As you get older, do you find yourself getting up more often at night to urinate? Or do you have to wait a while to urinate? Do you sometimes feel like you have more urine even after you've finished urinating? These can be related to small changes in the prostate gland that many men experience as they age. Today, we'll talk about this condition called benign prostatic hyperplasia (BPH).
What is this BPH (Benign Prostatic Hyperplasia)?
Simply put, Benign Prostatic Hyperplasia (BPH) is an enlargement of your prostate gland. The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum. Did you know that part of the urethra passes through this gland?
This urethra is a tube that carries urine and sperm out of the body. So, imagine, as this prostate gland gets bigger, that urethra that I mentioned starts to tighten. That's when the way for the urine to come out gets blocked, and the way for the semen to come out can also get obstructed.
The important thing is that BPH is not cancer. However, the symptoms of BPH can sometimes be similar to those of a more serious condition, such as prostate cancer, so it's important to be aware of that as well.
Does having BPH increase the risk of developing prostate cancer?
This is a question that many people ask. According to current research, having BPH does not increase your risk of developing prostate cancer. However, as I mentioned before, the symptoms of both BPH and prostate cancer are very similar. Therefore, if you have BPH, you may be developing prostate cancer at the same time without even knowing it.
That's why it's important for everyone with a prostate, especially those between the ages of 55 and 69, to get a prostate exam at least once a year. This can help detect cancer early. If you're black or have a family history of prostate cancer, you're at a slightly higher risk. For those with a prostate, it's best to start getting screened at age 40.
Who is most affected by this BPH condition? How common is it?
BPH is the most common prostate problem among men. In fact, almost everyone with a prostate gland will experience some degree of enlargement of their prostate gland as they age.
It is so common that by the age of 60, about 50% of men will have some symptoms of BPH. And by the age of 85, this number increases to about 90%. However, not all of them will need treatment. Only about half of those with BPH will need treatment for their symptoms.
What are the warning signs of BPH?
As I mentioned earlier, the urethra is located around the prostate gland. So when the prostate gland enlarges due to BPH, it starts to block the urethra. Therefore, early symptoms of BPH include:
- Slowness or dribbling of urine when urinating .
- Difficulty starting to urinate, having to wait a while.
- Inability to control urine and some leakage (incontinence).
- A sudden, strong need to urinate (`(urgency)`). It's almost unbearable.
- Having to get up frequently at night to urinate.
- Feeling like the bladder has not completely emptied even after urinating.
- Pain after ejaculation or when urinating.
- Change in urine color.
- A strange odor in the urine.
If you have one or more of these symptoms, it's a good idea to see a doctor.
What happens if the prostate gland is enlarged and left untreated?
If you don't get treatment, BPH can cause further blockage of the urethra. Your symptoms may then become worse. Not only that, but you may also develop other problems, such as:
- Urinary Tract Infection (UTI).
- Bladder stones .
- Blood in the urine (hematuria).
- Kidney damage. This happens when urine starts flowing back up from the bladder to the kidneys. This damage is caused by the increased pressure on the kidneys.
Therefore, if you have symptoms, it is very important to seek medical advice without ignoring them.
Why does BPH occur? What are the causes?
In fact, doctors and researchers still don't know exactly what causes BPH. However, there are several factors that are thought to contribute to it.
One theory is that as you age, your body's levels of a hormone called testosterone decrease. At the same time, your levels of a hormone called estrogen remain the same. It is thought that changes in these hormones can cause prostate cells to grow. However, sometimes, men who take testosterone in addition to taking it can also develop BPH.
Also, older men have higher levels of a hormone called dihydrotestosterone (DHT). This DHT is a more powerful form of testosterone. It is also believed to increase the size of the prostate gland.
Is BPH contagious?
No, BPH is not a contagious disease. You cannot spread it to someone else.
What kind of doctor treats BPH?
If your GP suspects you have BPH, they will refer you to a urologist, a doctor who specializes in diseases of the urinary system. These doctors are specially trained to treat these types of diseases of your urinary system.
How do you know for sure if you have BPH?
When you go to see a doctor, he or she will first ask you about your medical history, ask you questions, and then perform a physical exam. As part of this physical exam , a digital rectal exam (DRE) is performed.
During this ``Digital Rectal Exam'', the doctor carefully inserts a gloved finger into your rectum and feels the edges and surface of the prostate gland. This can give you an idea of the size of the prostate gland and detect any hard areas, such as lumps that could be cancerous.
In addition, your doctor may also perform tests such as:
- A questionnaire to assess how severe your symptoms are.
- A urine flow test measures the speed of your urine stream.
- A test to see how much urine is left in the bladder after you finish urinating.
- A cystoscopy is a test to look inside the bladder. This involves inserting a tube with a small camera through the urethra.
Can BPH be completely cured?
There is no specific cure for BPH, but there are effective treatments that can help control your symptoms.
So how is BPH treated?
If you have mild symptoms, you may not need any treatment. Your doctor may recommend a "watchful waiting" approach. This means that you see your doctor regularly to make sure your BPH doesn't get worse.
But if the symptoms are a bit more severe, there are treatments like these:
Medications
Most commonly prescribed medications work by relaxing the muscles in the prostate gland, which reduces the pressure on the urethra. Some examples include:
- Tamsulosin (Tamsulosin - Flomax®)
- Terazosin `(Terazosin - Hytrin®)`
- Doxazosin `(Doxazosin - Cardura®)`
- Alfuzosin `(Alfuzosin - Uroxatral®)`
- Silodosin (Silodosin - Rapaflo®)
Some medications reduce the production of the hormone DHT (Dihydrotestosterone) that I mentioned earlier. This can slow down the rate at which the prostate gland enlarges. These medications are especially useful for men with very large prostates. Examples:
- Finasteride (Finasteride - Proscar®)
- Dutasteride (Dutasteride - Avodart®)
Sometimes your doctor may prescribe a combination of two medications to help control your symptoms and make it easier to urinate. An example is Dutasteride and Tamsulosin (Jalyn®).
After you start taking the medication, it can take anywhere from one to eight weeks for your symptoms to subside.
Surgery
There are different types of surgery to remove parts of the prostate gland that are blocking the urethra. Some of them are:
- Transurethral Resection of the Prostate (TURP): In this procedure, your urologist inserts a special instrument (resectoscope) through your urethra to view and remove any remaining parts of your prostate gland.
- Transurethral Incision of the Prostate (TUIP): In this procedure, the doctor makes two small incisions in the prostate and where the urethra connects to the bladder (the bladder neck) to widen the urethra and make it easier to urinate.
- Transurethral Electrovaporization: In this procedure, the doctor uses an electrode to heat the prostate tissue, causing the enlarged prostate cells to vaporize.
- GreenLight™ Laser Treatment: In this procedure, the doctor uses a special laser beam to vaporize and remove the enlarged prostate tissue. This is also called Photoselective Vaporization of the Prostate (PVP).
- Aquablation®: In this procedure, the doctor uses high-pressure water jets to remove prostate tissue.
After surgery, you can return to normal activities within a few days or a week.
Minimally Invasive Treatments
Newer treatments for BPH are less invasive than surgery, meaning less damage to healthy tissue. Most of these treatments can usually be done as outpatient procedures. This means you can go home the same day. They are also less expensive, have fewer side effects, and can help you recover faster. However, because these treatments are new, there is not much information yet about their long-term effects or complications.
Some examples:
- Prostatic Urethral Lift (UroLift®): This procedure involves separating the enlarged prostate gland and widening the urethra. This makes it easier to urinate. The doctor inserts a special device (UroLift®) up the urethra and into the prostate gland. Once it reaches the side wall of the prostate, several small implants are inserted to pull the prostate gland apart and open the urethra. Depending on the size of the prostate, two to six implants may be placed.
- Rezūm™ Therapy: In this procedure, a doctor inserts a device into the urethra and moves it to the prostate gland. Then, a needle is inserted into the prostate gland. The needle releases steam, which turns into water. The heat in this water destroys prostate cells. The dead cells are reabsorbed by the body, causing the prostate gland to shrink.
The most common side effects of these treatments are the need to urinate more than usual and some discomfort or burning until the prostate gland heals.
After this minimally invasive treatment, you can return to normal activities within a few days. You should see a significant improvement in your symptoms within three to six weeks.
What is the best treatment for BPH?
TURP surgery is the most effective treatment for most cases of BPH.
However, for those over the age of 65, medication and minimally invasive treatments are best. This is because older people are more likely to have complications after surgery and may take longer to recover.
What are the good and bad foods to eat if you have BPH?
Fruits, vegetables, and healthy fats can be good for your prostate health. It's a good idea to follow a Mediterranean diet or add the following to your diet:
- Berries
- Broccoli
- Citrus fruits
- Nuts
- Tomatoes
- Turmeric
Bad eating habits can make your BPH condition worse. If you have BPH, it's a good idea to avoid processed foods, foods high in sugar and carbohydrates. Also, cut down on the following:
- Alcohol
- Caffeine (like tea, coffee)
- Dairy
- Red meat
- Sodium (salt)
Can an enlarged prostate gland return to normal?
Some people with mild BPH have their symptoms go away without any treatment. But if your symptoms don't improve while you're on the "watchful waiting" approach, you and your doctor should start talking about treatment options.
What should I expect if I have BPH?
The outlook for people with BPH is very good. Although there is no cure for BPH, there are treatments that can help control your symptoms. Mild symptoms may not require treatment at all. More severe cases can be helped with medications, surgery, and minimally invasive treatments.
How can you reduce the risk of developing BPH?
The best way to reduce your risk of developing BPH is to make lifestyle changes and take certain supplements to maintain the health of your prostate and heart.
Exercising for at least 30 minutes a day can help prevent BPH and slow down the growth of the prostate gland. It is also important to maintain normal cholesterol levels, blood pressure, and blood sugar levels.
These herbal supplements may also help reduce the risk of developing BPH:
- Beta-sitosterol: This is a micronutrient found in plants. It may help keep the heart healthy.
- Pygeum africanum: This is an herbal extract from the bark of the African cherry tree. It may help shrink the prostate gland.
- Flaxseed: Flaxseed is rich in dietary fiber and omega-3 fatty acids. It can help lower cholesterol.
- Pumpkin seed oil: This is an oil extracted from pumpkin seeds. It may help shrink the prostate gland.
But remember, you should always talk to your doctor before starting any new supplements, as they can interact negatively with other medications or supplements you are currently taking.
When should I see a doctor?
If you have any of these symptoms, call your doctor immediately:
- Pain in the lower abdomen or genital area when urinating.
- Difficulty urinating or being unable to urinate at all.
- Getting a fever or feeling cold while urinating.
- Blood in the urine.
What questions should I ask my doctor?
Here are some questions you can ask your doctor:
- How exactly do you tell if I have BPH?
- If I don't have BPH, what other condition could I have?
- What can I do to reduce my prostate enlargement?
- Do I need treatment?
- What is the best treatment for me?
- What nutritional supplements do you recommend?
- Will these supplements interact with other medications or supplements I am currently taking?
- Should I see a urologist?
What is the difference between prostate cancer and BPH?
Prostate cancer is a common type of cancer that develops in the prostate gland. In its early stages, prostate cancer rarely causes symptoms. However, as it grows, it can cause many of the same symptoms as BPH. For example, a weak urine stream, pain during ejaculation or urination, and the need to urinate frequently. Prostate cancer can spread to your bones, lymph nodes, or other parts of your body. Treatment options include radiation therapy and surgery.
The symptoms of BPH are similar to those of prostate cancer. However, BPH is not cancer, and it does not increase the risk of developing cancer. It does not spread to other parts of the body. Treatment options include medication, surgery, and minimally invasive procedures.
What is the difference between BPH and Benign Prostatic Enlargement (BPE)?
Benign Prostatic Hyperplasia (BPH) is the name of a condition that causes your prostate gland to enlarge.
`Benign Prostatic Enlargement (BPE)` is a term doctors use to describe an enlarged prostate gland due to BPH. Simply put, BPH is the cause, and BPE is the result of the enlarged prostate gland.
Finally, things to remember (Take-Home Message)
An enlarged prostate, also known as BPH, is a very common condition in men. BPH usually starts to develop around the age of 55. If you have mild BPH symptoms, you and your doctor can monitor your symptoms by doing regular checkups. But if BPH is affecting your life, there are effective treatments that can help shrink the prostate.
If you have symptoms of BPH, be sure to talk to a doctor. Together, you can decide what is the best course of action for you. Don't worry, there are good solutions!
` Enlarged prostate, BPH, prostate, urinary problems, men's health, prostate cancer, urinary symptoms
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