Benign Prostatic Hyperplasia: Symptoms, Causes & Treatments

Posted by Dr Anil Agarwal on August 28th, 2021

What is Benign Prostatic Hyperplasia (BPH) or prostate adenoma?

Benign Prostatic Hyperplasia (or prostate adenoma) is the non-malignant growth of prostate tissue that occurs in middle-aged men onwards. In a young individual, the prostate gland is rudimentary, almost undetectable, and spreads like a cluster of seeds over the lining of the urinary tract. However, at puberty, this anatomy begins to change due to the high production of the hormones testosterone and dihydrotestosterone, explains the Best Urologist in Delhi.

Testosterone causes “seeds”, called acini, to germinate and grow. Thus, in adult life, and due to their growth and proliferation, these small glandular structures can cause obstructive symptoms associated with urinary flow disorders.

Benign Prostate Hyperplasia is one of the most common diseases in men and is considered part of the physiological aging process. The incidence of this disease is 51% in men 60 to 69 years of age and 75 to 90% in the eighth decade, says the Best Urologist in Delhi.

Symptoms

Although the concept of BPH encompasses an enlarged prostate and mechanical obstruction to voiding flow, there is not always a direct relationship between the volume of hyperplasia and the intensity of symptoms. Very enlarged prostates may not cause symptoms and minor ones can be a source of intense discomfort, explains the Urologist in Delhi.

The symptoms of Benign Prostate Hyperplasia can be divided into obstructive and irritative.

Obstructive symptoms

• Weak and / or intermittent urine flow.
• Decrease in the force and calibre of urine.
• Feeling of incomplete emptying of the bladder.
• Double urination (urinating a second time in a 2-hour period).
• Post void drip.
• Difficulty or delay in starting urination.
• Urinary retention.

Irritative Symptoms

• Polyakiuria, or increased frequency with which you urinate.
• Nocturia, or the need to urinate frequently at night.
• Sudden urgency.
• Urge urinary incontinence.

Causes of benign prostate hyperplasia

Prostate hyperplasia is related to age, so that over 80 years of age, 9 out of 10 men have it, and may or may not produce symptoms depending on the magnitude of their growth, says the Urologist in Delhi.

How is benign prostate hyperplasia diagnosed?

Although prostate hyperplasia is a benign disease, in the presence of symptoms such as those mentioned in the previous section, prostate cancer must always be ruled out. To do this, it is necessary to perform a digital rectal examination, determine the concentration of PSA (prostate specific antigen) in a blood test, and perform an ultrasound of the prostate, says the Kidney Specialist in Pitampura.

In those cases where the PSA value is high, it is necessary to perform a prostate biopsy. The biopsy is done transrectally, that is, inserting a needle into the anus and puncturing through the rectum. For this, the biopsy is guided by rectal ultrasound.

An ultrasound probe is inserted through the anus and several biopsies are obtained with a fine needle. About 6 biopsies are usually obtained so as not to leave any area of ??the prostate without evaluating, explains the Urologist in Delhi.

What care does it require?

Patients with this disease require periodic check-ups to assess the possibility of developing cancer. However, having benign prostatic hyperplasia does not imply that there is a higher risk of developing cancer.

How to treat benign prostate hyperplasia?

Early diagnosis of Benign Prostate Hyperplasia is essential to avoid complications such as urinary tract infections, kidney or bladder damage, bladder stones, or incontinence.

The possible existence of these secondary processes derived from urinary obstruction, together with the degree of discomfort of the patient, will determine the treatment against BPH.

The indications for Prostate treatment in Rohini, depends on the discomfort that the disease is producing. These discomforts are generally related to difficulty urinating, subsequent dripping and the permanent feeling of wanting to urinate, mainly at night. If there are no discomforts, no treatment is indicated, says the Kidney Specialist in Pitampura.

Medical treatment

Initial Prostate treatment in Rohini is usually with medication. Two types of drugs can be used, which are usually used together:

• 5α reductase inhibitors. These drugs block the effect of male sex hormones (androgens) on the prostate, which prevents it from continuing to grow and even favours its reduction in size, with subsequent improvement in symptoms. A typical drug in this group is finasteride.
• Α-adrenergic blockers. They relax the urethra and facilitate urine output. They do not modify the evolution of the disease or the size of the prostate. Drugs in this group are doxazosin, tamsulosin, and terazosin.

Surgical Treatment

When the discomfort continues to be very important despite Prostate treatment in Pitampura with medicines, when infections are frequent, when there is bleeding with the urine or when there are stones in the bladder, the prostate surgery in Pitampura is usually recommended by the urologist in Delhi.

The prostate surgery in Rohini involves removing the prostate, which is called a prostatectomy. Prostatectomy can be done through the urethra (transurethral route) or by opening the abdomen and directly accessing the pelvis. The decision to perform one technique or another depends on the size of the prostate, the patient’s health status and their preferences.

The most used are transurethral resection techniques. These techniques are done through the urethra (the hole in the penis where urine comes out) and can be done with general anaesthesia, spinal anaesthesia, or epidural anaesthesia (leaving the lower half of the body asleep after puncturing the anaesthesia in the spine) or with local anaesthesia and sedation. There are different ways to remove the prostate transurethrally:

• Prostate Urethral Lift (PUL): This procedure uses permanent implants to lift and keep enlarged prostate tissue out of the way, so it no longer blocks the urethra.
• Transurethral resection of the prostate (TURP): This procedure involves the use of a heated wire to cut the prostate tissue and has been used for years to treat an enlarged prostate.
• Transurethral Incision of the Prostate (TUIP): One or two small cuts are made in the prostate gland, making it easier for urine to pass through the urethra.
• Transurethral Microwave Thermotherapy (TUMT): Microwave energy from the electrode destroys the inner portion of the enlarged prostate gland, reducing it and facilitating the flow of urine.
• Transurethral needle ablation (TUNA): An endoscope is passed into the urethra to place needles into the prostate gland. Radio waves pass through the needles, heating and destroying excess prostate tissue that blocks the flow of urine.