|
|
ABOUT BPH (BENIGN PROSTATIC
HYPERPLASIA)
What is benign prostatic hyperplasia (BPH) or enlarged prostate?
- BPH (benign prostatic hyperplasia) is a
progressive condition in which the prostate becomes enlarged and leads to
frequent urination, decreased urine stream, difficulty or pain while
urinating, or a feeling of incomplete emptying of the bladder3
- BPH or enlarged prostate is not cancer. Although some of the signs of BPH
and prostate cancer are the same, having BPH does not seem to increase the
chances of getting prostate cancer2
- BPH is one of the most common health problems in older men4
Men who experience severe symptoms of BPH can experience develop serious
problems over time such as kidney disease3
Who suffers from BPH?
- BPH affects nearly 8 million men in the United States5
- BPH affects more than 50 percent of men over age 602
- BPH affects as many as 90 percent of men over age 702
What are the symptoms associated with BPH?
The symptoms of BPH vary, but the most common involve changes or problems
with urination that disrupt a man’s personal and professional life with
interruptions on a daily basis such as3:
- Frequent need to urinate in short intervals
- Feeling of little warning when urge to urinate develops
- The need to urinate during the night
- Weak urine stream
- Delay and difficulty in initiating urination
- Feeling of incomplete emptying of the bladder
- Stopping and starting urination several times during voiding
BPH can also be associated with:
- Decreased quality of life6
- Worsened sex performance7
- Reduced sexual drive7
- More frequent erectile dysfunction7
Progression of BPH can result in:- Urinary retention3
- Urinary tract infection3
- Bladder stones3
- Kidney damage3
- Blood in urine3
How is BPH diagnosed?
- Preliminary Doctor’s Visit: Patients suffering from BPH-associated
symptoms should first have a physical exam from their doctor to address
their medical history and identify their symptoms8
- Urine Test: A urinalysis is a preliminary test to rule out
urinary tract infections or other conditions that cause BPH-like symptoms,
such as temporary inflammation of the prostate (prostatitis), bladder
infection and kidney disease8
- Digital Rectal Exam (DRE): If a doctor concludes that a
patient’s condition may be BPH, he will conduct a Digital Rectal Exam (DRE)
which allows the doctor to assess the size, shape and general condition of
the prostate gland8
- Prostate-specific antigen (PSA) blood test: The prostate
produces prostate-specific antigen (PSA) to help liquefy semen. When this
blood tests reflects a higher than normal level of PSA in the blood, it
can indicate BPH, prostate cancer or prostatitis8
- Transrectal Ultrasound: Estimating the size of the gland can
help with the diagnosis. A transrectal ultrasound takes about 30 minutes
to administer and uses sound waves to provide an image of the prostate8
- Urine Flow Study: This test measures the strength and amount
of urine flow when a patient urinates into the test machine. Charting the
results of this test over time helps determine if the condition is getting
better or worse8
What are some of the treatment options for BPH?
- Watchful Waiting: The method is the preferred approach for
men with mild symptoms or who have symptoms that don’t bother them. During
this observation therapy, the doctor examines the patient and monitors the
condition to see if the symptoms are improving or getting worse8
- Medications: Medications are the most common way to control
mild to moderate symptoms of BPH. This is considered the preferred way to
treat BPH, unless the condition is severe enough to require surgery.
Medications significantly reduce major symptoms for about two-thirds of
men treated8
- Alpha-blockers are prescription medicines that relax the muscles in
and around the prostate, making it easier to urinate. The most common side
effects of alpha-blockers are headaches, dizziness and fatigue8
- 5-alpha-reductase inhibitors are prescription medicines that can
reduce the size of the enlarged prostate in some men. They do not work as
quickly as alpha-blockers and generally work best on men with severe
prostate enlargement. The most common side effects of 5-alpha-reductase
inhibitors are ejaculatory dysfunction, erectile dysfunction and decreased
libido8
- Minimally Invasive Therapies: These procedures are less invasive
than surgery and have recently been developed to treat BPH symptoms. Most
approaches use heat to destroy prostate tissue that’s pressing against the
urethra and blocking urine flow. Generally, minimally invasive therapies
require local anesthetic and can be performed on an outpatient basis8
- Transurethral microwave therapy- This approach uses microwave heat
to remove excess prostate tissue via a small microwave antenna inserted
through the urethra. The antenna emits a dose of microwave energy that
heats overgrown prostate cells and destroys them without damaging nearby
normal tissue8
- Transurethral needle ablation- Transurethral needle ablation
(TUNA), also called radiofrequency therapy, is an outpatient procedure
that uses radio waves to heat and destroy the part of the prostate that's
blocking urine flow. A special catheter is guided through the urethra
where small needles are inserted into the prostate and radio waves then
heat the prostate8
- Interstitial laser therapy (ILT)- During ILT, a small tube
containing a laser fiber is inserted into the prostate tissue by
puncturing through the part of the urethra that's next to the prostate.
The procedure destroys overgrown prostate tissue by directing laser energy
at the inside of the enlarged prostate gland8
- Surgery: In the past, surgery was the most common way to
treat BPH but its popularity has been declining with the advancement of
new medications and minimally invasive treatments with minimal sexual side
effects. Surgery will be considered if the patient suffers from severe
symptoms. The two primary types of surgical procedures currently in use
are transurethral surgery and open prostatectomy8
|
|
|