Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate gland grows abnormally. It is a major cause of lower urinary tract symptoms (LUTS), which is an abnormal function of the prostate, urethra, bladder, or sphincter. Here is an overview of the evaluation and treatment of BPH and its associated urinary tract symptoms (LUTS):
Factors Of BPH And Its Relationship With LUTS
The BPH causes the enlargement of the prostate gland, which can squeeze the urethra and the neck of the bladder. This makes the urination process more difficult due to the force that is created to pass the urine through the narrow urethra.
- Age- Aged men are more likely to have BPH, which is due to the hormonal changes that occur in them.
- Diabetes- Individuals who have hyperinsulinemia may have an increased amount of sex hormones that enter the prostatic cells, which in turn influence the growth of the prostate gland.
- Hypertension- Men who have hypertension are 1,5 times more likely to develop BPH compared to other men.
- Obesity– Men who are obese will have increased intra-abdominal pressure, which also increases bladder pressure and can worsen the BPH symptoms.
- Hypogonadism- The low production of testosterone can increase the risk of BPH in individuals.
Evaluation Of BPH And Its Symptoms
The BPH can be evaluated by the following process, which is given below:
Urinalysis:
The urine samples from the patients can be collected to detect urinary tract infections, metabolic disorders (glycosuria), and microscopical examination (microscopic hematuria).
Blood Test:
Blood urea nitrogen (BUN) and creatinine are the two blood tests that are useful to evaluate renal failure and acute kidney injury, which is associated with chronic BPH symptoms in patients.
Prostate-Specific Antigen (PSA): Prostate-specific antigen is a special protein in the prostate cells that is high in BPH patients.
Treatment of BPH
BPH can be treated by various options. Some of the treatments for BPH are given below:
Watchful Waiting:
Watchful waiting is a process of giving lifestyle advice to manage the BPH in patients. For example, advice related to weight loss, reduced caffeine intake, restricting fluid intake in the evening, muscle exercises, and avoiding constipation to try and reduce risk factors and improve urinary symptoms.
Medications:
Medications containing tamsulosin (Alpha-Blockers) and dutasteride (5 Alpha reductase inhibitors) are effective in treating BPH in patients. The alpha-blockers relax the smooth muscles in the prostate, bladder, and neck and help improve urine flow. The 5-alpha reductase inhibitors are effective in reducing the size of the prostate over time.
Combination Therapy: Using both alpha-blockers and 5-alpha reductase inhibitors for BPH is effective in treating it. For example, the Urimax D Tablet contains both tamsulosin and dutasteride as active ingredients, which help treat BPH effectively and reduce the associated urinary problems.
Minimal invasive methods:
Transurethral Microwave Thermotherapy (TUMT): TUMT is a minimal invasion therapy that uses microwave energy to shrink the prostate.
Transurethral Needle Ablation (TUNA): It is also a minimal invasion therapy that involves radiofrequency energy to reduce prostate enlargement in BPH.
Prostatic Urethral Lift (UroLift):
It is a minimally invasive procedure that lifts and holds the prostate tissue which was enlarged; hence, it can no longer block the urethra.
Surgical Intervention:
Transurethral Resection of the Prostate (TURP): It is a common surgery that uses electrical current or laser light to remove the excess prostate tissue.
The evolution of science in the field of medicine has helped to treat and evaluate BPH and the urinary symptoms associated with it. It is recommended for individuals experiencing urinary symptoms to consult with your healthcare provider for proper diagnosis and personalized treatment promptly. The risk of BPH can be prevented by proper weight management and diet and also by early diagnosis. Let’s spread the importance of prevention and diagnosis (evaluation) in prostatic hyperplasia.
