Benign Prostatic Hyperthropy - Enlarged Prostate

Benign prostatic hypertrophy (BPH) also called enlarged prostate is a non-cancerous condition of the prostate gland. The cells divide too rapidly leading to gradual enlargement of the gland. This is unlike cancer of the prostate where there is an uncontrollable growth of cells leading to a malignant tumor. The actual changes can begin as early as age 30, but in most cases prostatic hypertrophy occurs after age 50. The enlarged gland will restrict urine flow from the bladder as the urethra becomes too narrow for normal passage of urine. The person with BPH will experience difficulties with urinary function interrupting quality of life.

The cause of an enlarged prostate is unknown, but changes in the levels of hormone in the blood may be a factor. Aging does seem to play a role as the enlargement takes place gradually over several years.

Diagnosis
Diagnosis is usually made by a digital rectal examination ( DGE). Using a gloved finger the rectum and anus are examined by a physician who is able to feel the prostate for any irregularities. Hyperplasia can then be distinguished from cancer of the prostate. Other diagnostic tests are: Ultrasound of the prostate and blood test for prostate specific antigen.

Signs & Symptoms: Signs and symptoms may not appear immediately, so many years may go by before treatment is sought for enlarged prostate. Restriction of the urine flow will lead to incomplete emptying of the bladder and eventual retention of urine. They are:

• Urinary retention
• Frequency
• Blood in the urine
• Urgency
  
• Raised PSA

Complications

Urinary tract infection can occur if the urine retained in the bladder becomes infected. They are:

• Urinary infection
• Kidney disease
• Stone formation

Treatment

The treatment of BPH is aimed at restoring normal urinary function. This means returning the urethra to its normal state for the normal passing of urine.

Drugs: These are used to:

• Relax the muscles around the bladder outlet allowing the urine to flow
• To shrink the prostate glands and prevent the need for surgery

Surgery: Trans-urethral resection (TUR) is a surgical procedure in which the tissue surrounding the urethra is removed. This is done using an instrument or a heated wire loop. No incision is made. Side effects are blood in the urine, hypertension and impotence.

Alternative Medicine: A herbal remedy has been used successfully to decrease the hyperplasia. After taking the extract for about two months, symptoms are significantly improved. The herb, an extract of saw palmetto is also recommended for continued use. Side effects are nausea, headache and upset stomach, these are however rare. Compared to other drugs it is safe.

Another treatment is destruction of the tissue obstructing urine flow, using radio frequency energy. When surgery is not necessary and drugs have not been effective this is the treatment of choice. It is done under local anesthetic and does not require hospitalization.

Prognosis: The outcome is good if treatment is commenced early. Complications of treatment are usually of short duration. Once symptoms are relieved quality of life is expected to be restored. Some may even see an improvement in lifestyle as they strive to promote healthier prostates.

Treatment for enlarged prostate
For information on the alternative treatment for BPH