Tuesday 29 January 2019

What are the treatment options for BPH?


An enlarged prostate can affect a person's ability to urinate, which can impact on their quality of life. Treatment options for an enlarged prostate include watchful waiting, medication, minimally invasive procedures, and surgery. Certain lifestyle changes can also help to prevent or improve symptoms.
In this article, we look at treatment options, lifestyle changes, and promising natural treatments for an enlarged prostate.

What is an enlarged prostate?
The prostate is a small gland that sits between the penis and the bladder. It functions as part of the male reproductive system.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that carries urine from the bladder out through the penis. The medical term for an enlarged prostate is benign prostatic hyperplasia, or BPH.
BPH is a common health condition in older people. In the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases, BPH affects:

  • around 50 percent of men aged 51–60 years
  • up to 90 percent of men over the age of 80

Common symptoms of BPH include:

  • needing to urinate more than eight times a day
  • being unable to delay urination
  • waking up frequently at night to urinate
  • straining to urinate or having difficulty starting urination
  • having a weak or intermittent urine stream
  • being unable to empty the bladder completely, which is called urinary retention
  • urinating accidentally, or urinary incontinence
  • dribbling after urinating

Treatment options
BPH is a progressive condition, which means that if a person does not get treatment, their symptoms may get worse over time. Treatment options for BPH include:
Watchful waiting
The primary stage of BPH treatment is usually called watchful waiting. During watchful waiting, the affected individual will be:

  • learning about BPH
  • making positive lifestyle changes, such as becoming more physically active
  • taking no further action until their symptoms change

A doctor will also work with the individual and keep a close eye on their condition. Many people with an enlarged prostate remain at this level of care for some time.

Medication
When BPH becomes more advanced, a doctor may recommend medication. Medication can help to control the growth of the prostate and reduce the symptoms of BPH. Common medications for BPH include:

Alpha blockers. These can relax prostate muscles and improve the functioning of the urinary system.

Phosphodiesterase-5 (PDE5) inhibitors. Doctors primarily prescribe these for erectile dysfunction. However, PDE5 inhibitors can also relax muscles in the urinary tract to help relieve symptoms of BPH.

5-alpha-reductase inhibitors. These may help to limit the growth of the prostate gland in people with BPH.

Combination medications. A doctor may recommend the concurrent use of two or more different types of medication to help improve BPH symptoms.

Minimally invasive procedures
When medication alone does not relieve the symptoms of BPH, the next level of treatment typically involves minimally invasive procedures. During these procedures, a doctor will insert an instrument into a person's urethra or rectum to either destroy excess prostate tissue or widen the urethra.

Surgery
If medication and minimally invasive procedures are unable to improve the symptoms of BPH sufficiently, a doctor may recommend surgery. A person may also require surgery if their symptoms become severe or if complications develop. Potential complications include:

  • pain or severe difficulty with urination
  • recurrent urinary tract infections
  • blood in the urine
  • sexual dysfunction
  • stones in the bladder
  • kidney damage

Surgery is not uncommon for people with BPH. According to the Urology Care Foundation, around 150,000 men in the U.S. undergo transurethral resection of the prostate (TURP) for BPH each year. TURP is the most common type of surgery for BPH in the U.S., but there are now several other surgical options.
Some procedures can take place under local anesthetic on an outpatient basis, but others are likely to require full anesthesia and a hospital stay.


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