What Treatments Are There For Bph
If you have LUTS linked with BPH, its important to think about how much the symptoms are bothering you before deciding on treatment.
If your symptoms are mild, it might be best not to have any treatment, as treatment side effects can affect your quality of life more than your initial symptoms prior to treatment. There are medicines that can help if you have mild to moderate symptoms. If your symptoms are moderate to severe, there are a number of surgery options with varying risks and benefits.
Because BPH can affect your relationships, it can help to include your family or partner in the treatment process.
Urodynamic Assessments Of Bladder Outflow Obstruction Associated With Benign Prostatic Hyperplasia
- Kun Dou1
1physician in the Department of Urology at Kunming General Hospital in Kunming, P.R. China
2surgeon in the Department of Urology at Kunming General Hospital in Kunming, P.R. China
3surgeon in the Department of Urology at Kunming General Hospital in Kunming, P.R. China
4surgeon in the Department of Urology at Kunming General Hospital in Kunming, P.R. China
5surgeon in the Department of Urology at Kunming General Hospital in Kunming, P.R. China
DOI:10.31083/jomh.v11i6.18Vol.11,Issue 6,December 2015 pp.29-34
07 December 2015
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Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
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Is Bph Prostate Cancer
Remember, the b stands for benign. BPH is not prostate cancer, and having BPH doesnt mean a man is more or less likely to get prostate cancer.
Prostate cancer begins in the outer peripheral zone of the prostate, and grows outward, invading surrounding tissue . It often has no symptoms for months or even years, prompting scientists to dub it silent. Because BPH grows inward, it produces annoying, difficult-to-ignore symptoms. An enlarged prostate alone may or may not cause symptoms . However, the degree of bothersome symptoms is the most common reason men seek treatment.
Personal And Family Medical History
Taking a personal and family medical history is one of the first things a health care provider may do to help diagnose benign prostatic hyperplasia. A health care provider may ask a man
- what symptoms are present
- when the symptoms began and how often they occur
- whether he has a history of recurrent UTIs
- what medications he takes, both prescription and over the counter
- how much liquid he typically drinks each day
- whether he consumes caffeine and alcohol
- about his general medical history, including any significant illnesses or surgeries
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What And Where Is The Prostate
The prostate gland, which is found only in men, is an important part of the reproductive system. It secretes a fluid that is part of semen and keeps sperm alive and healthy.
The prostate is found behind the base of the penis and underneath the bladder. The urethra runs through the middle of the prostate.
Others Forms Of Diagnosis
If the IPSS diagnosis appears inconclusive or suggests a possible problem, your doctor may recommend one of several other diagnostic procedures, including:
- Digital rectal examination used to assess the size and shape of the prostate gland.
- An abdominal examination to check whether the bladder can be felt .
- Urine and blood tests checking for infection or unusual cells.
- A prostate-specific antigen test. Increased levels of PSA often suggests prostate damage. A high PSA can indicate the presence of prostate cancer or BPH.
- Urine flow tests . Several different tests designed to measure urine flow. Peak flow rate, for example, tests for a flow rate of less than 15 ml/second. This often suggests an obstruction. However, urine flow measurements may also be affected by the bladder being unable to contract or shrink properly.
- Post-voidal residual urine measurement. This involves using ultrasound equipment to check the volume of urine left in your bladder after you have urinated. In general, volumes of 200ml or more suggest a problem and may prompt doctors to consider less conservative therapies.
- Trans-rectal ultrasound. This allows an accurate measurement of the volume of the prostate and may guide the physician in choosing the correct therapy.
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What Are Medications And Surgery Procedures That Treat Bph
There are several different ways to treat BPH, and the treatment may vary with the different factors. Alpha-blockers and PDE-5 inhibitors commonly treat the dynamic factors associated with BPH, whereas 5-alpha reductase inhibitors and surgical interventions treat the static factors, and anticholinergics and beta 3-adrenoceptor agonists treat the compensatory factors.
Men should carefully weigh the risks and benefits of each of these options. Although surgical intervention tends to produce the most significant impact on symptoms, it is associated with greater risk and is typically reserved for individuals who fail medical therapy, either by lack of adequate symptom improvement or side effects of the medication.
Medical treatment of BPH is usually reserved for men who have an elevated AUA-SI :
Surgery or office procedures may also be used to treat BPH, most commonly in men who have not responded satisfactorily to medicine or those who have more severe problems, such as a complete inability to urinate, kidney problems due to the BPH, recurrent urinary tract infections, recurrent bladder stones, or gross hematuria .
Are There Other Non
Yes, aside from BPH, there are a number of prostate problems that also have nothing at all to do with prostate cancer. Among these benign disorders of the prostate are acute prostatitis and chronic prostatitis and, rarely, prostatic infarct .
Acute prostatitis is a bacterial infection of the prostate. It can occur in men at any age. Symptoms include fever, chills, and pain in the lower back and between the legs. This problem also can make it hard or painful to urinate. Doctors prescribe antibiotic medicines for acute prostatitis and recommend that the patient drink more liquids. Treatment is usually successful.
Chronic prostatitis is a prostate inflammation that tends to recur over time. It is usually not associated with true bacterial infection but causes similar symptoms of pain and discomfort, without fevers or chills. Chronic prostatitis is difficult to treat, and the exact cause is not well understood. Antibiotics may be used in some cases as well as anti-inflammatory medicines such as ibuprofen. In many cases, symptoms will resolve on their own.
Prostate infarct is a localized area of dead prostate tissue as a result of inadequate blood supply. Prostate infarct is uncommon and may cause sudden increases in the PSA test.
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How Is Bph Diagnosed And Evaluated
Early diagnosis of BPH is important because if left untreated it can lead to urinary tract infections, bladder or kidney damage, bladder stones and incontinence. Distinguishing BPH from more serious diseases like prostate cancer is important.
Tests vary from patient to patient, but the following are the most common:
Global Benign Prostatic Hyperplasia Treatment Market Research Report 2021
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What Is Benign Prostatic Hyperplasia Or Prostate Adenoma
This condition is known as Benign Prostatic Hyperplasia because it refers to the non-malignant growth of prostatic tissue in men from middle age onwards. In a young man, the prostate gland is at an almost undetectable rudimentary stage, and spreads across the coating of the urinary tract like a cluster of seeds. However, during puberty, its form begins to change due to the increased production of the testosterone and dihydrotestosterone hormones.
Testosterone causes the “seeds”, called acini, to germinate and grow. In adult life, due to this growth and proliferation, these small glandular structures can give rise to obstructive symptoms associated with urinary flow disorders.Benign Prostatic Hyperplasia is one of the most common diseases in men and is considered to be part of the physiological ageing process. The incidence of this disease is 51% in men aged 60 to 69, and between 75% and 90% in octogenarians.
Who Is Most Likely To Be Affected
The precise cause of BPH remains poorly understood despite ongoing research. That said, a number of contributors and risk factors have been identified, including the following.
- Males only
- Age: This is the most significant risk factor for BPH. It is almost unheard-of in young men, while post-mortem studies suggest more than 80 percent of men over 80 years old have at least some BPH.
- Hormones: Particularly androgens such as testosterone and dihydrotestosterone are known to contribute to BPH development and progression. This is based on the knowledge that blocking these hormones can treat BPH while supplementing them can worsen BPH or even trigger it. However, these hormones are also part of normal biology and most men with BPH have normal hormone levels.
- Race: This may play a role in BPH risk, though the evidence for this is somewhat unclear. Some studies have found that black men are more likely to need surgery for BPH than white men, while Asian men are less likely than either group to require prostate surgery.
Various other possible risk factors such as obesity have been proposed, though evidence for these is conflicted.
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What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.
What Other Problems Might An Enlarged Prostate Cause
A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:
- youre aged 70 or over
- your prostate is very large
- you have a raised prostate specific antigen level
- you have severe urinary symptoms and a very slow flow.
Chronic urine retention
This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.
Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.
There are treatments for chronic urine retention, including:
- passing a thin, flexible tube called a catheter to drain urine from your bladder
- surgery to widen the urethra.
Acute urine retention
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What Are The Risk Factors For Enlarged Prostate
Researchers are still largely unclear on what causes the prostate to become enlarged but risk factors include:
- Age: As many as 90 percent of men over the age of 80 have an enlarged prostate.
- Family history: Men who have a family history of the condition are more likely to suffer from it.
- Other health issues: Men who suffer from obesity, heart disease, or type 2 diabetes have higher rates of an enlarged prostate diagnoses.
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
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Treatment If The Condition Gets Worse
If any of the following occur, you will probably need surgery for benign prostatic hyperplasia :
- You cannot urinate.
- Your BPH is causing repeated urinary tract infections, bladder stones, or bladder damage.
- You have blood in your urine that is not getting better and is causing other problems such as clots that make it hard to urinate.
- You have kidney damage.
How Is Enlarged Prostate Diagnosed
The first step is a standard physical exam which often involves a urine analysis and a digital rectal exam, which involves a doctor inserting a finger into the rectum. The physician will assess the size and contour of the prostate and determine if any nodules are present, which may suggest the presence of prostate cancer.
The physician may also assess for tenderness, which can be found when the prostate is inflamed. Tests may be done in the office to assess strength of urine flow or to check for residual urine in the bladder.
Next, doctors may run one or several tests to make an accurate diagnosis. These can include a PSA blood test, urodynamic tests , cystoscopy and transrectal ultrasound .
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Turp / Greenlight Pvp Laser / Thermotherapy
Transurethral resection of the prostate has long been the mainstay of enlarged prostate surgery, but less invasive alternatives are now available, with the potential for equal results. With TURP, the obstructing portion of the enlarged prostate tissue is removed. Although effective, TURP requires hospitalization and catheterization for 48 hours or more and comes with risks associated with anesthesia bleeding during and after the operation and, in rare cases, fluid absorption that can be life-threatening.
Prostate LaserOne alternative that has emerged is laser enlarged prostate surgery. Like TURP, the so-called GreenLight PVP Laser Therapy aims to create a channel in the urethra through which men can urinate more freely but the surgery is considerably less invasive. Instead of cutting tissue out, the newer technique creates the channel by vaporizing the tissue using laser energy. Thus far, almost every study has shown that when done by experienced urologists, the laser enlarged prostate surgery produces results that are equal to those with TURP, but without the severe side effects and risks. It is an outpatient procedure with minimal to no bleeding, no risk of fluid absorption, and catheterization only overnight, if at all.
What Causes An Enlarged Prostate
We still dont really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.
Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they dont all get symptoms. And some men have symptoms that don’t bother them.
The balance of hormones in your body changes as you get older. This may cause your prostate to grow.
Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.
There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.
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