The Causes, Symptoms and Treatment for an ENLARGED PROSTATE (BPH)
Typically, the prostate gland in a man will begin to enlarge from the age of 40 upwards. This particular condition is known as BPH (benign prostatic hyperplasia).The prostate gland performs the function of secreting fluids that assist in nourishing the sperm. This gland surrounds the area of the urethra (a tube which plays the role of carrying the urine out of the bladder to the end part of a man’s penis). When the prostate begins to grow in size, it can start to press on the tube, which causes the urethra to narrow and can cause issues with urination.
What Causes an ENLARGED PROSTATE (BPH)
The prostate starts to grow from an increase in the amount of cells, known as hyperplasia. But the exact reasons for these increases are still unknown. There are various factors involved that include androgens, cell-signaling pathways and estrogens. When the prostate continues to grow in size, the urethra is squeezed tightly and the bladder may not be able to handle this issue or empty completely.
When at a normal size, a prostate gland is around the shape and size of a walnut. In the initial stages of enlargement, the muscles in the bladder begin to thicken due to straining to empty the bladder. This often results in the muscles in the bladder becoming more sensitive and contributing to sensations of needing to urinate more frequently. In certain cases the blockage caused from the prostate enlargement can result in repeated urinary tract infections that start to cause damages to the kidneys and the bladder.
LUTS (Lower Urinary Tract Symptoms)
LUTS is the term that is used for describing various symptoms that affect the lower urinary tract, which includes the urethra, prostate and bladder. LUTS are grouped into storage and obstructive symptoms. The obstructive symptoms are typically associated with a blockage that is usually associated with an ENLARGED PROSTATE. The enlargement of this gland can cause both obstructive and storage issues.
Treatments for an Enlarged Prostate (BPH)
Once a doctor has diagnosed an enlarged prostate, it is important to evaluate for any signs or symptoms that may contribute to potential urinary difficulties. Oftentimes, milder cases of BPH do not require any treatment at all. However, in more advanced cases, there are medical, minimally invasive, and surgical treatments available.
Medications Used To Treat Prostate Enlargement (BPH)
There are a number of medications that have been recommended as well as approved for treating prostate enlargement. Men who suffer from severe symptoms may need a combination of different medications. Some of these traditionally include:
- Alpha-blockers (such as Flomax or tamsulosin), which are used to relax the prostate muscles, which can relieve the symptoms
- 5-alpha Reductase Inhibitors (such as Proscar or Avodart), which can make the prostate decrease or shrink in size
Office Procedures for Prostate Enlargement (BPH)
Like most areas in medicine, urology has seen an explosion of technological advances over the past several decades. The ability to successfully treat medical conditions in the office setting which previously required several nights in the hospital has been transformative. For BPH, one such advance is in office microwave thermotherapy for BPH.
Transurethral microwave thermotherapy (TUMT) is a 30 minute comfortable non-surgical procedure where the prostate is gently warmed. Over the course of several weeks after the procedure, the body’s scavenger cells (macrophages) remove the previously heated cells from the prostate, and remove the obstruction from a man’s water channel so that he may urinate freely. Additionally, people are usually able to discontinue all prostate medications after 3 months.
Surgical Treatments for Prostate Enlargement (BPH)
If the patient has severe symptoms or complications, surgery may be the only choice available. This will require a trip to the OR for transurethral resection of the prostate (TURP) or even a “simple” prostatectomy for BPH, which is an open surgical procedure. These will require overnight hospital admissions.