Benign Prostatic Hyperplasia (BPH) – Enlarged Prostate, Symptoms, Diagnosis & Treatment

Prostate is a small walnut sized organ present in men. It sits right below the bladder and the urethra (the tube that ejects urine and semen outside the body) passes right through the prostate gland. Prostate produces seminal fluids that are sent out along with sperms during ejaculation. The fluids nourish the sperms during their journey in the female body.

What is BPH, Benign Prostatic Hyperplasia?

As the name indicates, the condition occurs in the prostate and it is non-cancerous (benign). BPH is the enlargement of the prostate gland which is caused due to overgrowth of the cells inside the prostate. When the prostate grows in size, it squeezes the urethra passing through it resulting in problems with urination and ejaculation. BPH is not the same as prostate cancer but can affect one’s quality of life with urination and other problems.

Symptoms of BPH

As the urethra gets squeezed, most of the symptoms of BPH are related to urination such as:

1. Incomplete emptying of bladder
2. Dripping of urine even after you think you have completed peeing.
3. Incontinence / leakage of urine
4. Sudden urge to urinate
5. Slow stream of urine when peeing
6. Pain during urination
7. Rarely, blood can be seen in the urine.

Please do not ignore any of these symptoms. Though these symptoms are not exactly same as those of prostate cancer, you must get tested and treated by a good urologist or sexologist near you. Your sexologist will make sure that the cells growing in the prostate are non-cancerous when you submit yourself with any of the above symptoms. Typically BHP is seen in aged men and there is no specific identifiable cause for BPH.

Diagnosing BPH

Diagnosis of BPH starts with a series of questions related to your lifestyle, current medications that are being taken followed by certain tests such as physical examination. Doctor may insert a lubricated, gloved finger into the rectum to feel the prostate and ascertain the size of the prostate. Other tests may include:

1. Urinalysis – Analysis of urine to check for presence of bacteria or blood. (Infection of the prostate can also cause the gland to swell)
2. Urodynamic Test – The test aims at testing the pressure of the bladder. The bladder is filled with liquid using a catheter and the pressure of the bladder is measured. The pressure of the bladder determines the outflow of urine through the urethra.
3. PSA Test – Prostate Specific Antigen Test. The test looks for the presence of antigens that are produced to fight cancer when cancer cells are present in the prostate.
4. Post Void Residual Test – The test looks at the amount of urine that is left inside the bladder after urinating. More the amount of urine left behind, severe could be the symptoms.
5. Cystoscopy – Cystoscope is a small tube with a camera at its end that is inserted into the urethra. It is used to look through the urethra and the prostate gland.

Natural treatment of Benign Prostatic Hyperplasia

In addition to the treatment prescribed by the doctor, some natural treatment options can also be followed to control the symptoms of BPH. However, there is no scientific backing/evidence that these remedies can help alleviate or reduce the symptoms of BPH.  Natural treatment options of BPH include:

1. Urinating at regular intervals (instead of waiting for your body to signal you to use the restroom)
2. Urinating as soon as your body tells you that you need to urinate. (Not holding back the urine).
3. Avoiding cold drinks, coffee, alcohol and other liquids after dinner. This can help reduce nocturnal urination problems.
4. Working out regularly, focusing on strengthening pelvic muscles.
5. Staying in warm climate. Colder weather can lead to frequent urination.

Treatment options for BPH

1. Alpha-1 blockers. These medicines relax the muscles of the bladder and prostate.  When the neck of the prostate is relaxed, urine flows freely through the urethra allowing the person to empty the bladder completely.
2. Hormone Reduction Medications. Lowering the hormone, DHT (DiHydroTestosterone) can help in reducing the size of the prostate gland. (Side effects of Hormone Reduction Medications include reduced sex drive and in rare cases, impotence.)
3. If the doctor has figured that an infection (typically bacterial) is the cause of the enlarged prostate, you will be put on antibiotics until the infection is cleared.

Surgical Treatment options for BPH

Surgical treatment options of BPH can be categorized into two. One of set of procedures that can be performed at doctor’s clinic as out-patient procedures and others that need hospitalization. Out-patient procedures aim at removing the excess prostate tissue using energy waves or water (hot water or water vapour) etc.

Outpatient treatment procedures for BPH include:

1. TUNA – TransUrethral Needle Ablation. The enlarged prostate tissue is scarred and shrunk using radiowaves.
2. TUMT – TransUrethral Microwave Therapy. Similar to TUNA but microwave energy is used to shrink the prostate tissue.
3. TransUrethral Watervapor Therapy (Režum). Water vapour is used to shrink/remove the excess tissue.
4. Water-Induced Thermotherapy. Hot water is used to destroy/remove the excess prostate tissue.
5. High-Intensity Focused Ultrasonography (HIFU). Sonic energy is used to destroy the extra prostate tissue.
6. The prostate is surgically lifted with implants effectively reducing the pressure on the squeezed urethra. This helps the person pee normally. This is a minimally invasive procedure but the results are comparable with that of surgical treatment of BPH.

Inpatient treatment procedures of BPH include:

1. TURP – TransUrethral Resection of the Prostate. A gold standard procedure in which the prostate gland is removed piece by piece through the urethra.
2. Simple Prostatectomy. In this procedure, instead of the entire prostate, inner tissue of the prostate is removed keeping the outer part intact. This is done through an incision in the abdomen or the perineum.
3. TUIP – TransUrethral Incision of the Prostate. In this procedure, small incisions will be made to the prostate effectively making the urethral connection larger to facilitate larger amount of urine to pass through.

Conclusion

Ignoring the symptoms such as problems with urination, pain in abdomen or when urinating can be life threatening in some cases. Holding up urine for medical reason or for any other reason can hurt kidneys and can damage them. You must see a good doctor, preferably a urologist or a good sexologist when you see any such symptoms. Metromale Clinic & Fertility Clinic in T Nagar, Chennai is one of the leading multispecialty clinics hosting highly experienced sexologists who can give you the right treatment for BPH and improve the quality of your life.