Benign Prostate Hyperplasia (Enlarged Prostate)

Benign prostatic hyperplasia, a.k.a. enlarged prostate, is a medical condition characterized by a narrowed urethra and a difficult flow of urine. Urethra is the canal that conveys urine from the bladder out of the body. Benign prostatic hyperplasia (BPH) is something many men older than 50 are likely to experience. As its name suggests, it is not cancerous.

BPH comes with age and is most likely to appear between 55 and 75, when the main symptoms display (prostate pain, for instance). About one man out of ten will require some form of treatment for enlarged prostate sooner or later. This condition affects Caucasians a lot more often than Asians or Afro-Americans.
Many people ask the same question: what is prostate hypertrophy caused by? Unfortunately, there is no definitive answer to that. The process happens in the following way: as the prostate increases in size, it prevents the urine from flowing through the urethra, which results in the bladder not being emptied completely each time. As the urine gets accumulated in the bladder, infection can take place, which causes the formation of kidney stones and further damage to this organ. Therefore, other symptoms of BPH are frequent urination and occasional dribbling out of the urine.

Split stream can also help you recognize BHP early, as well as prostate pain (you can feel it between the anus and scrotum). Many patients are likely to experience dramatic increase in size of their prostate before they start to notice the first signs.
When the patient has some reasons to believe he has BHP, he must go to the doctor immediately. The doctor will conduct a careful examination to rule out diseases such as cancer of prostate. Digital rectal examination is a common practice; the doctor will examine your prostate from the inside of the anus to see how much it is enlarged. If the surface of the prostate is smooth, it’s most likely BPH, while a lump means it may be a case of cancer of prostate.
Another test you may need to go through is PSA (prostate-specific antigen) blood test. Numerous studies showed that as many as 30–50% of men with enlarged prostate have high levels of PSA. There are other tests aimed at confirming that the condition is benign.

The best ways to rule out prostate cancer include ultrasound examination and prostatic tissue biopsy (taking a sample of tissue to determine the cause or extent of a disease). Biopsy may be a bit painful but it gives the most accurate results.

After ruling out other possible causes, it’s required to determine how obstructed the urethra is. For that purpose a catheter may be inserted into the urethra all the way to the bladder; the patient can urinate into a special device called uroflowmeter; there is also a cystoscopecan – another instrument inserted into the bladder to view its condition. In order to understand whether there has been an infection, the doctor may order a urine test (if it shows many white blood cells, serious measures need to be taken to prevent the spread of the infection). As enlarged prostate is potentially dangerous for the health of your kidneys, these organs are checked also. This can be done by an ultrasound examination, blood test for creatinine or a dye injection.
Benign prostatic hyperplasia is commonly treated with alpha-adrenergic blockers (phenoxybenzamine and doxazosin), which are aimed at dealing with the symptoms, and finasteride, which is used to decrease the size of the prostate. Alpha-adrenergic blockers do not stop the process of the prostate enlargement. Most patients also need some drugs to treat their infection, namely antibiotics. However, some antibiotics are likely to make things even worse – such as decongestants and antihistamines as they lead to the retention of the urine.

There are cases when the growth can be dealt with in quite a painless way: if your doctor thinks the drugs aren’t working, but there are no clear indications for a surgery, transurethral needle ablation can be done. This procedure is performed under a local anesthetic, and the tissue blocking the flow of the urine gets destructed by radiofrequency energy.
There are a number of other ways of dealing with your enlarged prostate: TUR (transurethral resection), microwave hyperthermia, laser ablation of the prostate, transurethral incision of the prostate, transurethral vaporization of the prostatic tissue, open prostatectomy or the gland removal. Microwave hyperthermia involves a special device delivering microwave energy through a catheter. Transurethral resection is one of the most common operations during which the tissue surrounding the urethra is removed with the help of a heated wire loop or another surgical instrument. The surgeon observes the whole operation through a cystoscope and the pieces of tissue are later washed out through the scope. Other procedures are easier but also performed in an operating room in sterile conditions.

BHP is one of those diseases when your doctor may advise you to watch and wait. It’s not always clear how the symptoms will be developing and whether any interference will be necessary. Transurethral resection quickly relieves the symptoms and provides for easier urination in most men that go through this surgery. Saw palmetto extract is also known to decrease the size of the prostate. The best advice would be to talk to your doctor about any methods of treatment available if you believe you may have an enlarged prostate.

Related Articles