There are several causes of prostate enlargement. Benign prostatic hyperplasia (BPH) is the most common cause among others
The prostate is a gland. A gland is an organ in the body that secretes fluids, hormones, etc. The prostate gland sits around the urethra (the tube that urine passes through from the bladder to exit the penis). It secretes fluids that protect sperms from the hostile environment of the vagina during ejaculation.
Ok, then what is Benign Prostatic Hyperplasia?
BPH refers to an enlarged prostate which is not cancerous of nature. The word benign means “non-cancerous” while hyperplasia means “overgrowth” or “enlargement”.
As men age, the production of a potent male sex hormone, dihydrotestosterone, may be increased. This hormone promotes the multiplication and growth of prostate cells and in turn will cause the prostate to be enlarged. With an enlarged prostate, it can compress against the urethra and cause problems with urination.
To better understand this, let’s look at an illustration of the structures
As we can see, the prostate is located around the urethra, therefore, when enlarged, it will compress on the urethra narrowing the space for urine to flow out of the bladder. This causes various symptoms such as:
- Frequent urination, especially at night
- Difficulty initiating urination (having to strain or wait longer than usual before urine starts flowing out of the penis)
- Poor/Weak urine stream
- Urine continues to dribble after completing urination
- Feeling that bladder is not empty despite completing urination
Rarely, BPH may also cause a man to be completely unable to pass urine. This is a medical emergency and needs medical attention immediately.
I think I have some of the symptoms, what should I do?
When one experience the above-mentioned symptom(s), it is advisable to consult a doctor to find out the cause. The doctor may do a rectal examination (by putting a finger into the anus to feel the size of the prostate) and run some blood and urine tests to confirm the diagnosis.
My doctor says that I have BPH, what are my options?
If the symptoms are not bothersome to you, treatment may not be necessary. This is called watchful waiting. This means waiting to see if there are any changes or worsening of symptoms and deciding to get treatment later when symptoms become unbearable.
There are also medicines available for BPH. They are broadly classified into two types. One that relaxes the surrounding muscles of the urethra, making it easier to urinate while the other shrinks the prostate size. These medications are usually given in combination as the former works almost immediately providing relieve to those who have difficulty in urinating while the latter takes a couple of months before the prostate size is substantially reduced.
Surgery is often the last resort where part or the entire prostate may be removed.
Is there anything I can do to help myself?
There are many things one may do to help oneself in order to reduce the severity of the symptoms of BPH. These include:
- Reducing the amount of caffeine-containing and alcohol-containing drinks as these drinks promote urination
- Drinking less fluids, especially right before bedtime
- Try the “double voiding” method. This involves urinating twice; After completing urination for the first time, wait for a moment, relax, then urinate again.
- Avoid certain cold and allergy medications which contain decongestants and/or anti-histamines as these medications can worsen BPH symptoms.
- Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J et al. Schwartz’s principles of surgery.
- Williams B, Chang A, Ahalt C, Conant R, Ritchie C, Chen H et al. Current diagnosis and treatment.
- Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison’s principles of internal medicine.
- Benign prostatic hyperplasia (enlarged prostate) (The Basics [Internet]. UptoDate.com. 2017 [cited 25 October 2017]. Available from: https://www.uptodate.comy/contents/benign-prostatic-hyperplasia-enlarged-prostate-the-basics