Prostate Health After 40: Know About BPH

What is benign prostatic hyperplasia?

Benign Prostatic Hyperplasia, or BPH, is a growth of the prostate gland that is not cancerous. It usually happens to men as they get older and can cause problems with urination because it presses on the urethra.

As the cells in the prostate gland divide, the gland gets bigger. This is called benign prostatic hyperplasia (BPH). It lies just below the bladder and wraps around the urethra, which is the tube that takes pee out of the body. The urethra gets squeezed as the prostate gets bigger, which stops pee from flowing.

Signs and symptoms

• Urinary problems, such as a weak pee stream, dribbling, and difficulty starting to urinate, are common signs and symptoms.
• Increased need to urinate, especially at night (nocturia), is a frequency problem.
• Urgency: A strong, sudden need to go to the bathroom.
• Feeling like the bladder hasn't fully emptied is called incomplete emptying.

What Causes

• Changes that come with getting older: BPH is strongly linked to getting older; most men's prostates start to grow after age 40.
• Hormonal factors: Changes in the mix of testosterone and estrogen may play a role.
• Cell growth: When prostate cells divide too quickly, the gland becomes bigger.

Findings

• The medical history of the patient and a score for their symptoms, such as the International Prostate Symptom Score, are also considered.
• A digital rectal exam (DRE) to determine the size of the prostate.
• There are tests like PSA (Prostate-Specific Antigen), urine flow studies, and ultrasounds that can rule out cancer.

Choices for Treatment

• Changes to your lifestyle: Drink less water in the evening, and drink less booze and caffeine.
• Alpha-blockers (quiet prostate muscles) are medicines.
• 5-alpha-reductase drugs (make the prostate smaller).
• Laser therapy and transurethral microwave therapy are examples of minimally invasive treatments.
• Transurethral resection of the prostate (TURP) is a surgery that is done for serious cases.

Issues that can happen if bladder stones are not handled

• UTIs are infections in the urinary system.
• Bad bladder damage
• Back pain can cause kidney trouble.

Also, read https://www.mdpi.com/1420-3049/26/23/7141.

Having problems

If you don't treat benign prostatic hyperplasia (BPH), it can cause problems with your bladder and kidneys, such as damage to your bladder, repeated infections, and even kidney failure.

Major Problems Caused by BPH Urinary Retention

• The inability to urinate may necessitate immediate catheterization.
• It can be acute (sudden blockage) or chronic (worsening over time).
• Urinary Tract Infections that happen again and again
• Bacteria grow faster when pee stays in the bladder for a long time.
• This can lead to a burning sensation, increased body temperature, and frequent bathroom visits.

Stones in the bladder

• The result is urine that is highly concentrated and crystallized.
• They can cause pain, blood in the urine, and infections.

Bad Bladder Health

• Incomplete emptying of the bladder causes the walls to become too stretched.
• This condition weakens the muscles in the bladder, making it harder for them to contract properly.
• Hematuria (blood in the urine): A swollen prostate can rupture blood arteries that aren't strong enough.
• Damage to the kidneys or hydronephrosis
• Back pressure from holding on to the bladder can hurt the kidneys.
• If not treated, the condition may worsen and result in kidney failure.

Why do these problems happen

• When the flow is blocked, the bladder becomes too full and weak.
• Residual urine increases the risk of developing an infection and forming kidney stones.
• Pressure transfer issues with the bladder can lead to long-term problems for the kidneys.

Monitoring and preventing

• Early medical screening for bladder problems is crucial.
• Regular check-ups, including PSA tests and ultrasounds when necessary, are important.
• Progression can be stopped by getting treatment (medications or surgery) right away.
• Lifestyle changes include staying hydrated, limiting caffeine and booze, and training your bladder.

Treatment of BPH: 

The main goals of treatment for benign prostatic hyperplasia (BPH) are to ease urinary symptoms, prevent problems from happening, and improve the quality of life. Depending on how severe it is, options include introducing changes to your lifestyle and taking medicine, as well as slightly invasive procedures and surgery.

Ways to Treat BPH 

The video about the latest treatment for an enlarged prostate

1. Lifestyle Changes and Self-Care (Mild Symptoms)

• To avoid nighttime bathroom trips, limit evening fluid intake.
• Limit your booze and caffeine intake; both can make your bladder hurt.
• Avoid double-voiding, which involves going to the bathroom, waiting a few minutes, and then going again.
• Regular exercise can help your kidneys work better.

2. Medicines:

• Alpha-blockers, such as tamsulosin and alfuzosin
• Loosen up the muscles in your prostate and bladder neck to make it easier to pee.
• Do it quickly, but don't make the prostate smaller.
• 5-alpha-reductase inhibitors (like dutasteride and finasteride)
• Reduce the size of the prostate by stopping changes in hormones.
• Take months to work, but lower the risk of staying with the company in the long run.

Men with bigger prostates and serious symptoms should take a combination of an alpha-blocker and a 5-alpha-reductase inhibitor.

The other choices

• A drug called tadalafil, which blocks PDE5, is sometimes given to men who have both BPH and sexual dysfunction.

3. Procedures with little damage

• With transurethral microwave treatment (TUMT), heat is used to remove excess prostate tissue.
• Radio waves are used in transurethral needle ablation (TUNA) to shrink prostate cells.
• Laser therapy (HoLEP, PVP) precisely evaporates or cuts away tissue that is in the way.
• UroLift: Implants keep prostate tissue away from the urethra during a prostatic urethral lift.
• Rezum water vapour therapy: Steam burns away prostate tissue.
• People don't have to stay at the hospital for these treatments, and they heal faster than with surgery.

4. Options for surgery (serious cases)

• The gold standard is transurethral prostate removal (TURP), which removes prostate-blocking tissue.
• When the prostate is massive, an open or robotic procedure is used.
• Through the urethra, the prostate is cut (TUIP): Small urethral widening cuts are ideal for smaller prostates.

How to Pick the Best Treatment

• For mild symptoms, lifestyle changes and careful monitoring are recommended.
• Medications or slightly invasive procedures can help with moderate symptoms.
• For severe signs or problems, surgery is the recommended treatment.
• The choice is based on the patient's age, illnesses, prostate size, and level of discomfort.

Conclusion: 

Excellent Men often develop Prostatic Hyperplasia while they are growing older. This is a condition in which the prostate gland grows without cancer. It doesn't raise the risk of getting prostate cancer, but it can make it difficult to use the bathroom and lower your quality of life.