Enlarged Prostate - Remedies and Management

What Is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia (BPH) is a common clinical condition that affects mostly older men. It is a benign (non-cancerous) condition but can still cause symptoms such as frequent urination, urgency, and difficulty in bladder emptying. Different remedies are available to manage and alleviate the symptoms associated with BPH. An individual with benign prostatic hyperplasia should consult a healthcare provider to understand the underlying causes and get specific treatment based on the cause.

What Is the Incidence of Benign Prostatic Hyperplasia?

BPH affects aging men, most commonly in the age group of 55 to 70 years and older.

What Are the Symptoms of Benign Prostatic Hyperplasia?

Different signs and symptoms associated with BPH are:

• Difficulty with urination.

• Frequently urge to urinate.

• Difficulty in emptying the bladder.

• Incontinence.

• Weak urine stream.

How Is BPH Diagnosed?

The following methods diagnose BPH:

• History: A detailed clinical history is recorded by the doctor to evaluate the signs and symptoms of BPH. Any underlying medical history, drug history, and symptoms such as frequency of urination, blood in urine, or pain on urination are recorded for diagnosis of the underlying cause.

• Pressure Flow Studies: This study records bladder pressure flow while urinating.

• Urine Culture Test: A urine culture test is performed to check for any signs of infection.

• Blood Urea Nitrogen (BUN): The doctor usually performs BUN and creatinine tests to evaluate compromised or reduced kidney function.

• Prostate-Specific Antigen (PSA) Test: This test is done to detect prostate cancer.

The doctor might ask the patients with BPH to fill out the questionnaire forms to thoroughly understand the signs and symptoms of BPH and how it affects their daily lives.

What Are the Different Treatment Remedies for Managing Benign Prostatic Hyperplasia?

Various treatment remedies for BPH include:

1. Wait and Watch: In mild symptoms, the doctor may recommend a "watchful waiting" approach, monitoring the condition without immediate intervention.

2. Changes in Lifestyle: A few lifestyle changes can help alleviate symptoms associated with BPH, including:

• Dietary Alterations: Some studies suggest that a diet rich in fruits, vegetables, and low-fat dairy products may help reduce the risk of BPH.

• Limited Intake of Caffeine and Alcohol: Some studies suggest that limiting the intake of caffeine and alcohol can help to improve urinary symptoms.

3. Medications: Medications that help to deal with BPH are:

• Alpha Blockers: These drugs help to relax the bladder and prostate muscles, improving urinary flow. Examples are Tamsulosin and Alfuzosin.

• 5-Alpha Reductase Inhibitors: These medications reduce the size of the prostate gland by blocking the action of a hormone called dihydrotestosterone (DHT). Finasteride and dutasteride are examples.

• Combination Therapy: In a few patients, rather than single therapy, a combination therapy of alpha Blockers and 5-alpha reductase inhibitors is used for the management of symptoms associated with BPH.

4. Minimally Invasive Treatment Procedures: A few minimal intervention management procedures that help in managing BPH are:

• Transurethral Microwave Thermotherapy (TUMT): In this procedure, microwave energy is used to shrink the prostate.

• Transurethral Needle Ablation (TUNA): Radiofrequency energy is used to shrink and reduce the prostate size thermally.

• Prostatic Urethral Lift (UroLift): In this method, the healthcare provider usually uses implants (artificial material) to lift and hold the enlarged prostate tissue, improving the urinary flow.

5. Surgical Options: Different surgical options to treat BPH are:

• Transurethral Resection of the Prostate (TURP): This common surgical procedure involves removing a part of the prostate and blocking urine flow.

• Holmium Laser Enucleation of the Prostate (HoLEP): In this surgical method, a laser removes excess prostate tissue.

• Open Prostatectomy: In rare cases, particularly for very large prostates, surgeons may recommend open surgery to remove the obstructing tissue.

6. Water-Assisted Therapies: A few water-assisted therapies are available, such as:

• Aquablation Therapy: A robotically assisted procedure using a high-velocity water jet to remove excess prostate tissue.

7. Catheterization: In severe cases, if urinary retention occurs, a temporary or permanent catheter may be required to relieve the obstruction.

8. Herbal Remedies:

• Saw Palmetto: Saw palmetto, an herbal supplement, may help to reduce the symptoms of BPH.

9. Pelvic Floor Exercise: Some exercises, such as Kegel exercises, may help improve bladder emptying and reduce symptoms.

10. Acupuncture: Some individuals find relief from BPH symptoms through acupuncture. While more research is needed, some studies suggest potential benefits.

How Can Benign Prostatic Hyperplasia Be Prevented?

There is no way to prevent BPH in men, and the researchers have updated it. However, individuals with risk factors can get help from healthcare professionals if any initial symptoms related to kidney functions are noticed.

Self Care Tips

Here are a few self-care tips:

• Avoid drinking lots of fluid at once. Avoid fluids two hours before bed.

• Avoid over-the-counter medications like nasal decongestants and antihistamines, as they may aggravate the symptoms.

• Try to keep the mind relaxed and avoid too much stress, as overstressing may result in frequent urination.

• Try regular exercise and keep the body warm, as a cold may aggravate the symptoms.

• Avoid caffeine after dinner or before bed.

What Are the Clinical Trials Ongoing for BPH?

Researchers from the NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) are working on a few clinical trials to discover newer strategies for prompt diagnosis and early management of the symptoms associated with BPH.

Conclusion

BPH is a common, prevailing condition in aging men that requires thorough diagnosis and management. It is advised to visit the doctor if any symptoms associated with BPH are experienced for a proper diagnosis and customized treatment plan. The choice of management plan usually depends on the severity of symptoms, the overall health of the patient, and individual preferences. Regular follow-up with the doctor is vital to monitor the condition and adjust the treatment plan. However, future clinical research trials are ongoing to develop and implement new strategies for promptly diagnosing and managing benign prostatic hyperplasia.