Thursday, June 6, 2024

What Is Benign Prostate Enlargement

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What Are Medications And Surgery Procedures That Treat Bph

What is Benign Prostate Enlargement? | Dr. Amit Goel (Hindi)

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 .

What Are The Later Consequences Of The Prostate Procedures

Incontinence: This can occur due to damage to the sphincter during the operation. This risk is small in less than 1%. Leakages due to urgency may occur for the first few weeks due to the irritation from the procedure and any infection.

Erectile Dysfunction : There is 5-10% risk of impotence if your erectile function is normal prior to the procedure.

Retrograde Ejaculation : This occurs inevitably in a large proportion of patients undergoing prostate resection procedures. You should be able to have the same feeling of ejaculation without the emission of semen. This occurs due to the passage of semen into the bladder instead of its expulsion down the urethra. This is usually permanent. If you think you are keen to father a child, you should consider alternate methods of treatment or you might wish to consider cryopreservation of sperms.

Late scarring of bladder neck and urethra causing blockages: After the initial improvement in the flow and symptoms, if you feel that the flow is getting weaker, it may be due to development of scarring in your bladder neck of urethra which may need further treatments.

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:

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Prostate Measurements And Questionnaire

All the participants were invited to receive prostate measurement by TRUS with a 6-MHz uniplanar scanning probe , which was performed by an investigator who had 6 years of ultrasound experience. Under TRUS guidance, prostate width was measured on an axial image, while prostate length and height were measured on a mid-sagittal image. The TPV was calculated with the prolate elliptical formula, /6ÃwidthÃheightÃlength.,,, The transition zone was measured similarly to the above description. Length was defined as the greatest longitudinal distance on the sagittal scan, and width and height as the largest transverse and antero-posterior distance on axial scan. The TZV was also calculated with the prolate elliptical formula.

Every participant was invited to perform a self-administered International Prostate Symptom Score questionnaire. Although a Chinese version of IPSS questionnaire was used, a urologist, who had 10 years working experience, explained the questionnaire to participants. The IPSS questionnaire was comprised of seven questions, which were stratified to determine the storage symptoms and voiding symptoms.

Diagnosis Of Benign Prostatic Enlargement

Benign Prostatic Hyperplasia: Causes, Risk Factors and ...

The doctor and nurses do a series of tests to understand what causes your symptoms. This is called a diagnosis.

The symptoms listed in the previous section can point to many diseases and not only BPE. This is why you may need to take several tests before the doctor can make a diagnosis.

First, the doctor or nurse will take your medical history and do a physical examination. Then they may do urine and blood tests, take images of your bladder and prostate, and perform other tests if needed.

This section offers general information about diagnosis and situations can vary in different countries and hospitals.

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Are You At Risk Of Bph

Some factors that can put you at a higher risk of BPH include:1

  • Aging: BPH rarely affects men younger than 40
  • Family history: Youre more likely to have BPH if a blood relative, such as a father or a brother, has prostate issues
  • Diabetes and heart disease: Studies show that your risk of BPH increases if you live with diabetes or heart disease and if you are taking beta blockers
  • Lifestyle: Obesity is known to increase the risk of BPH

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

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Currently, the main options to address BPH are:

  • Watchful waiting
  • Medication
  • Surgery

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How To Get The Benign Prostate Treatment Cost In India

Many of them dont know that benign prostatic hyperplasia is also known as prostate gland enlargement. If anyone is looking for benign prostate treatment cost in India then we will offer cost-saving treatment options. In case you have an enlarged prostate gland then you have these problems like blocking the flow of urine out of the bladder. It makes you feel very uncomfortable. Due to benign prostate, you have bladder, urinary tract, or kidney problems. Now we will tell you what is benign prostate enlargement treatment.

Symptoms Of An Enlarged Prostate

What Is Benign Prostatic Hyperplasia (BPH)?

As mentioned above, the most common symptoms of an enlarged prostate are urination problems. Its because the prostate portion surrounding the urethra narrows the normal passage of urine. These problems become worse as the patient gets older.

The progression prolongs which some patients may not even realize. They learn to live with the symptoms and sometimes wont even report them. However, it is crucial to recognize the symptoms of an enlarged prostate and consult your doctor.

Heres a list of the most important symptoms .

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Enlarged Prostate A Common Condition

When the cells of the prostate gland begin to multiply, the prostate grows. The prostate doubles in size in your teens, and then continues to grow for the rest of your life.2

An enlarged prostate is also called benign prostatic hyperplasia . The enlarged prostate presses against the urethra and can restrict the flow of urine. BPH affects 50% of men by age 60.3 By age 85, this number grows to 90%.4

BPH is a benign condition. It does not mean you have prostate cancer. But the constant urination issues can hamper your quality of life.5

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.

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How Is Bph Diagnosed

Your doctor will probably ask for your personal and family medical history and a description of your symptoms. They might also give you a physical examination and take blood or urine tests. A biopsy or ultrasound might be needed to check whether the problem is BPH, prostate cancer or prostatitis. But remember, BPH is more likely to be the cause than prostate cancer.

Symptoms Of Benign Prostatic Enlargement

Benign Prostatic Hyperplasia

Benign prostatic enlargement can affect the way you normally urinate. This happens because the enlarged prostate puts pressure on the urethra at the outlet of the bladder.

Sometimes the symptoms are mild. For example, you may need to urinate more often or find it more difficult to empty your bladder completely. These mild symptoms are a normal part of the ageing process â just like a decline in mobility, memory, or flexibility. It is possible that your doctor will not recommend treatment for mild symptoms.

Sometimes the symptoms are very bothersome and can have a negative effect on your quality of life. In this case, you may benefit from treatment.

The symptoms which are often called lower urinary tract symptoms may be caused by BPE and may be due to other conditions which affect the urinary system.

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Using Pads Or A Sheath

Absorbent pads and pants can be worn inside your underwear, or may replace your underwear altogether. These will soak up any leaks.

Urinary sheaths can also help with dribbling. They look like condoms with a tube coming out of the end. The tube connects to a bag that you can strap to your leg under your clothing.

Imaging Of The Urinary Tract

You may get an ultrasonography , which uses high-frequency sounds to create an image of your bladder and your prostate.

The doctor or nurse will scan your bladder using ultrasound to check how much urine is left in the bladder after urinating. This information helps to see if your symptoms are caused by chronic urinary retention, which can occur in men with BPE.

An ultrasound may also be used to measure the size of prostate volume. This may help to select the best treatment option for you.

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How Is Enlarged Prostate Treated

Treatments for enlarged prostate include:

Lifestyle changes: These can include reducing liquid intake, bladder training , abstaining from alcohol and caffeinated beverages and regularly exercising the pelvic muscles.

Medication: A class of medication called Alpha Blockers works to relax muscle fibers in the prostate and bladder. This relaxation allows for increased urine flow and less frequent urination. A second class of medication, called Alpha Reductase Inhibitors, works to block the hormones that cause the prostate to swell. Many patients will take a combination of these two types of medication.

Minimally invasive procedures: Our specialists are trained in two minimally invasive procedures that can help remove or reduce the obstructing prostate tissue:

Surgery: For severe cases of a very enlarged prostate, surgical removal of the prostatecalled transurethral resection of the prostate may be the recommended course of action. Patients will decide with their doctor if aggressive treatment is warranted, depending on the size of the prostate and severity of symptoms.

How Might An Enlarged Prostate Affect My Life

Enlarged Prostate (Benign Prostatic Hyperplasia/BPH) Q& A

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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What Is The Importance Of Psa Blood Test

PSA blood test is used to diagnose some clinical conditions affecting the prostate. PSA is a normal substance produced by the prostate gland and its concentration is very high in semen. Its level in the blood is very small and its normal range varies according to the age of the person. The PSA level can be raised in benign enlargement of the prostate, inflammation of prostate and prostate cancer. Its level can be also temporarily raised during urinary infections and after any endoscopic examinations or procedures in the urethra and bladder.

When the PSA level is high , it is important to determine if the cause of this rise is due to benign conditions or cancer of the prostate. If the prostate is abnormal by finger examination, then there is a high likelihood of prostate cancer and your doctor will refer you to a urologist for consideration of possible biopsy.

If the prostate is felt to be normal, then the decision making depends on your age and fitness as well as your choice. The only way to rule out significant prostate cancer in this situation is by undergoing a prostate biopsy . Alternatively you may be given an option to monitor the PSA over 6-12 months and decide for a biopsy if there is significant further rise in the level of PSA.

Apart from diagnosing or ruling out prostate cancer, PSA blood test is also useful to determine the risk of progression and potential for complications by the benign enlargement of the prostate.

Causes Of Benign Prostate Enlargement

The exact cause of benign prostate enlargement is unknown, but research suggests that hormones probably play an important role in the condition’s development.

Hormones are powerful chemicals that can have a wide range of effects on the cells of the body.

One theory is that as some men get older, the levels of a type of hormone called dihydrotestosterone increases, which may stimulate the growth of the prostate.

Another theory suggests that two hormones, testosterone and oestrogen, play a role. Younger men produce high levels of testosterone and much smaller levels of oestrogen. But as men get older, their levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. It’s been suggested that the relative increase in oestrogen may stimulate prostate growth.

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What Are The Causes Of Benign Prostatic Hyperplasia

The exact cause is not known. Enlargement of the prostate gland is a normal process that develops as men get older. Therefore it becomes more common with increasing age. it is thought that changes in the male sex hormones that occur with ageing may be at least part of the cause.

Prostate gland enlargement can be caused by other conditions such as prostate cancer, acute prostatitis and chronic prostatitis. See the separate leaflets called Prostate Cancer, Acute Prostatitis and Chronic Prostatitis.

What Causes Prostate Enlargement

Benign Prostatic Hyperplasia: Symptoms, Causes &  Treatment

The causes of prostate enlargement are not yet fully understood but are thought to be related to the male sex hormone which controls the growth of the prostate. The prostate is initially quite small, but as men age, testosterone feeds the prostate and it starts to get bigger. From birth to around the early teenage years, the prostate increases in size by around 8 times. It doubles again in size from around the early 20s through to 50 years of age, and then doubles again by around the age of 80. With such large increases in size, its easy to see why the prostate can begin to squeeze the urethra and make it difficult to urinate.

There may also be a genetic link to prostate enlargement, because the sons of men with an enlarged prostate are more likely to develop prostate disease.

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Symptoms Of Prostate Cancer: What Are The Symptoms For Prostate Cancer

Usually, prostate cancer does not produce symptoms by itself until it is fairly advanced. Prostate cancer arises silently and usually passes through a curable stage into an incurable stage silently. Therefore, the only means of detecting it when it is curable is to actively look for it with screening. Symptoms could include urinary difficulties however, these symptoms are usually caused by benign enlargement of the prostate. However, these symptoms are usually caused by urinary obstruction from benign prostatic enlargement,scar tissue or from inflammation. Bone pain occurs in very advanced prostate cancer, but the aches and pains that most people experience are usually caused by arthritis.

Diagnosing Benign Prostate Enlargement

You might have several different tests to find out if you have an enlarged prostate.

A GP may do some of these tests, such as a urine test, but others might need to be done at a hospital.

Some tests may be needed to rule out other conditions that cause similar symptoms to BPE, such as prostate cancer.

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What Are The Surgical Options Of Treatment And When Would That Option Be Recommended To You

Surgical treatment is recommended when non surgical options does not adequately improve the symptomatic bothersome symptoms. In the presence of ongoing bother with symptoms of obstruction, surgery is recommended.

If the symptoms are predominantly storage symptoms like frequency and urgency, then the urologist may want to confirm if these symptoms are secondary to obstruction. They may be able to determine this by doing a special test called Urodynamics. Only if these symptoms are confirmed to be due to the obstruction, then a prostate operation may be helpful.

The surgery will be recommended early if you who cannot urinate, have kidney damage, frequent urinary tract infections and/or significant urethral bleeding or bladder stones which are considered to be complications of prostatic enlargement.

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