Benign prostatic hyperplasia (BPH)

DEFINITION

Prostate gland enlargement, also known as Benign prostatic hyperplasia (BPH), is a common condition in aging men. It can lead to urinary symptoms and, if left untreated, can cause complications affecting the bladder, urinary tract, or kidneys. Treatment options include medications, minimally invasive therapies, and surgery.

SYMPTOMS

Symptoms of BPH can vary in severity and may worsen over time. Common signs include:

• Frequent or urgent need to urinate
• Increased nighttime urination (nocturia)
• Difficulty initiating urination
• Weak urine stream
• Dribbling at the end of urination
• Straining while urinating
• Incomplete emptying of the bladder

Other possible causes of urinary symptoms

Conditions such as urinary tract infections, prostate inflammation (Prostatitis), urethral stricture, bladder or kidney stones, nerve problems, or prostate or bladder cancer can present with similar symptoms to an enlarged prostate.

WHEN TO SEE A DOCTOR

If you experience urinary issues, it's essential to consult your doctor to identify any underlying causes. Seek immediate medical attention if you are unable to urinate at all.

CAUSES

The exact cause of prostate enlargement is not fully understood but is believed to be related to hormonal changes as men age. Risk factors include aging, family history, ethnicity, diabetes, heart disease, and lifestyle factors like obesity and lack of exercise.

RISK FACTORS

Risk factors for BPH include age, family history of prostate issues, ethnicity, diabetes, heart disease, and lifestyle factors such as obesity and lack of exercise.

COMPLICATIONS

Complications of BPH can include urinary retention, urinary tract infections, bladder stones, bladder damage, and kidney damage. Prompt diagnosis and treatment are crucial to prevent these complications.

PREPARING FOR YOUR APPOINTMENT

Before your appointment with a urologist:

• Make a list of symptoms.
• Keep track of your urination patterns.
• Note your medical history and current medications.
• Prepare questions for your doctor.

Questions to ask your doctor:

1. Is an enlarged prostate causing my symptoms?
2. What tests are needed?
3. What are the treatment options?
4. How can other health conditions be managed alongside an enlarged prostate?
5. Are there any restrictions on sexual activity?

TESTS AND DIAGNOSIS

Diagnosis involves a physical exam, urine tests, blood tests (including PSA levels), neurological exams, urinary flow tests, postvoid residual volume tests, and possibly imaging studies like ultrasound or cystoscopy.

TREATMENTS AND DRUGS

Treatment options range from medications (alpha blockers, 5-alpha reductase inhibitors) to minimally invasive therapies (TURP, TUMT) and surgery (prostatectomy). The choice of treatment depends on the severity of symptoms and individual health factors.

LIFESTYLE AND HOME REMEDIES

Managing BPH symptoms can be aided by lifestyle changes such as limiting evening beverages, reducing caffeine/alcohol intake, following a healthy diet, staying active, and practicing timed voiding techniques.

ALTERNATIVE MEDICINE

While herbal remedies like saw palmetto extract have been suggested for BPH relief, their efficacy is not conclusively proven. Consult with your doctor before using any alternative treatments.

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QUESTIONS

1. What are some common symptoms of BPH?

Frequent or urgent need to urinate.

Weak urine stream.

Difficulty starting urination.

2. What are some risk factors for prostate gland enlargement?

Aging.

Family history of prostate problems.

Diabetes.

3. When should you seek immediate medical attention regarding urinary issues?

If you are unable to pass any urine.

4. What are some complications that can arise from an enlarged prostate?

Urinary retention.

Bladder stones.

Kidney damage.

5. What are some lifestyle recommendations for managing BPH symptoms?

Limiting evening beverages.

Staying active.

Following a healthy diet.

6. What types of treatments are available for BPH?

Medications.

Minimally invasive therapies.

Surgery.

7. How can BPH be diagnosed?

Through physical exams.

Urine tests.

Imaging studies like ultrasound or cystoscopy.

8. What questions should you ask your doctor about BPH during an appointment?

Is an enlarged prostate causing my symptoms?

What are the treatment options?

9. Are there any approved herbal medications for treating enlarged prostate?

No herbal medications have been approved by the FDA for this purpose.

10. What might be recommended if medication doesn't relieve moderate to severe BPH symptoms?

Minimally invasive therapies or surgery may be recommended based on individual circumstances.