University of Maryland Medical Center (UMMC) defines benign prostatic hyperplasia (BPH), a common condition in older men, as a noncancerous enlargement of the prostate gland. Normally the size of a walnut, with BPH, the prostate gland may become as large as a tennis ball says Merck Manuals.
The prostate is located under the bladder and surrounds the urethra (which empties urine from the bladder). Mayo Clinic describes BPH as the urethra passing through the prostate as if passing through a doughnut hole. When the prostate enlarges, the hole shrinks and begins to block urine flow.
Risk factors for BPH include aging, family history, and ethnic background. It’s more common in black and white men. Some over-the-counter cold and allergy medications can also drastically worsen BPH.
Mayo Clinic lists BPH symptoms as weak urine stream; difficulty starting urination; stopping and starting while urinating; dribbling at the end of urination; frequent or urgent need to urinate; increased frequency of urination at night; straining while urinating; inability to completely empty the bladder; blood in the urine; urinary tract infection; stones forming in the bladder; and impaired kidney function.
Merck Manuals says treatment isn’t necessary unless there are especially bothersome symptoms or complications like urinary tract infections, impaired kidney function, blood in the urine, stones, or urinary retention.
Several treatments are available and include medications, surgery and minimally invasive techniques.
Medication is the most common treatment for moderate BPH. These include, according to UMMC, alpha blockers which cause the bladder muscles to relax, making it easier to urinate, and 5-alpha-reductase inhibitors which shrink the prostate by preventing hormonal changes that cause prostate growth.
NKUDIC says most doctors recommend BPH surgery as the best long-term solution. Transurethral resection of the prostate, says UMMC, is the most common. Surgeons insert a scope through the penis and remove the interior of the prostate piece by piece.
Another procedure, says NKUDIC, is transurethral incision of the prostate. This widens the urethra by making small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself. Open prostatectomy says UMMC is an incision in the lower abdomen to remove the inner part of the prostate.
Minimally invasive techniques may better relieve symptoms than medications, but often aren’t as effective as surgery. UMMC says transurethtral microwave therapy uses heat to shrink the prostate. Transurethral needle ablation uses radio waves to remove part of the prostate blocking urine flow.
Laser therapy uses lasers to destroy excess tissue and shrink the prostate. Mayo Clinic says another option is a prostatic stent; a tiny device inserted into the urethra to keep it open. Tissue grows over the stent to hold it in place.
Sources:
Benign Prostatic Hyperplasia. MerckManuals.com by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Web 17 Nov 2011.
http://www.merckmanuals.com/home/mens_health_issues/prostate_disorders/benign_prostatic_hyperplasia_bph.html
Prostate Enlargement: Benign Prostatic Hyperplasia. Kidney.niddk.nih.gov by National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Web 18 Nov 2011.
http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/
Prostate Gland Enlargement. MayoClinic.com by Mayo Foundation for Medical Education and Research. Web 18 Nov 2011.
http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027
What Is BPH or an Enlarged Prostate? About.com Prostate Cancer by the New York Times Company. Web 18 Nov 2011.
http://prostatecancer.about.com/od/prostatecancer101/a/bphbasics.htm
Benign prostatic hyperplasia. UMM.edu by University of Maryland Medical Center (UMMC). Web 18 Nov 2011.
http://www.umm.edu/altmed/articles/benign-prostatic-000018.htm
Reviewed November 22, 2011
by Michele Blacksberg RN
Edited by Jody Smith