BENIGN PROSTATIC HYPERTROPHY

By: Marissa Miuccio

Description:

Benign prostatic hypertrophy is an enlargement of the prostate gland.

The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body.

As the prostate gets bigger, it may squeeze or partially block the urethra. This often causes problems urinating.

BPH occurs in almost all men as the age but BPH is not cancer. An enlarged prostate can be a nuisance. But its usually not a serious problem.

Description:

Benign prostatic hypertrophy is also known as benign prostatic hyperplasia.

It is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth.

BHP may cause the bladder to be blocked, making it impossible or extremely hard to urinate. This problem may cause backed-up urine, leading to bladder infections or stones, or kidney damage.

BHP does not cause prostate cancer, does not cause erection problems, and does not affect a man’s ability to father children.

Prostatic enlargement depends on the potent androgen dihydrotestosterone (DHT). In the prostate gland, type II alpha-reductase metabolizes circulating testosterone into HDT, which works locally, not systemically. DHT binds to androgen receptors in the cell nuclei, potentially resulting in BHP.

In vitro studies have shown that large numbers of alpha-1-adrenergic receptors are located in the smooth muscle of the stoma and capsule of the prostate, as well as in the bladder neck, stimulation of these receptors causes increase in smooth muscle tone, which can worsen lower urinary tract symptoms. Conversely blockade of these receptors can reversibly relax these muscles, with relief of lower urinary tract symptoms.

Signs and Symptoms

Many men with benign prostatic hyperplasia have no symptoms.

When symptoms (known as lower urinary tract symptoms occur, they may range from mild and barely noticeable to serious and disruptive.

The amount of prostate enragement is not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms. And some men with great deal of enlargement have few symptoms.

Signs and symptoms

Symptoms of BHP may involve problems emptying the bladder or bladder storage.

Symptoms related to bladder emptying include: Difficulty starting a urine stream (hesitancy and

straining). Decreased strength of the urine stream (weak flow). Dribbling after urination. Feeling that the bladder is not completely empty. An urge to urinate again soon after urinating. Pain during urination (dysuria).

Signs and Symptoms

Symptoms related to bladder storage include: Waking up at night to urinate (nocturia) Frequent urination A sudden uncontrollable urge to urinate.

These symptoms are not always related to prostate enlargement and can be caused by other conditions. BPH symptoms are often balanced between the two types of symptoms.

Treatments

Medications are most common treatment for moderate symptoms of prostate enlargement. Medications used to relieve symptoms of enlarge prostate include Alpha blockers 5 alpha reductase inhibitors Combination drug therapy. Taking an alpha

blocker and a 5 alpha reductase inhibitor at the same time is generally more effective than taking just one or the other by itself.

Tadalafil (Cialis)

Treatment

Surgery Transurethral resection of the prostate (TURP)

a surgeon places a special lighted scope (resectoscope) into your urethra and uses small cutting tools to remove all but the outer part of the prostate (prostate resection).

Transurethral incision of the prostate (TUIP or TIP) Like TURP, TUIP involves special instruments that are

inserted through the urethra. But instead of removing prostate tissue, the surgeon makes one or two small cuts in the prostate gland to open up a channel in the urethra — making it easier for urine to pass through.

Treatment

Open prostatectomy Minimally invasive surgery

Laser surgery Laser surgeries (also called laser therapies) use

high-energy lasers to destroy or remove overgrown prostate tissue.