Overview

A lot of men experience having an enlarged prostate, especially as they reach their older years. This kind of condition leads to symptoms, and as time progresses, other complications may develop. Fortunately, there are treatments available for this.

What is BPH?

BPH or benign prostatic hyperplasia is another term used for the enlargement of the prostate. This condition happens when the cells of the prostate gland start to multiply, and these new cells lead to the swelling of the gland, which then pushes the urethra and limits urine flow.  

Benign prostatic hyperplasia is not the same as having prostate cancer, and having this type of condition does not also mean that you have an increased risk of having this kind of disease. Having BPH, though, may cause symptoms that may affect the quality of life, and this is more common in men who are more than 50 years old.

Causes of Enlarged Prostate

What exactly causes the enlargement of the prostate is not known. Still, it is said that those who have had their testicles removed at a young age because of a medical condition are not likely to develop benign prostatic hyperplasia (BPH). And if a man’s testicles are removed after developing BPH, the size of his prostate will start to shrink.

Though the causes for the prostate’s enlargement are not known, certain factors affect the gland’s growth as well as the testosterone levels, and these are aging and changes in the cells of the testicles.

Some Facts about Prostate Enlargement

• As men increase in age, the higher the chance that they will develop an enlarged prostate
• BPH is a common condition in men, and it is believed that if they live long enough, it is more likely that they will develop an enlarged prostate
• For men who are over 40 years old, the percentage of those who have an enlarged prostate is small, while those who are more than 80 years old have about 90% with this condition
• Having an enlarged prostate does not mean having risk factors except for the testicles functioning normally

Diagnosis and Treatment

To get a proper diagnosis, the doctor will ask about your medical history and will do a digital rectal exam to feel the prostate gland.

Other tests that may be done are the following:

• Urine flow rate
• Post- void residual urine test, to check how much urine in the bladder is left after urinating
• Pressure-flow studies which are done to measure the pressure in the bladder as you urinate
• Urinalysis, to see if there is a presence of blood or infection
• PSA (prostate-specific antigen) blood test, to screen for prostate cancer
• Cystoscopy
• Blood urea nitrogen (BUN)
• Creatinine tests

Aside from these, your doctor may also ask you to fill out a form and rate your symptoms and how much it is affecting your everyday life. The score from this may be used to assess if your condition is progressing.

Treatment

Your treatment will depend on how severe your symptoms are and how much they are affecting your daily life. The doctor will also consider your other medical conditions if you have any. But one thing for sure, once you have developed BPH, you would need to undergo a yearly exam to monitor the situation. So the doctor can also evaluate if your treatment needs to be changed.

Some of the options for treatment are: “watchful waiting,” lifestyle change, medicine, or surgery (which is usually the last alternative). And typically, self- care methods are also implemented.

For Mild Symptoms:

• As soon as you get the urge to pee, go right away and do it. Also, try going to the bathroom on a timed schedule whether you need to pee or not
• Do not consume alcohol or caffeine anymore after dinner
• Avoid drinking a lot of liquids all at the same time, and most especially so 2 hours before bedtime. Spread them out throughout the day instead
• If you can avoid taking over- the- counter medicines such as colds and sinus medications that have decongestants or antihistamines would be better as they can increase BPH symptoms
• Try to exercise regularly and keep warm because cold weather and the lack of physical activity can make the symptoms worse
• Learn to do Kegel exercises
• Lessen your stress as tension and nervousness may result in frequent urination

Medicines

• Alpha- 1 Blockers are a group of medications that are used to treat high blood pressure, and at the same time, also work to relax the muscles of the bladder neck and the prostate making urination easier. Those who are using this type of medication feel some improvements within 3 to 7 days after starting this treatment.
• Finasteride and Dutasteride work by reducing the size of the gland and increasing the rate of urine flow. This medicine also decreases the symptoms of BPH and lowers the levels of hormones produced by the prostate. Users of this product notice signs of improvements within 3 to 6 months of medication. Possible side effects of this cialis drug are impotence and decreased sex drive
• Antibiotics are sometimes recommended to treat chronic prostatitis that may develop along with BPH, and in some cases also improve the symptoms of BPH in some men

Saw Palmetto

Saw Palmetto is a type of palm which has berries that are used to improve prostate health. This is why a lot of men use it to help relieve the symptoms of BPH. Several herbs have also been tried to treat an enlarged prostate, and they are said to improve the symptoms. But even with the claims, studies reveal that results are still mixed, and more research is needed.

Surgery

Surgery is usually recommended if the patient has the following:

• Incontinence
• Recurrent blood in the urine
• Not being able to empty the bladder fully
• Recurrent Urinary Tract Infection (UTI)
• Decreasing kidney function
• Stones in the bladder
• Annoying symptoms that do not respond to the medications

There are different types of surgical procedures as well, and the choice would depend on the degree of the signs and the size and shape of the prostate gland. Those who have had the procedure say that the rate of their urine flow and the symptoms have improved.

Some of the surgical procedures available are:

• TURP or Transurethral Resection of the Prostate- this is the most common and the most proven surgical procedure for BPH and is done by inserting a scope through the penis then removing the prostate piece by piece
• Simple Prostatectomy- this type of system is usually done on those with large prostate glands, and it is done by doing a surgical cut in the lower belly. What this surgery does is to remove the inside part of the prostate gland
• Heat or Laser are also used as less- invasive options for destroying the prostate tissue
• Tacking the prostate open without removing the masses is also another option for a less invasive treatment

Among the surgical procedures, TURP is still proven to be the best option.  

Those who have opted to have surgery are also likely to have another surgery within 5 to 10 years, but this may be an option for:

• Younger men
• Older people
• Those with severe medical conditions such as cirrhosis and uncontrolled diabetes
• Alcoholism
• Psychosis
• Severe lung, kidney or heart disease
• Men taking blood-thinning drugs
• Men who are at an increased surgical risk

Higher chance of an enlarged prostate is based on these factors:

• Age
• Family history
• Ethnicity- it affects black and white men more often than Asian men, and the symptoms for black men may be experienced at an earlier age.

Health conditions may raise the odds you will get BPH:

• Obesity
• Diabetes
• Heart disease and problems with blood flow
• Erectile dysfunction

If you are taking beta-blockers to treat high blood pressure and migraines, then you will have a high chance of developing BPH.

Can Lifestyle Changes Help?

Having a heart-healthy diet and exercising regularly may help manage your weight, which is good for your prostate’s health as well, and these can help empty your bladder at a reasonable rate. Hence, it is right for your prostate.

To Control the Symptoms, It May Help to:

• Limit your intake of antihistamines and decongestants
• Do exercises that strengthen your pelvic floor muscles
• Limit intake of alcohol and caffeine
• Lessen fluid intake before bedtime or going out
• Pee as soon as you get the urge because it is easier for your bladder
• Stay warm because the cold will make you pee easily

Risks of Having Enlarged Prostate

• Aging
• Family history
• Diabetes and heart disease
• Obesity

Complications

• UTI
• Bladder stones
• Bladder damage
• Kidney damage
• Sudden inability to urinate

When to Seek Medical Attention

Those with symptoms of BPH may be a sign of underlying severe medical conditions, which includes cancer, that is why if you have the symptoms, see your doctor right away.

Seek medical care immediately if you have these:

• Complete inability to urinate
• Painful and frequent urination with fever and chills
• Blood in the urine
• Pain or significant discomfort in the lower abdomen and urinary tract

Table of Medications

• tamsulosin
• Flomax
• finasteride
• Cialis
• Avodart
• doxazosin
• Proscar
• terazosin
• Cardura
• Cardura XL