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Is your (P)rostate making you struggle for your (P)ee?!

An enlarged prostate gland and the urinary worries are something which are as old as humanity itself. A vexing problem in men as they age,BPH or Benign Prostatic Hyperplasia /enlargement is by far the commonest reason for reduced quality of life in the elderly.

What is BPH? What are the symptoms of BPH? What can I do for my BPH? Let us find the answer to these pressing questions in a few minutes!

PC: twitter

Where is the prostate gland in the first place?!

The prostate is a walnut-sized gland composed of muscular and glandular tissue which is located just beneath the urinary bladder and in front of the rectum.The urethra(the passage for urine and semen)passes right through the prostate.Naturally as the gland enlarges,the urethra is compressed leading to urinary difficulties.

What is BPH?

BPH refers to the non-cancerous enlargement of the prostate gland that normally occurs with age.The nature and severity of symptoms vary according to the size of the gland and other patient factors.

How common is BPH?

Occuring in men over the age of 50 years,it is by far the commonest condition during this period.By age 60, 50% of men will have some signs of BPH; by age 85, 90% of men will have signs of the condition.

What are the symptoms of BPH -How do I know if I have BPH?

Think of the possibility of BPH if you have the following:

  • Increased frequency of urination

  • Feeling of ‘urgency’ to urinate

  • Increased night-time episodes of urination interfering with sleep

  • Weak urinary stream

  • Need for straining at urination

  • Long waiting period for initiation of urination

  • A feeling of incomplete emptying after urination

  • Dribbling after urination.

  • Inability to void in advanced stages

  • Recurrent episodes of Urinary tract infection or blood in urine

Keep in mind that the size of your prostate gland may not always correlate with your symptoms! Men with huge prostates may have a little symptoms while men with small prostates can experience troublesome symptoms!

Also remember that there are so many other conditions which can also present with these similar complaints.Hence it is important to get your workup done by a qualified medical practitioner.

Whom should I visit if I have any or many of these symptoms?

A Urologist is the right person to visit in presence of these symptoms.

What are the tests done to confirm BPH in me?

A careful medical history and physical examination, along with prudent use of diagnostic tests, can yield an accurate diagnosis.

Your doctor will perform a digital rectal examination by inserting a gloved, lubricated finger into your rectum to feel the prostate, estimate its size and detect any hard areas that could be cancer(Digital Rectal Examination,DRE).Various tests might be suggested by your urologist as enumerated below:

  1. A sonogram of your abdomen to correctly assess the prostate size and presence of residual urine after voiding and to rule out any suspicious nodules.

  2. A flow study to evaluate your pattern of urinary stream and degree of obstruction.

  3. Blood tests like PSA-Prostate Specific Antigen.

  4. Cystoscopy: endoscopic study of the genitourinary system which is performed under local anesthesia also to assess the prostate,urethra and bladder.

What are the treatment options for BPH?

Medical and Surgical management are the two pillars of treatment in a case of BPH.Based on the severity of symptoms and size of the gland,your urologist would decide which is the best management for you.

Medications : While some of the medications target the muscular component of relatively smaller glands(alpha blockers) others work by decreasing the production of potent hormones which are useful for larger glands in the long run(alpha reductase inhibitors).Combination of drugs are also judiciously used in some situations.

Surgery: There are a multitude of surgical options for treatment of BPH.The most routinely available surgical options are:

  1. Transurethral Resection of Prostate(TURP)- Here the portion of prostate obstructing the urethra are removed endoscopically by the urologist under anaesthesia. This is however not without its share of complications.

  2. Transurethral Incision of Prostate-TUIP-Small cuts at the junction of bladder with urethra.

  3. Laser treatment.

  4. Open surgeries.

  5. Robotic surgeries.

  6. Microwave therapy

  7. Needle Ablation

Minimally Invasive treatment modalities: These include procedures like prostatic urethral lifts/implants and water vapour therapy.However these are still not widely accepted modalities of treatment options in most settings.

Does having BPH increase my risk for acquiring prostate cancer?

This is a common doubt from most patients.Though the symptoms of both BPGH and prostate cancer are more or less the same,there is no evidence as of now,to suggest that there is a relation between both.

To help detect diagnosis of prostate cancer at an early stage,routine screening and surveillance is advocated in men above the age of 50 years.The most important screening tools are the Digital Rectal Examination by the doctor and estimation of PSA in blood with imaging as and when required.

Any questions?Ask away!!

This post is part of #BlogchatterA2Z

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