When Is Bph Treatment Necessary
The course of BPH in any individual is not predictable. Symptoms, as well as objective measurements of urethral obstruction, can remain stable for many years and may even improve over time for as many as one-third of men, according to some studies. In a study from the Mayo Clinic, urinary symptoms did not worsen over a 3.5-year period in 73% of men with mild BPH. A progressive decrease in the size and force of the urinary stream and the feeling of incomplete bladder emptying are the symptoms most correlated with the eventual need for treatment. Although nocturia is one of the most annoying BPH symptoms, it does not predict the need for future intervention.
If worsening urethral obstruction is left untreated, possible complications are a thickened, irritable bladder with reduced capacity for urine infected residual urine or bladder stones and a backup of pressure that damages the kidneys.
- Inadequate bladder emptying resulting in damage to the kidneys
- Complete inability to urinate after acute urinary retention
- Incontinence due to overfilling or increased sensitivity of the bladder
- Bladder stones
- Recurrent severe hematuria
- Symptoms that trouble the patient enough to diminish his quality of life
Find a Location
Currently, the main options to address BPH are:
- Watchful waiting
What You Can Do
The best thing to do is** create a bladder diary to log your symptoms**, and bring it to your doctor. If the onset of symptoms is acute or sudden, its less likely to be BPH. Gradual onset of symptoms, and weak or slow urine flow is more likely to be BPH, or related condition. OAB is usually associated with more urinary tract infections, although there is some overlap.
How To Treat An Enlarged Prostate
Of all medical conditions affecting a mans prostate gland, an enlarged prostate, medically known as benign prostatic hyperplasia , is the most common. Practically all men who live past the age of 50 will experience BPH in their lifetime. Percentage-wise, about half of all men between the ages of 51 and 60 will develop it and up to 90% of men over the age of 80 will have it. Since it is so ubiquitous in older men, being educated about BPH is key to knowing and understanding symptoms and treatment.
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Signs Of An Enlarged Prostate
Your enlarged prostate may cause:
- The need to urinate more frequently, especially at night
- A more urgent need to urinate
- Trouble starting and stopping your urine stream
- A weak urine stream
- Difficulty fully emptying your bladder
- Urinary tract infections
With an enlarged prostate, something you once saw as simple urinating can become a more prominent and even more challenging part of your life.
Heres the good news: Youre not stuck with those symptoms.
Medications For An Enlarged Prostate
Several drugs are FDA-approved to relieve common symptoms of an enlarged prostate. Each works differently, says Westney. They either shrink the enlarged prostate or stop the prostate cell growth, she explains. For many men, medications are very effective, Westney tells WebMD. They have a significant change in symptoms, and side effects are very uncommon â¦ so medications are an attractive treatment.
Doctors use the BPH Index to gauge how the patient responds to medication, Westney adds. We see how symptoms are progressing â¦ if theyve stabilized or not.
Alpha blockers: These drugs dont reduce the size of the prostate, but they are very effective at relieving symptoms. They work by relaxing the muscles around the prostate and bladder neck, so urine can flow more easily. These drugs work quickly, so symptoms improve within a day or two. They are most effective for men with normal to moderately enlarged prostate glands.
Alpha blockers were originally created to treat high blood pressure dizziness is the most common side effect other side effects are generally mild and controllable. Possible side effects include headache, stomach irritation, and stuffy nose. These drugs are not for men with significant urine retention and frequent urinary tract infections.
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How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms arent noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
When Should I Call A Doctor
Your symptoms may not bother you too much. But itâs important to talk over any urinary problems with your doctor.
Itâs hard to predict how BPH will play out, and you canât assume that the problem will get better on its own. Your doctor also will want to rule out things that cause similar problems.
Some symptoms need quick medical attention. If you have any of these, call your doctor right away or head to an emergency room:
- You canât urinate at all.
- You have to pee frequently, itâs painful, and you have fever and chills.
- You have blood in your urine.
- You feel a great deal of pain in your lower belly and urinary tract.
National Institutes of Health: National Institute of Diabetes, Digestive and Kidney Diseases — Prostate Enlargement: Benign Prostatic Hyperplasia.
Cleveland Clinic: Diseases and Conditions — Benign Prostatic Enlargement .
Johns Hopkins Medicine Health Library: Benign Prostatic Hyperplasia.
Mayo Clinic: Diseases and Conditions — Benign Prostatic Hyperplasia .
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Diagnosis Of An Enlarged Prostate
In order to establish the possible underlying causes for an enlarged prostate, doctors will perform a variety of tests.
Tests which are commonly used to find the cause of an enlarged prostate include:
- A digital rectal exam. A physician or nurse will insert a gloved finger into the patientâs rectum to digitally examine the prostate for swelling and/or enlargement.
- Swab tests for urethral discharge or urine. To determine underlying conditions such as STIs/STDs and urinary tract infections. A swab of discharge or urine is taken and sent to a medical laboratory for culturing, so that any microorganisms are identified.
- Urinalysis. A urine sample is sent to a medical laboratory for analysis and may be tested for urea nitrogen or creatinine, among other things.
- Blood tests. A sample of blood is sent to a medical laboratory for analysis, which may include tests for creatinine or blood urea nitrogen, as well as antibodies and infectious agents.
- Prostate-specific antigen test. A blood sample is sent to a medical laboratory to be tested for prostate-specific antigen , an enzyme produced by cells in the prostate. A change in PSA levels can indicate that there is a problem with the prostate.
If patients are referred to a urologist, they may have further tests, including:
Before referring the patient for tests, the physician may also ask questions in order to determine the possible causes of the discomfort, their severity, and their duration. Such questions may cover:
Are There Treatments For An Enlarged Prostate
We review your age, medical history and overall health, the size of your prostate, and the severity of your symptoms before creating a customized treatment plan designed to offer you the best help possible.
Treatment may begin with medication for mild or moderate symptoms of an enlarged prostate. If your BPH symptoms are more severe and affecting your quality of life, we may recommend a surgical intervention called the UroLift® System.
The UroLift System is a revolutionary treatment that addresses the primary issue associated with an enlarged prostate: the restriction BPH places on your urethra. The UroLift System solves this problem by holding back excess prostate tissue to keep the urethra open.
We perform this minimally invasive procedure using specially designed implants. We insert a small device through your urethra and then place implants in your prostate and lift the excess tissue away from the urethra.
The UroLift System doesnt require any cutting or removal of prostate tissue, and it only requires a local anesthetic. This means youre treated as an outpatient in about an hour or less.
The UroLift System offers several benefits compared to other BPH treatments, including less severe side effects than other surgical interventions for BPH and a faster recovery time than the surgical alternatives.
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Treating Benign Prostate Enlargement
Treatment for an enlarged prostate is determined by the severity of your symptoms.
If you have mild to moderate symptoms, you wonât receive any immediate medical treatment, but youâll have regular check-ups to carefully monitor your prostate.
As well as lifestyle changes, medication is usually recommended to treat moderate to severe symptoms of benign prostate enlargement. Finasteride and dutasteride are medications that are commonly used. They block the effects of a hormone called dihydrotestosterone on the prostate gland, which can reduce the size of the prostate and improve associated symptoms.
Alpha blockers may also be prescribed. They help to relax your bladder muscles, making it easier to pass urine. Tamsulosin and alfuzosin are two alpha blockers commonly used to treat benign prostate enlargement.
Surgery is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication.
Medication For Urinary Problems
Your doctor may suggest various medications to help ease your urinary problems, including:
- medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
- medication to reduce the size of the prostate gland. These medications work by blocking the action of male hormones produced by the prostate gland
- medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination
- the over-the-counter preparation âsaw palmettoâ is sometimes used. This may help some men, especially if frequent urination at night is a problem.
However, recent reviews of the evidence for using saw palmetto as a treatment for mild or moderate urinary symptoms did not show any improvement, compared to no treatment, in men with BPH.
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How Should I Prepare For The Exam
You should tell your doctor if you have hemorrhoids, anal tears, or other problems with your anus. The exam will be easier if you breathe normally and try to relax.
Before having a PSA test, tell your doctor about any medications and supplements you take. Recent ejaculation can also affect your PSA levels. Ask your doctor if you should abstain from sexual activity before the test.
Your blood must be sent to a laboratory for analysis, so your PSA results wont be available immediately. Your doctor will let you know when they have the results.
The lab report will show the level of PSA in your blood as:
In addition to looking at the amount of PSA in your blood, your doctor will assess how quickly this number is changing. Many things can affect PSA, so test results require careful analysis by an expert. Your doctor will take all of your health information into account.
If you have an abnormal PSA test result, it doesnt mean you have prostate cancer. Most men with a high PSA level dont have prostate cancer. About 25 percent of men who have a biopsy due to a high PSA level have prostate cancer.
Its also possible for men with prostate cancer to have normal DRE and PSA test results.
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What Is A Prostate Infection
A prostate infection occurs when your prostate and the surrounding area become inflamed. The prostate is about the size of a walnut. Its located between the bladder and the base of the penis. The tube that moves urine from the bladder to the penis runs through the center of your prostate. The urethra also moves semen from the sex glands to the penis.
Several types of infections can affect the prostate. Some men with prostatitis experience no symptoms at all, while others report many, including intense pain.
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Active Surveillance Or Watchful Waiting:
If the prostate enlargement is stable and a man has mild or few symptoms, likely there is no need for treatment. Up to one-third of men with mild BPH find that their symptoms clear up without treatment and therefore may opt to just watch and wait. During this time, lifestyle changes such as drinking fewer liquids before bedtime and becoming more physically active can help manage symptoms of an enlarged prostate.
Initial Tests For Bph
- A urine test will rule out any infection or another issue.
- A PSA blood test looks for levels of a Protein Specific Antigen found only in the prostate gland. This protein should be at a low level for a healthy prostate. Higher levels can indicate an inflammation known as prostatitis, BPH, or prostate cancer. This is a routine test for men over age 50.
- A DRE is a digital rectal exam performed by the doctor using a lubricated glove. As the man bends forward or lies on his side, the doctor inserts one finger into the rectum to feel the prostate and determine if it has an abnormal shape or thickness.
Some additional tests may be ordered. Among them are a uroflowmetry test, measuring how fast the urine flows, a PVR or post-void residual test to determine how much urine is left in the bladder after urination, and an ultrasound of the prostate, plus others.
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Is Diabetes Curable If Detected Early
But experts say diabetes can be reversed early on. If you follow the advice of your doctors and nutritionist and make an effort to lose weight, diabetes can be reversed by normalizing your blood sugar levels without medication early in the course of the disease, that is the first three to five years, Dr.
What Are Additional Tests For Detecting Prostate Problems
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.
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What Is The Turp Approach
A transurethral re-sectioning of the prostate is amongst the most common surgical procedure which works on the principle of the endoscopy. In this process, an excellent tubular camera is a slit through the tip of your penis until it reaches the urethra. Later, it passes through your bladder for removing the presence of any excess tissue present lining it.
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Effective Energetic Treatment For Enlarged Prostate
Enlarged prostate, also called benign prostatic hyperplasia , is a common condition as men get older. By age 60, about 30% of men show moderate to severe symptoms of BPH by age 80, it is 50%. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as a weak urine stream, urine stream that starts and stops, frequently getting up at night to urinate, and inability to void the bladder.
There are many different treatment options for BPH, ranging from behavior medications to surgery. A minimally invasive option is bipolar enucleation of the prostate, or BipoLEP. If you are considering treatment, here’s what you need to know.
The prostate is a small organ that sits at the bottom of the bladder. The urethra, the tube the drains the bladder, runs through the middle of the prostate.
Early in a mans life, the prostate is roughly the size of a walnut or a small tangerine. Often around 50, the prostate increases in size. For some men, this change closes off the urethra and makes it more difficult for the bladder to empty.
The prostate has two parts. The adenoma is the inner part that surrounds urethra. It is the part of the prostate that grows as men get older. The capsule is the outer part of the prostate and does not change in size over the course of life. A good analogy is to think of an orange. The orange peel represents the capsule, and the fruit represents the adenoma.
Removal of prostate tissue
History of transurethral enucleation
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Latest Men’s Health News
At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.