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bph (Enlarged Prostate) treatment and surgery

BPH (Enlarged Prostate) Treatment Hospital, Symptoms & Diagnosis in India

Enlarged Prostate (BPH)

BPH (Enlarged Prostate) / Benign Prostatic Hyperplasia :
 

We lose control over the physiological, psychic and other aspects of the body as we age, to a certain extent. While we may be exercising regularly, consuming a nutritious diet and also have a lifestyle devoid of bad habits, still certain conditions may develop as we age. Benign Prostate Hyperplasia (BPH) or enlarged prostate is one of these conditions.

The urethra or the tube which carries the semen and urine out of the body through the penis is surrounded by the prostate gland. The enlargement of the prostate gland with aging to a certain extent is normal and does not cause any abnormalities. But when the enlargement exceeds these limits, the urethra gets squeezed. This particular condition is termed as Benign Prostate Hyperplasia.

The squeezing of the urethra does not allow the normal evacuation of the urine. You may have to go to the bathroom multiple times for excreting small amounts of urine and there may also be other bothersome or inconvenient impacts of the condition. Enlarged prostate gland may also adversely impact the kidney and urinary bladder.

Causes of BPH (Enlarged Prostate) :

The prostate gland doubles in size at the onset of puberty and again starts to grow at the age of around 45 years. From then on it continues to grow.

In some people, it may enlarge to an abnormal extent and be referred to as an enlarged prostate. Many doctors are of the opinion that the regular and normal hormonal changes that occur in the body may be a cause of the disease.

The changes that occur in the body as men get older and that is associated with the balancing of the sex hormones may specifically cause the condition. But the more exact causes are not known.

Symptoms of an Enlarged Prostate Gland or BPH :

There are a number of symptoms related to the enlargement of the prostate gland which clearly indicate the presence of the condition. These symptoms may also worsen gradually over a period of time if the disease is not treated early.

Some of the Symptoms of BPH (Enlarged Prostate) Include :

  • Nocturia or increased  urination frequency during the night
  • Frequent and urgent need of urination during the day
  • Difficulty in starting urination
  • A urine stream that starts and stops abruptly
  • A weak stream of urine
  • Difficult incomplete urination or thorough emptying of the bladder
  • Dribbling at the end of urination


As said earlier, the enlargement of the prostate gland may also pose problems to other organs including the kidneys. There are also certain other symptoms of BPH but these are less common and include:

  • An Infection in the urinary tract
  • Urine containing blood
  • A complete inability towards urination
     

There is no clear link between the size of the prostate and the symptoms. Some men having smaller prostate enlargements have more severe symptoms and vice versa. In some cases, it has been found that the symptoms of BPH stabilize or may even get more improved over a period of time.

Symptoms of an enlarged prostate gland may also coincide or be the same as the symptoms of other medical conditions including cancer or inflammation of the prostate, the presence of stones in kidney or bladder, scarring in the bladder and other conditions. Enlargement of the prostate is not cancer but only a doctor can diagnose the real cause of the symptoms.

Risk factors of BPH (Enlarged Prostate) :

Below are the most common risk factors for BPH -
  • BPH has been found to run in families, which means that if you have a family relative affected by the condition you are more likely to have it.
  • Age is another risk factor of BPH and one-third of men in between the ages 40 to 60 years may have moderate to mild symptoms. Around half the male population at the age of 80 and above has the symptoms of BPH.
  • Diseases including heart disease and diabetes may increase the risk of BPH.
  • Those having higher body mass index (BMI) or suffering from obesity are more exposed to the risk of BPH while those who exercise regularly have a reduced risk.


When to see your doctor?

An enlarged prostate is mostly having the symptoms related to difficulty in urination, as stated earlier. It is important to see the doctor if you have any of the symptoms as these will worsen over time and may also impact the health of other organs that are part of the urinary system.

As the symptoms of BPH are similar to other grave and fatal diseases, it is very important for you to reach out to an expert to diagnose the condition in the best way and with most reliable results. A grave or more complete obstruction of the urinary tract may also occur if the condition is not treated in time.

Complications of BPH (Enlarged Prostate) :


The disease may have serious and grave complications later on.
 
Urinary Retention - When the patient has a complete inability towards urinating, the urine gets accumulated inside the bladder and a catheter may be used for draining it out of the body. Surgery may also be done to improve the condition.

Frequent UTIs - If the urine is not adequately drained, frequent infections of the urinary tract may occur.  A part of the prostate gland may be removed through surgery if infections are occurring frequently.

Kidney Damage - Damage to kidneys may also occur because of the increased pressure in the bladder due to retention of urine. The infections of the bladder may also reach  the kidneys.

Bladder stones may occur in the bladder because of urine retention and may be a cause of irritation, infections, and occurrence of blood in the urine. The stones may also obstruct the flow of urine. 

Damage to Kidneys and the condition of acute urinary retention are grave and serious conditions.

Diagnosis of BPH (Enlarged Prostate) :

The doctor will try to know your family history and other aspects of your physical condition. He may ask you questions directly about your condition or you may be required to fill a survey form, which will have questions pertaining to urination and other aspects of the condition.

The doctor will also try to examine the shape and size of your prostate  gland through the digital rectal examination. During the examination, he will wear the gloves and insert a finger gently into the rectum area for the examination.

Prostate Specific Antigen or PSA test, blood test, and urine test are also carried out. Apart from detecting the condition of the prostate, these tests also aim to find out the presence of any infection or adverse impact on the kidney.

Advanced tests including ultrasound, biopsy (for ruling out the presence of cancer), and urodynamics test (for evaluating the functioning of the bladder).

Treatment of BPH (Enlarged Prostate) :

The severity of symptoms of BPH, shape, and size of the prostate/other organs, the age of the patient, overall health and other aspects are carefully evaluated to decide the best course of treatment. Some patients have very mild symptoms so that they do not bother much and these patients may wait a while and see how it actually goes.
 

Lifestyle Changes :

For very mild symptoms, lifestyle changes may be adequate in some cases. Patients are advised certain exercises that can strengthen the muscles of the pelvic floor area. They should also drink and consume less alcohol and caffeine and should avoid fluids at the time they go to sleep.
 

Medications :

Medicines can be used for treating the moderate to mild prostate enlargement condition. The medications can directly shrink the prostate so that it assumes a more normal size. Some medications also relax the bladder and the urethra so that urination is more comfortable.
 

Surgical Procedure and Techniques :

When medications and lifestyle changes do not work, surgery is the only resort available to the physician. The new minimally invasive surgical procedures ensure that no large cuts are made to the body, and these can be carried out through probes and scopes.

TUMT (TransUrethral Microwave Therapy) - Use of cold and heat for killing excess prostate cells and tissues. A catheter is entered inside the prostate and has instruments for generating and delivering microwave heat/energy.

TUNA (TransUrethral Needle Ablation) - A Cystoscope (a surgical and visual instrument is inserted via the penis into the urethra. Tiny radio-frequency (RF) needles are also passed through the Cystoscope and these deliver heat and cause necrosis, thereby shrinking the prostate issues. 

Procedures including Laser Therapy and TransUrethral Resection of Prostate (TURP) are more involved surgical procedures and are carried out to remove a part of the prostate gland. 

Laser Therapy - A scope is inserted via the penis tip into the urethra. As the urethra is surrounded by the prostate gland, the heat/energy (passed through the scope subsequently) cuts the excessive tissues of the prostate or melts them. 

TUIP (Transurethral Incision of Prostate) - The method involves making some small incision on the prostate so that the pressure on urethra can be released.


A Robotic Surgery or an Open Surgery may also be performed if all these measures are incapable of treating the enlarged prostate condition.

Open Surgery - Open surgery for enlarged prostate (or open prostatectomy) is usually carried out if the prostate is excessively large, or when TURP cannot be done because of some reason. It may also be carried out if bladder stones are there, or the bladder wall has pouches (bladder diverticula).

Surgery for treating BPH may also have certain complications and side effects. Erectile dysfunction, incontinence, stricture/ narrowing of the urinary tube, and bleeding may be some of the side effects of a surgery. While some of the conditions may heal themselves naturally, others may require medical intervention.

A number of treatment methods are available for the treatment of the disease BPH. But it is important for the patient to reach out to the doctor early so that the symptoms do not aggravate and worsen over a period of time and cause damage to other vital organs of the body. A prompt medical intervention will avoid the complications and may improve the condition easily.

BPH (Enlarged Prostate) FAQs :


How can I reduce the size of my prostate?

Certain lifestyle changes like reducing the intake of caffeine and alcohol, and exercises, and medications and supplements can be used for reducing Prostate’s size. Supplements including saw palmetto, ryegrass, pygeum, and beta-sitosterol can help provide relief from the symptoms of enlarged prostate and BPH and may also reduce the size of the prostate.
 
The size of the prostate may also be managed through medications and surgical procedures. A doctor will better diagnose the condition, the extent of enlargement, and will help you choose the right course of treatment.
 

Is enlarged prostate a serious problem?

In most cases, an enlarged prostate does not possess a serious threat or problem to health and is a normal aging process. In other cases, it may lead to serious conditions including urinary retention and kidney damage. Hence, it is important to get the condition diagnosed at an expert clinic or hospital.
 

What is the best medicine for BPH?

Medications can shrink the prostate and/or can provide for easy and convenient urination. For instance, the “Alpha blockers” relax the prostate muscles and allow the urine to flow easily. Medications can be used alone or in combination and their choice depends on the condition of the prostate and the symptoms, among other aspects.
 

What is the main cause of BPH?

Changes that affect the balance of the sex hormones in adults are considered to be the main cause of BPH.
 

Which drug is best for BPH?

The choice of medication depends on the results of the diagnosis. Medications including “Alpha blockers” and the “5 Alpha-reductase inhibitors” are used for treating BPH. No single medication can be termed as the best.
 

What medication should be avoided in BPH?

Diuretics, tricyclic antidepressants, Antihistamines, and decongestants are a certain class of drugs that should be avoided during enlarged prostate as they may worsen the symptoms of BPH.
 

Which drug shrinks the prostate?

The “5 alpha reductase inhibitors” including Dutasteride and Finasteride prevent the occurrence of certain hormonal changes that lead to the growth of prostate and also shrink it.
 

What do doctors prescribe for enlarged prostate?

Drugs used for treating enlarged prostate include: 
  • Alpha Blockers - These drugs relax the muscles of the bladder and the prostate and relieve symptoms. The medications includes Alfuzosin and Terazosin among others.
  • 5 Alpha-reductase Inhibitors - These drugs do not allow the prostate to grow any further and also cause its shrinkage. Finasteride and Dutasteride are 2 drugs of this classification.
  • Phosphodiesterase 5 Inhibitors - Drugs of this class including Sildenafil can improve the flow rate of urine.
Surgery may also be done in certain cases.
 

What is the best treatment for BPH?

There is no one-size-fits-all or best treatment for enlarged prostate and benign prostate hyperplasia. The extent of prostate enlargement, the effect of the condition on other organs, symptoms and their gravity and other aspects are evaluated for choosing the best treatment course for BPH, for a given individual or patient.
 

What foods are good for shrinking the prostate?

A Mediterranean style diet including lots of fruits and vegetables is good for preventing BPH and reducing the size of the prostate. You should also choose plant protein over animal protein. Processed, refined, and fried food should be avoided and the caffeinated drinks and beverages including tea and coffee should only be consumed in moderation.
 
Vegetables high in vitamin C, including broccoli, bell peppers, and Brussels sprouts, and food high in zinc including the coasters and crabs should be included in the diet. BPH symptoms can be lessened by consuming at least four servings of vegetables each day, and by consuming a diet low in fat.
 

Can you shrink an enlarged prostate?

An enlarged prostate can be shrunk by medications and lifestyle changes. Minimally invasive surgery or open surgeries may also be performed for lessening prostate size. An expert and well-qualified doctor can provide you with the necessary medications, tips related to lifestyle changes and habits, and may also perform surgery when required.
 


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