BPH or Benign Prostatic Hyperplasia, is the non cancerous enlargement of the prostate. The prostate is a walnut-sized gland that forms part of the male reproductive system. As the prostate enlarges, it can put pressure on the urethra causing a slowing of the urinary stream, causing more frequent urination, and dribbling. It can also result in urinary retention- the inability to urinate.
The type and severity of symptoms experienced will vary from person to person and may change over time. For many men, BPH is never more than a minor to moderate discomfort; for others, it may greatly diminish their quality of life.
BPH Symptomps: How to Recognize BHP?
The symptoms of BPH may be different from individual to individual, but the most common signs involve changes or problems with urination, including
- weak urinary stream
- irregular need to urinate
- urgency and leaking or dribbling
- frequent urination
- hesitancy
- Nocturia (need to urinate during the night)
- Incontinence (involuntary leakage of urine)
The size of the prostate is not an accurate indication of how serious your symptoms will be. While some men with significantly enlarged glands have little obstruction and few symptoms, there are many others, with prostate glands not as large, but who experience severe obstruction and other symptoms.
Sometimes a man may not even realize that he has this problem until he suddenly finds himself unable to urinate at all. This is called acute urinary retention, and it may be triggered by taking over-the-counter medication, such as allergy or cold pills; drinking alcohol, cold temperatures, or a long period of immobility.
You need to talk to your physician if you are experiencing any of the above mentioned symptoms. In majority of patients, these symptoms suggest BPH, but they also can be a sign of other, more serious conditions, such as prostate cancer, that can be ruled out only by a doctor’s examination.
BPH Treatment Options
Behavioral Therapy
- By introducing changes to your diet – by cutting out bladder irritants, and reducing fluid intake in the evening one can reduce the severity of the symptoms.
Medications
If you are experiencing moderate symptoms, medications can be used to control this condition.
Alfa blockers relax the smooth muscle of the obstructing prostate and improve the symptoms.
Flomax, Doxazocin, Therazosin, Uroxatral, Rapaflow all belong to this family of drugs, inquire with your plan which one is covered.
5 alfa reductase inhibitors shrink the prostate that is large, more than 50 cc in volume, that need to be taken along with alfa blockers to improve symptoms.
Proscar(Finasteride) and Avodart belong to this family of drugs. Check your insurance for coverage.
Combination of both categories of drugs alfa blockers and 5 alfa reductase inhibitors came to the market most recently.
Jalyn is the only combination drug on the market. Check your insurance for coverage.
Minimally invasive Therapies
TUMT – Transurethral Microwave Thermotherapy is using microwave energy to remodel the prostatic tissues. It induces changes from voluminous glandular tissues to fibrotic small volume prostate. These effects can last 7-10 years. Most of patients do not need to take medications 3-5 months after the therapy.
Laser Therapy – using laser energy to evaporate obstructing prostatic tissues without causing bleeding. It is a very important feature for patients who are on anticoagulation therapy for a variety of reasons. These patients do not need to interrupt their anticoagulation.
Surgical Treatments
Transurethral resection of the prostate (TURP) – This procedure involves removing (part of) the prostate through the urethra. It was one of the most common surgeries performed on men but is rapidly being replaced by laser prostatectomy and other less invasive procedures.
Open prostatectomy is usually done in men who have a prostate larger than 100 cc of volume, bladder damage or other complicating factors, such as bladder stones or urethral narrowings.
Robotic simple prostatectomy starts to take place amongst all the methods. It offers the same advantages; short recovery, minimal blood loss and short hospital stay. It is reserved for patients with large prostates where the minimally invasive technologies would not be effective.
BPH can lead to various complications, ranging from urinary tract infections, weakening of the bladder muscle, hematuria (blood in the urine), renal failure, to impaired sexual function and bladder stones.
When BPH is found in its earlier stages, there is a lower risk of developing such complications. If you are experiencing BHP problems and are looking for treatment, contact Dr. Plawner, urologist in New York (Manhattan or Brooklyn office), or urology specialist in New Jersey (Nutley office). Call (212) 737-2330 for a consultation or appointment, or use our contact form for further information.