Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is a condition which involves non-malignant enlargement of the prostate gland. This condition is commonly prevalent in older men. BPH usually begins when a man is in his 30s, evolves gradually, and causes symptoms only after he is 50.

The enlargement of the Prostrate gland would compress the urethra, thus obstructing the flow of urine from the bladder to the outside of the body. This can further result in the retention of urine in the bladder. Some of the complications that could arise from this condition include urinary tract infections, complete blockage of the urethra and injury to the kidneys.

Signs and Symptoms:

  • Frequent urination
  • Blood in urine or semen
  • Painful or burning sensation during urination
  • Difficulty in urinating/ having an erection
  • Painful ejaculation
  • Frequent pain or a feeling of stiffness in lower back, hips, or upper thighs
  • Inability to urinate
  • Dribbling of urine

Treatment of BPH

Treatment of Benign Prostatic Hyperplasia is generally reserved for men who have major symptoms. It should be noted that this condition is not a precursor to prostate cancer.

Some of the ways to treat BPH:

Watchful waiting is recommended for men who have not been affected by the symptoms of BPH. They have to go for regular checkups to examine whether or not the condition has worsened over the specified time.

Medical treatment of BPH is usually reserved for men who have significant symptoms. The available drugs include:

  • Alpha blockers which helps to relax the prostate muscles and the bladder neck. This helps to relieve urinary obstruction caused as a result of an enlarged prostate. The most commonly used alpha blockers include Tamsulosin (Flomax), Alfuzosin (Uroxatral), and medications such as Terazosin (Hytrin) or Doxazosin (Cardura).
  • 5-alpha reductase inhibitors which disrupt or block the male hormone, testosterone from getting converted into its active form (DHT) in the prostate. The enlargement of the prostrate in BPH is directly related to DHT. Hence, these drugs lead to around 25% reduction in prostate size over a period of six to 12 months. Some of the commonly used 5-alpha reductase inhibitors include Finasteride (Proscar) and Dutasteride (Avodart).
  • Surgery is recommended for the treatment of BPH if the patient has not satisfactorily responded to medication or those who have severe and complicated issues, such as a complete inability to urinate.
  • Transurethral Resection of the Prostate (TURP): In this procedure, after the patient has been administered anesthesia. the doctor inserts a unique instrument into the urethra through the penis. Using the instrument, the doctor shaves away a portion of the inner prostate to enable the easy and smooth flow of urine from the bladder. Nowadays a modification of this procedure using Normal Saline and Bipolar current has made this a very safe operation.
  • Laser procedures: Today, different kinds of laser procedures are available which help to remove the obstructing prostate tissue. Laser procedures are advantageous when compared to TURP as it causes less bleeding and quicker recovery.
  • Microwave therapy: In this procedure, microwave energy is delivered straight to the prostate to eliminate some of the cells. This finally leads to shrinkage of the prostate. This approach is not successful and given up these days.