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Prostate gland is a part of the male reproductive system that is responsible for the production of the fluid that carries the sperms. Enlargement of the prostate refers to an increase in the size of the prostate gland. Prostate enlargement is generally noted in almost all men as age progresses. Because of its close approximation to the urethra, prostate enlargement can cause an increased pressure on the urethra leading to problems related to urination and urinary bladder.

The enlargement of the prostate is often referred to as benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. However, it should be noted that this is not a cancerous process and it also does not increase your risk for developing prostate cancer.

The exact cause for benign prostatic hyperplasia (BPH) is not known. Nevertheless, it is considered as a part of the aging process wherein minor increases in size of the prostate gland is noted among men over the age of 40 and in more than 90% of the men above the age of 80 years. Diagnosis of BPH is based on the signs and symptoms noted and physical examination of the prostate.


Benign Prostatic Hyperplasia (BPH) Symptoms

As the prostate gland lies very close to the urethra which carries urine from the urinary bladder, the symptoms of benign prostatic hyperplasia are related to urination. Benign prostatic hyperplasia symptoms are slow in onset and tend to become severe if prostate gland expands too much or if an infection develops as a consequence of urinary problems.

Not all men who suffer from benign prostatic hyperplasia develop symptoms. In those who do develop, the symptoms can include any of the following:

• Inability to urinate – a condition commonly referred to as urinary retention
• Dribbling at the end of urination
• Getting up more often at night to urinate or having an urge to urinate many times during the day
• Inability to control urination at times
• Difficulty in urinating or slow or delayed start while trying to urinate
• Having strong or sudden urge to urinate quite often

One may have pain while urinating or notice blood mixed with urine in certain instances. Such a finding is often indicative of underlying infection.

Benign prostatic hyperplasia symptoms are often similar to that of other problems of the urinary system or other associated glands. Any changes in the urination pattern should be considered important and one should consult a doctor to rule out the presence of any major illnesses.

Severe cases of benign prostatic hyperplasia can lead to a number of problems as the growth of the prostate increases over time. Retention of the urine or increased stress on the urinary bladder can result in infections of the urinary tract, damage to the bladder or the kidneys, formation of stones in the bladder and urinary incontinence (inability to control urination).


Benign Prostatic Hyperplasia (BPH) Treatment

The treatment of benign prostatic hyperplasia is based on the amount of enlargement of the prostate and the severity or type of symptoms noted. Benign prostatic hyperplasia treatment includes several options such as self care, watchful waiting, changes in lifestyle, administration of medications and surgical correction.

Watchful waiting

Watchful waiting involves evaluating the enlargement process at regular intervals until symptoms develop. The medications or surgical treatment may be advised if this occurs or if the prostate gland is enlarging at a rapid pace.

Self care and lifestyle changes

These methods are advised if the benign prostatic hyperplasia is associated with mild symptoms. Individuals with mild symptoms should make it a point to urinate whenever there is an urge to urinate. Alcohol and caffeine consumption should be avoided, especially at bedtime. Stay warm and be physically active. Cold weather can worsen the symptoms and so does the lack of physical activity. Pelvic exercises referred to as Kegel’s exercise have also been tried.

Medications

Benign prostatic hyperplasia treatment involves the administration of medications when the condition is symptomatic. Six drugs have been approved by the FDA as a part of the benign prostatic hyperplasia treatment. Two of the drugs known as finasteride and dutasteride lead to a reduction in the levels of hormones produced by the prostate gland and also decrease the size of the prostate gland. Other 4 drugs belong to the class known as alpha 1-blockers and they help in relaxation of the bladder neck and prostate muscles. Antibiotics may be advised if any infection is suspected.

Surgery

Surgery is generally advised if the symptoms do not subside following the administration or medications or self care methods. It is also advised if the symptoms are quite severe and occurrence of complications is suspected or is to be prevented. Several different surgical options are available for the treatment of benign prostatic hyperplasia.

Minimally invasive surgical procedures are the most preferred ones and they include the following options:

• Transurethral resection of the prostate (TURP) – most commonly used surgical procedure wherein the prostate is removed in small pieces with the help of a scope inserted through the penis
• Transurethral incision of the prostate (TUIP) – procedure similar to TURP, but incision are placed on the bladder neck to widen the urethra instead of removing the prostate
• Other minimally invasive procedures involve the use of heat generated through different forms to destroy the prostate tissues. Some of the commonly used procedures include: transurethral needle ablation (TUNA), transurethral microwave thermotherapy (TUMT), transurethral electrovaporization (TUVP), water-induced thermotherapy (WIT) and Laser

Open prostatectomy is a minor surgical procedure performed under general anesthesia wherein the prostate gland is partially removed through the incision placed in the abdomen or perineum (the area behind the scrotum).

Robot-guided prostatectomy is one of the newer techniques being used for removal of the prostate gland. This treatment option is still being researched. Although being used in many hospitals, further studies are required to substantiate the safety and efficacy of this treatment option.

In conclusion benign prostatic hyperplasia is a common finding in most of the aged males and does not signify any risk of developing cancer. Treatment becomes necessary if the affected individuals begin developing any symptoms. An annual checkup for monitoring the growth of prostate may be beneficial in individuals aged above 40 years.