Benign prostate enlargement: symptoms, causes, treatment

Definition

What is benign prostate enlargement (BPH)?

Benign prostate hyperplasia (BPH) or benign prostate enlargement is a condition in which the male prostate gland enlarges but not due to cancer. The prostate gland itself is located between the bladder, where urine is stored, and the urethra, the tube through which urine flows out.

As we get older, the prostate will increase in size. There are two main growth periods of the prostate, the first at puberty and the second starting at age 25. It is in this second period that usually one of these types of prostate disease occurs.

When the prostate gland enlarges, it can press on the urethra causing the bladder wall to thicken and weaken and lose the ability to pass urine from the bladder.

As a result, you will experience urinary incontinence, which is a condition when you lose control of your bladder.

How common is this disease?

Benign prostate enlargement is a disease that only occurs in men and generally affects patients over the age of 50 years. As you get older, your risk for this disease will also increase. In fact, it is reported that BPH can attack 90% of men over 80 years of age.

However, it is possible if younger men can develop this condition. You can prevent prostate disease by reducing risk factors. Please consult your doctor for more information.

Signs & Symptoms

What are the signs and symptoms of benign prostate enlargement (BPH)?

Some of the common symptoms of benign prostate enlargement (BPH) are:

• Difficulty urinating, or difficulty stopping the flow of urine when urinating.
• Frequent urination, especially at night.
• Pee feeling incomplete.
• Urine flow is weak and intermittent.
• A feeling of fullness and severe pain in the lower abdomen.
• Pain when urinating.
• Unusual odor and color of urine.

Indeed, this pain arises from the urethra that is narrowed due to an enlarged prostate. However, prostate size does not always determine the severity of symptoms. In fact, in some cases, there are patients with less swelling who experience more blockage and have more symptoms.

Occasionally, patients may experience signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

If you have urinary problems, you should check with your doctor to see if the symptoms are caused by a benign prostate enlargement, and find a method of treatment.

Also pay attention to symptoms such as:

• can't urinate at all,
• an urgent urge to urinate accompanied by fever or a sensation of chills,
• there is blood in the urine, and
• severe pain in the lower abdomen, especially around the bladder.

If the above has happened, you should seek medical attention as soon as possible.

Cause

What causes benign prostate enlargement (BPH)?

Researchers have not found the exact cause of this prostate disease. However, experts believe that this condition is related to changes in the balance of hormones and cell growth factors.

Throughout life, the male body produces the hormone testosterone and a small amount of the hormone estrogen. However, the older the active testosterone level in the blood decreases and leaves the higher estrogen hormone.

Too much estrogen, or what is known as the female hormone, can increase the activity level of a substance that will promote the growth of prostate cells.

Another theory states that the occurrence of benign prostate enlargement is also due to the influence of dihydrotestosterone (DHT).

DHT is a male hormone that plays a role in prostate growth. It is believed that when testosterone levels start to drop, DHT levels still build up in the prostate. This is what may continue to trigger its development.

Risk Factors

What increases the risk of this disease?

Some of the factors that can increase your risk of having a benign prostate enlargement are:

• Age. About 1/3 of the group of people with moderate to severe symptoms are 60 years old, and about half of the sufferers are aged 80 years.
• Family history. People who have family members with prostate problems are more likely to develop this disease.
• Certain diseases. Studies show that diabetes, heart disease and the use of beta blockers (drugs used to reduce heart activity) can increase the risk of this disease.
• Lifestyle. Obesity increases the risk of prostate enlargement, while exercise can reduce the risk of this disease.
• Erectile dysfunction. Also known as impotence, someone who has experienced this has a high risk of benign prostate enlargement.

Diagnosis

What are the usual tests for benign prostate enlargement?

Just like any other diagnosis, the doctor will check your health condition and perform a series of physical examinations. Some of the tests performed to diagnose a benign prostate enlargement are:

• Plug in the rectum. The doctor will check the size of the prostate by inserting a lubricated finger into the rectum to feel the patient's prostate.
• Blood test.Blood tests are done to see if there are any problems with the kidneys.
• Urine test. This examination is performed if the doctor suspects that the patient's symptoms are not due to a benign prostate enlargement, such as an infection.
• PSA blood test. Doctors may also perform tests to measure prostate specific antigen (PSA) in the blood in male patients. The PSA test is also often done as a series of tests to diagnose prostate cancer.
• Urine flow rate test. Patients with symptoms of urinary distress may need to take measurements of urine volume and flow rate.
• Biopsy.The doctor will take a sample of the patient's tissue to diagnose the presence or absence of cancer cells that can develop into prostate cancer.
• Cystoscopy. This test is done so that the doctor can see the inside of the patient's urethra and bladder.
• Transrectal ultrasound. Ultrasound this can detect any abnormalities in the prostate. Later a device called transducer will emit painless safe sound waves to produce an image of the structure of the organ.

Medicines & Medicines

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the treatment options for benign prostate enlargement?

Treatment of the prostate is generally not necessary except Benign prostate enlargement causes especially annoying symptoms or complications (such as urinary tract infections, impaired kidney function, blood in the urine, gravel in the bladder).

Generally, treatment can be reached in two ways, namely through the consumption of drugs and surgery. Treatment will also depend on the size of the prostate, age, medical condition, and the level of discomfort the patient feels.

The following are various drugs and surgeries that are performed to treat benign prostate enlargement.

Medical medicine

The doctor will then prescribe a drug that can help shrink the prostate or stop its growth. Medication also works to reduce symptoms. Medical drugs to treat benign prostate enlargement are:

• Alpha blockers . These drugs relax the smooth muscles in the prostate and bladder. Some of the drug options are terazosin, doxazosin, tamsulosin, alfuzosin, and silodosin.
• Phosphodiesterase-5 inhibitors . More commonly used to treat erectile dysfunction, this drug can also help reduce symptoms by relaxing the smooth muscles in the lower part of the urinary tract. One of the remedies is tadalafil.
• 5-alpha reductase inhibitors . This drug works to block the production of the hormone DHT which can trigger prostate growth. Drug options that can be used are finasteride and dutasteride.
• Combination drugs. Combination drugs are widely considered to be the more effective drugs for treating BPH. This drug can consist of a combination of finasteride and doxazosin or drugs alpha blockers with antimuscarinics which are commonly used for urinary incontinence problems.

Herbal medicine

Sometimes patients are worried about the side effects that can result from the drug and want to reduce their consumption. If so, there are also several herbal medicines that can be an option, such as the following:

• Saw palmetto. Saw palmetto comes from a tiny palm tree that grows in North America. According to the National Institute of Health (NIH), saw palmetto can reduce symptoms such as urination problems. Although its use is not considered effective enough, this herbal remedy can be a safe alternative for those of you who don't want to experience the risk of many side effects.
• Beta-sitosterol. Beta-sitosterol is a mixture of various plants that contains a cholesterol-like substance called sitosterol. Similar to saw palmetto, this herbal remedy is believed to help make urine flow stronger.
• Pygeum.The drug, which is derived from the bark of the African plum, is claimed to be able to treat symptoms by helping to empty the bladder. Unfortunately, there are no strong studies on its effectiveness as a BPH drug. In addition, some people may experience side effects such as stomach upset after consuming it.
• Rye pollen extract. This pollen extract made from rye, timothy, and corn is also said to treat the symptoms of BPH. In fact, according to a study, men who took this extract managed to reduce the intensity of symptoms compared to patients who took the usual medication.

If you decide to try this remedy, please be aware that herbal remedies are used as a treatment for BPH not recommended regularly and in the long term. It is better to consult your doctor again before choosing any herbal remedy.

Operation

The last treatment that can be done is to undergo surgery. The doctor will recommend surgery if the patient has more severe symptoms, the disease does not go away after taking medication, or when the patient has other conditions such as bladder stones or kidney problems.

Some of the types of surgery include:

• Transurethral resection of the prostate (TURP). The operation is performed by inserting a tool through the urethra to remove the prostate tissue that is blocking the urethra.
• Transurethral incision of the prostate (TUIP) . This operation aims to widen the urethral tract by cutting several small parts in the prostate and bladder neck.
• Open prostatectomy. The doctor will make an incision through the skin into the prostate to remove all or part of the prostate tissue. This operation is performed when there are complications or the size of the prostate has become very large.
• Laser surgery. The operation is performed using a high-energy laser that is inserted through the urethra using a cystoscope. This laser will later destroy prostate tissue.

Home Remedies

What are some lifestyle changes or home remedies that can be done to treat a benign prostate enlargement?

Here are some lifestyle changes and home remedies that can help you treat a benign prostate enlargement.

• Limit fluid intake at night. Don't drink anything for an hour or two before bed to avoid nocturia, or frequent nighttime urination. However, don't also limit your daily fluid intake to avoid dehydration.
• Limit consumption of caffeine and alcohol. This can increase urine production, irritate the bladder and worsen symptoms.
• Limit use of decongestants or histamine antagonists. This drug tightens the muscles around the urethra to control urine flow, making it more difficult to pass urine.
• Pee when you feel the urge to urinate. Waiting too long can strain the bladder muscles and cause damage.
• Try to urinate regularly (eg every 4-6 hours during the day) for bladder "monitoring". This can be especially helpful if you have severe urination.
• Do " double voiding " or urinate in two stages. You can urinate frequently, rest for a few moments, then urinate again.
• Follow a healthy diet. Obesity is associated with the formation of prostate protrusions.
• Stay active. There is no activity that can hold urine. Even taking a little time to exercise can help reduce urinary problems caused by prostate fibroma.
• Warm up. Cold temperatures can cause urinary retention and increase the feeling of urinating.

If you have any questions, consult your doctor for the best solution to your problem.