Benign prostatic hyperplasia, as the name indicates, is a non-cancerous enlargement of the prostate gland. This condition is seen commonly among older men. The abbreviation of the condition, BPH, is popularly used in medical phraseology.
This condition primarily affects the prostate of men. This is a small organ usually about a walnut’s size. It surrounds the urethra and is located below the bladder. The primary function of the prostate is to make a fluid that is a part of the semen. Usually, problems related to the prostate are seen among men above age of 50 years.
In fact, BPH begins to take root in men in their 30s but shows significant symptoms only when they are into their middle ages. Most of the cases can also be treated successfully without impinging sexual function. The branch of medicine that deals with the diagnosis and treatment of all prostate related issues is urology.
Detection & Risk Factors of Benign Prostatic Hyperplasia
The condition of BPH can be detected and confirmed by a doctor after conducting an examination of the rectum. Additionally, the doctor may also want to examine the prostate, urethra and even the bladder. The examination of the same is conducted using a cytoscope. This instrument is entered into the body through the opening of the penis.
Most men tend to overrate the problem of BPH. It is one of the most common problems among older men and is certainly not life threatening. In fact, close to half of all men above the age of 50 years tend to develop benign prostatic hyperplasia symptoms. However, less than 10% actually need surgical or medical intervention.
Many also tend to confuse this condition with cancer of the prostate. However, this enlargement is totally benign. And in what is wrongly believed by quite a few, it is not at all a precursor of impending cancer of the prostate.
Due to the varied nature of benign prostatic hyperplasia symptoms among men, the treatment of the condition is undertaken on a case by case basis. Most men suffering from BPH can lead a life without any difficulties at all. However, some others may suffer from more severe symptoms and treatment is advised for this category of BPH sufferers.
For those with only mild symptoms of BPH, regular yearly monitoring and check-ups are recommended to keep a tab on the progress of the condition. Some of the early signs of BPHinclude frequent urinations, dribbling and difficulty while urinating and general discomfort.
Treatment of Benign Prostatic Hyperplasia
There exist several methods to treat the problem of BPH. As mentioned above, many men with slight problems of BPH adopt the policy of ‘watchful waiting’ rather than seeking medical intervention right from the beginning. They completely skip medical treatments and instead rely on regular monitoring to see if the condition is getting worse.
Medical treatment, however, is the only choice for men with decidedly severe symptoms of BPH. Some of the most commonly used drugs for the same include;
- 5-alpha Reductase Inhibitors – This drug stops the conversion of testosterone (the male sexual hormone) into its active form in the prostate. This is also known as DHT. The main symptom of benign prostatic hyperplasia, i.e. the enlargement of the prostate, is a direct derivative of DHT. So with continuous consumption of this drug, the overall size of the prostate can be reduced by almost 25% over a period of 6 to 12 months. This amount of time is also the reason why any improvements in the urinary symptoms take time to reflect in practice. Dutasteride (Avodart) and Finasteride (Proscar) are two popularly used 5-alpha reductase inhibitors. However, these drugs are not free from side effects with the most notable ones being a decreased libido, erectile and ejaculation problems.
- Alpha Blockers – These drugs help the prostate’s smooth muscles to relax. The same also holds true for the bladder neck. This helps in removing the obstruction to the smooth passing of urine that is the result of an enlarged prostate. However, the drug can cause side effects like fatigue, light-headedness and headaches. Examples of alpha blockers that are popularly used include alfuzosin, terazosin, doxazosin and tamsolosin. These drugs result in significant improvement of symptoms within a few weeks of time. However, there is no corresponding effect on the size of the prostate.
When medications are not enough to treat the symptoms of BPH, surgery or other office procedures may be resorted to. This is most common in the case of men who find it almost impossible to pass urine.
- Laser: There are a number of laser based procedures to treat BPH. Some of them can even be performed in a doctor’s office and with the least amount of anaesthesia. Procedures that make use of lasers usually result in the complete removal of the prostate tissue that causes the obstruction. With laser procedures, the recovery period is usually quite fast compared to TURP (Transurethral resection of the prostate). Same is the case with the amount of bleeding. However, TURP is seen to be better than laser procedures when it comes to long term effectiveness.
- TURP: This method has been in vogue for a long period of time. Here, a doctor enters an instrument through the penis’s opening and into the urethra. This is done after the patient is administered anaesthesia. With this instrument, the doctor shaves off a part of the prostate that is causing the obstruction. This frees up the passage for urine to flow.
- Microwave Therapy: A procedure usually performed in office, it involves the use of microwave energy to destroy certain cells of the enlarged prostate. Doing so reduces the prostate’s size.
The pros and cons of each method should be carefully discussed with the doctor. Although surgery has the most benefit in the long term, it is also a source of the most risk.
Guarding against Benign Prostatic Hyperplasia
The best way of preventing BPH is to regularly consult a doctor once middle age is attained. A doctor should also be consulted with in case one suffers from frequent urinations, difficulty and dribbling while urinating. Sooner the problem of Benign Prostatic Hyperplasia is recognized higher are the chances of painlessly treating it.