Benign Prostatic Hyperplasia

Benign prostatic hyperplasia is a common condition causing the prostate to enlarge, that happens as men get older. An enlarged prostate gland can cause urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause urinary tract or kidney problems.

Causes:

The prostate gland is located beneath the bladder around the urethra. It is not clear what causes the prostate to get enlarged, however it could be related to changes in the balance of sex hormones as men get older. There are some risk factors which could contribute to enlargement of the prostate such as:

Age, usually men may experience the symptoms by the age of 60 years oldFamily history Diabetes and heart diseaseObesity and lack of exercise also increased the risk

Symptoms:

They symptoms of benign prostatic hyperplasia can worsen overtime, the common signs and symptoms include:

Frequent or urgent urinationIncreased frequency of urination at night Difficulty starting urine streamWeak urine stream Dribbling at the end of urinationInability to completely empty the bladder

Also, some less common symptoms may occur such as:

Urinary tract infectionsBlood in the urineInability to urinate

Diagnosis:

Diagnosis of benign prostatic hyperplasia requires physical examination including a digital rectal exam to check for the prostate enlargement. Also your doctor may also order some additional tests such as:

Urine test: to rule out urinary tract infectionBlood tests are done to ass the kidney functionProstatic-specific antigen: PSA, which a substance produced by the prostate and is used to assess the prostate enlargement

Your doctor also may order some imaging studies such as ultrasound or CT-scan to assess for the extent of the prostate enlargement

Sometimes the doctor can order a cystoscopy, which is a small camera inserted through the urethra to see the inside of your bladder to rule out any cancer

Treatment:

There are many treatment options available for prostate enlargement such as medications, minimally invasive procedures and surgery. Your doctor will decide the best option based on your symptoms and severity of enlargement.

For medications the options include:

Alpha blocker:  these medications relax the muscles of the neck of the bladder and the muscle fibers of the prostate making urination easier5-alpha reductase inhibitors: These medications help in decreasing the size of the prostate by blocking hormonal changes that increase the size.

Your doctor can use combination of the medications above

Then there are the minimally invasive and surgical options, which are considered if there is no improvement on medical therapy alone. Some of these options include:

Transurethral resection of the prostate (TURP): which is done through a scope inserted through the urethra and the surgeon removes the outer part of the prostate to decrease the size and improve any obstruction in the urine flow

 Laser therapy can also be done, which uses a high energy laser to destroy the enlarged part of the prostate to improve the symptoms

Surgical removal can also be used as open or robot-assisted prostatectomy, which means removal of the prostate, and this option is usually considered when the prostate is very large and causing complications

Prevention:

The risk of developing benign prostatic hyperplasia can be reduced by lifestyle changes, which include:

Regular exerciseWeight reductionControlling diabetes and heart disease