Benign prostatic hyperplasia (BPH) refers to prostatic enlargement, which is the most common prostatic problem in men aged 50 years and older. In fact, at 60 years old, half the male population would have BPH and, at 85 years old, 90% would have this condition.
Although this is a benign condition and does not increase the risk of prostate cancer, it is still important to be aware of this condition. BPH can markedly decrease quality of life and can lower self-esteem and personal independence. It can also worsen over time, which is why diagnosis and management are highly recommended.
What is the prostate?
The prostate gland is located inside the body, below the bladder and above the pelvic floor muscles, with the rectum directly behind. It usually weighs between 30-40 grams and is about the size of a walnut (or a chestnut, or a ping-pong ball, whichever comparison you prefer).
Its most important function is the production of a fluid of which semen is partially comprised, in addition to fluids produced from other male reproductive glands and from the testicles. Also, the prostatic muscles help with expelling semen during ejaculation. That said, the prostate is then important for sexual health.
Symptoms of benign prostatic hyperplasia
Although the pathophysiology is still unclear, it is thought that the prostate increases in size in response to increased testosterone production.
Symptoms of BPH include urinary symptoms, given the fact that when enlarged, the prostate presses on the bladder and causes irritation. Urinary symptoms include difficulty beginning urination, dribbling, and the sensation that you have not completely emptied your bladder. Your sleep may also be affected by frequent nighttime urination, and you may also have some degree of incontinence. Because more urine stays in the bladder, you become more prone to urinary tract infections.
Other causes of urinary symptoms also exist, such as prostatic inflammation, kidney stones, opioid medicines, cold and allergy medicines, scarring due to previous surgeries, and problems with the nerves that control the bladder.
This is important to know because it is a common misconception that men ordinarily just tend to have increased urination urgency and frequency with age. Should you or your loved one have any of these symptoms, please consult your doctor.
Diagnosing and treating benign prostatic hyperplasia
Prostatic enlargement can easily be determined by a digital rectal exam, as performed by your physician. Should you have a urinary tract infection, as determined by testing a urine sample, this can also be treated by antibiotics. Your doctor will usually also ask for a blood sample to check for prostate specific antigen (PSA) to screen for prostatic cancer.
For BPH, there are two types of drugs that can be used to manage symptoms: alpha blockers (such as tamsulosin, commonly known as Flomax, and doxazosin) and 5-alpha-reductase inhibitors (5-ARIs, such as finasteride, trade name Proscar, and dutasteride). Alpha blockers work by relaxing the muscles around the prostate and the bladder opening, while 5-ARIs slowly shrink the prostate over a period of 6 months to a year. For patients who have both BPH and erectile dysfunction, tadalafil (Cialis) is a therapeutic option.
Should the medications not be effective, there is also the option for surgery. The most common type of surgery is minimally invasive and allows for the removal of excess prostatic tissue.
Here to help
We are here to help any way we can. From medication management to post-operative care to escorting you to your medical appointments, Likas Nursing is here for you. Give us a call today!
