) is an age-related growth and enlargement of the prostate gland. The tissue growth associated with BPH is benign (non-cancerous). But the growing prostate tissue can compress the urethra which it surrounds, resulting in obstruction to urine flow. Symptoms of BPH are due to urinary outflow obstruction.
The actual cause for benign prostatic hyperplasia could not be identified. Any alteration in the level of male sex hormones can be the reason.
Urinary urgency.
Frequent urination, especially at night.
Weak urine stream.
Dribbling of urine towards the end of micturition.
Feeling of incomplete voiding.
Recurrent urinary tract infections.
Rarely, blood in the urine.
Erectile dysfunction.
The several complications of benign prostatic hyperplasia are:
Urinary infections.
Prostatitis (infection of the prostate).
Urinary retention.
Bladder stone.
Kidney dysfunction.
The diagnosis of benign prostatic hyperplasia involves the following procedure.
Digital Rectal Examination: The doctor will perform a clinical examination to identify any presence of abnormal growth in the form of lump or mass. The prostate gland will also be assessed by insertion of the lubricated and gloved fingers into the rectum. The presence of nodules or any inflammatory conditions can be identified with the help of this digital rectal examination procedure.
Transrectal Ultrasound: The other name for transrectal ultrasound is prostate ultrasound. A probe with an ultrasound option is inserted into the rectum. This will help in assessing the condition of the prostate gland.
Urine Test: The urine is collected from the patient and tested to identify the presence of any infection.
Blood Test: A blood test will play a vital role in the identification of any problems in the kidney.
Prostate-Specific Antigen (PSA) Blood Test: A prostate-specific antigen is a component that is produced by the prostate glands. Whenever there is an enlargement of the prostate gland, the level of the prostate-specific antigen gets elevated.
Postvoid Residual Volume Test: Postvoid residual volume test helps in identifying the ability of the individual to excrete the urine completely and empty the bladder. This test is done with the help of catheter insertion or an ultrasound.
Biopsy of the Prostate Gland: A tissue sample of the prostate gland is taken for the assessment of the cells. A guided needle might be needed for this purpose. The analysis of the tissue can help in ruling out other conditions related to the prostate gland.
Cystoscopy: An instrument called a cystoscope is inserted into the bladder to see the internal parts of the bladder.
The treatment for benign prostatic hyperplasia depends on the following factors:
Overall health status of the patient.
Size of the prostate.
Age of the patient.
The various treatment options for benign prostatic hyperplasia are discussed below.
Lifestyle Changes: Taking small amounts of fluid spread throughout the day and limiting fluid intake during the evenings can help with increased urinary frequency at night. Whenever you need to urinate, try relaxing and void as completely as possible. This can help in reducing the volume of residual urine in the bladder and help with symptoms of urinary urgency and frequency.
One of the common habits which men have is the usage of gadgets like a laptop by placing them on their lap for a very long time. This is particularly noticed in men who are working in the IT profession or who continuously work from home on computers. Laptops have a capacity to emit heat on prolonged usage. When a working professional is in the situation of using the laptop for a long time, then the heat gets directly transferred to their prostate gland. It can have a direct effect on the reproductive system. This negative effect can happen for women too, but men are under a zone of higher risk. The temperature of the prostate gland should be maintained ideally for healthy functioning. When an individual places the laptop over the gland, the excessive heat transmitted can invite a lot of health-related problems. It is also advisable to wear loose clothing at home so that sufficient airflow reaches the prostate gland.
Medications:
Alpha-Blockers Like Terazosin and Tamsulosin: They relax the muscles in the urethra, thus helping with the urine flow.
5-Alpha-Reductase Inhibitors Like Finasteride and Dutasteride: They reduce the size of the prostate.
Phosphodiesterase Type 5 Inhibitors Like Tadalafil (Tadalafil): Tadalafil has been approved by the FDA for the treatment of both BPH and erectile dysfunction. Tadalafil improves the blood flow to the penis, thereby treating erectile dysfunction. It also relaxes muscles in the urethra and the prostate, thus increasing urinary flow.
Both alpha-blockers and 5-alpha-reductase inhibitors can cause sexual side effects like decreased sexual urge or libido and erectile dysfunction. If the sexual side effects are bothersome, then Tadalafil can also be tried. However, Tadalafil and alpha-blockers should not be taken together as they can dangerously lower blood pressure. It is important to stop alpha-blockers before starting Tadalafil.
Less Invasive Procedures: Transurethral needle ablation (TUNA), transurethral microwave therapy, and laser therapy. Less invasive procedures have faster recovery time and less incidence of complications like urinary incontinence, erectile dysfunction, and retrograde ejaculation.
Surgery: Transurethral resection of the prostate (TURP), which is more effective than less invasive procedures. The other evolving surgical methods for benign prostatic hyperplasia are:
Transurethral microwave thermotherapy (TUMT).
Transurethral incision of the prostate (TUIP).
Transurethral needle ablation (TUNA).
Prostatic urethral lift (PUL).
Embolization.
Prostatectomy.
Laser therapy.
The choice of treatment depends on the severity of the symptoms, complications, and response to the medications.
Benign prostatic hyperplasia's exact cause is not known. It occurs mostly due to age-related changes. There is a huge change in the level of hormones due to aging. Patients who have had surgical removal of their prostate glands, do not get benign prostatic hyperplasia.
Terazosin and Tamsulosin help in the relaxation of the urethral muscles that help in proper urinary flow. Finasteride and Dutasteride help in reducing the size of the enlarged prostate glands. In severe cases, surgical treatment options would be required.
The diagnosis of benign prostatic hyperplasia is made in the following ways:
- Prostate-specific antigen blood test.
- A physical examination of the rectum is called the digital rectal examination. This is done to identify the enlargement of the prostate glands.
- Blood tests.
- Urine tests for detecting the presence of infections.
Water is very important for the health of your prostate glands. Some patients with benign prostate hyperplasia are known to reduce water intake to decrease urinary excretion. This will make them dehydrated. It is necessary to drink a lot of water. Soda and aerated drinks should be avoided.
Patients with an enlarged prostate are known to have erectile dysfunction. It might be due to poor blood supply. This will interrupt with the sexual activities of men. Some patients might even experience pain when they try to involve in sexual activities.
There is no proper cure for benign prostatic hyperplasia. With proper treatment, it is possible to alleviate the symptoms. The main goal of the treatment is aimed at reducing the enlargement of the prostate glands. Many surgical options are available for complicated cases.
If the benign prostatic hyperplasia is left untreated, it might lead to other complications. They are:
- Kidney dysfunction.
- Urinary retention.
- Urinary infections.
- Infection of the prostate glands like prostatitis.
- Bladder stone.
The extracts of banana have anti-inflammatory and anti-proliferative activities. It is helpful for benign prostatic hyperplasia. In addition to this, green leafy vegetables like broccoli can be consumed for this condition. You can get help from a dietician to understand which foods would be suitable for you.
The common signs and symptoms of benign prostatic hyperplasia are:
- Frequent urination.
- Weak urine stream.
- Urinary tract infections.
The recommended food for enlarged prostate glands are:
- Salmon.
- Tomatoes.
- Avocados.
- Bell peppers.
- Vegetables.
- Sesame seeds.
- Tofu.
Medical reports suggest that a few patients do not experience any difficulty with benign prostate hyperplasia, and they do not require any treatment. In such patients, the inflammatory conditions are known to subside. Only in patients who are having severe pain and discomfort treatment are recommended.
Phosphodiesterase inhibitors like Tadalafil are known to increase blood flow to the prostate glands and are useful for erectile dysfunction patients. Terazosin and Tamsulosin are beneficial for the relaxation of the urethral muscles. Finasteride helps in reducing the enlargement of prostate glands. In severe cases, surgical treatment options would be required.
The surgical options for benign prostatic hyperplasia are mostly transurethral. The most recommend procedures for benign prostate hyperplasia are:
- Transurethral vaporization of the prostate (TUVP).
- Transurethral laser enucleation.
- Transurethral resection of the prostate (TURP).
- Photoselective vaporization of the prostate (PVP).
- Transurethral incision of the prostate (TUIP).
- Prostatic urethral lift (PUL).
Last reviewed at:
09 Feb 2022 - 4 min read
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