Benign Prostrate Hyperplasia

Benign Prostrate Hyperplasia

Dr.Satish Potluri profile Authored by Dr.Satish Potluri on 21 Mar 2013 - 19:59.

Enlargement of the prostate is a common condition seen in men over 60. Many of them do not have symptoms from enlargement. Even in men with symptoms due to prostate enlargement attribute these symptoms to general aging and do not seek medical attention. Here we list some of the basic information about benign (non-cancer) prostate Hyperplasia (enlargement).

 

What is prostate?

Prostate is a gland in male reproductive system. It is present below urinary bladder and encircles first part of urethra. Urethra is a tube like structure through which urine passes from bladder to outside.

Normal and enlarged prostate gland

(Image credit NCI and Alan Hoofring)

What is the function of prostate?

Prostate secretes alkaline fluid which forms a part of semen. It carries sperms during ejaculation. Vaginal fluid is acidic in nature. This alkaline fluid helps sperms to survive in acidic environment and help in fertilizing the  egg.

What is Benign Prostatic Hyperplasia (BPH)?

 

Benign prostatic hyperplasia (BPH) simply means non cancer enlargement of prostate gland. Prostate size increases with age in men.  It is said that around 90% of men have prostate enlargement by age 90.

 

Why does prostate enlarge?

Hormones play a role in prostate enlargement.  Testosterone is the main male hormone and estrogen is the main female hormone. There is an enzyme called aromatase which converts testosterone to estrogen. In men this enzyme increases with age and it in turn increases production of estrogen. Some theories suggest that increased estrogen level triggers enlargement of prostate. Another theory suggests that Di hydro testosterone (a derivative of testosterone) plays a role in prostate enlargement. 

 

How does prostate enlargement effect men?

 

As prostate enlarges, it squeezes the tube (urethra) which carries urine from urinary bladder to outside.
Depending on severity of enlargement, it can cause:

  • Urinary retention (inability to pass urine, leading to retention of urine in the bladder)
  • Difficulty starting urine
  • Straining to complete urination
  • Dribbling of urine at the end of urination
  • Need to urinate more often
  • People wake up multiple times at night to pass urine
  •  

How  to diagnose BPH?

Your doctor can diagnose BPH based on symptoms and few tests. Here are some of the tests that are commonly done

  • American urology association formulated a questionnaire to determine severity of symptoms 
  • Physical exam through rectum (DRE – Digital rectal examination )
  • Ultrasound of prostate
  • Urodynamic studies – Tests to check flow of urine etc are only done if needed
     

What else can mimic symptoms of Prostate enlargement?

There are many other conditions that can cause urinary symptoms and need to be ruled out before making the diagnosis of BPH. Here we list some of them:

  • Diabetes (sugar) – People have increased frequency  of urination
  • Infection of urinary tract
  • Prostate cancer
  •  Other conditions that cause obstruction to urethra like stricture (constriction of urethra)
  • Sometimes nerve problems can also cause difficulty passing urine
  •  

Is there a role of external factors on symptoms of BPH?

Heavy alcohol, caffeine, cold weather, stress, sedentary life style, cold and allergy medications can increase BPH symptoms. There is thought that Genistein, present in soy products can inhibit growth of prostate gland.

 

How can it be treated?

 

Medical: Based on the severity of your symptoms your doctor might recommend medication.

There are two classes of drugs are commonly used to treat BPH:

  • Drugs used to relax prostate help in free flow of urine. These are called alpha adrenergic blockers (in medical jargon). Example : Tamsulosin, Torazosin
  • Drugs which decrease conversion of testosterone to dihydrotestosterone (5 alpha reductase inhibitors, in medical jargon) Example: Finasteride
  •  

Surgical: If symptoms are severe your doctor might recommend surgery to remove the enlarging prostate gland.
Some of the surgical treatments available are listed below.

  • Removal of prostate gland (TURP)
  • Laser treatment of prostate 
  • PVP –photo selective vaporization of prostate 
  • Botox treatment (Under study) 

 

What needs to be done if one has any of the symptoms listed above?

You should see a doctor who specializes in treatment of prostate problems (Urologist). He will diagnose your condition and will decide the appropriate treatment for you. Below is a list of authentic sites for additional information.