According to the Cleveland Clinic, benign enlargement of the prostate, also called benign prostatic hyperplasia or BPH, is a common condition seen in men as they age. In fact, half of men show signs of BPH by the time they reach 60. And by the time they reach 85, 90 percent of men will show signs. Further, half of those affected will need treatment.
Unfortunately, symptoms can be both frustrating and embarrassing. "They can't sit through a meeting or a plane flight without getting up," Kevin Slawin, M.D., a professor of urology at Baylor School of Medicine in Houston tells Web MD. "It's very annoying…and when they have to go, they really have to go."
What Causes an Enlarged Prostate?
According to the Cleveland Clinic, an enlarged prostate can actually block the flow of urine. Consequently, patients may feel like it takes a long time to urinate. Further, it may be hard to start urinating in the first place. And patients may need to relieve themselves more often than usual -- with the need coming on suddenly. This can make it difficult to travel or sleep through the night.
As the condition progresses, patients may develop other issues like bladder stones or bladder infections, and blood may be present in urine. Kidney damage can occur, and at times, it may be impossible to urinate at all because the urinary tube is blocked.
Diagnosing BPH
According to Web MD, it can take months or years for patients to see a healthcare professional. Patients often don’t reach out for help until symptoms become so severe that they are intolerable. "When they're getting up several times a night and have trouble falling asleep again, that's when they come in," Slawin tells WebMD.
And when patients finally do seek help, it can be difficult to diagnose this health condition. "When men start having urinary problems, it's hard to know the reason. They should see a doctor when anything changes because there can be bladder cancer, stones, prostate cancer…” Slawin adds. “BPH is often a diagnosis of exclusion…after we make sure nothing more serious is going on."
To diagnose BPH, doctors use something called the BPH Impact Index. This is a list of questions created by the American Urological Association. In this process, urologists can gauge symptoms are to see if further action is required. When patients receive high scores on the index, symptoms are considered severe.
Treating Enlarged Prostate Conditions
The good news is that there are things that can be done for BPH. According to the Mayo Clinic, there are several treatments available. The first involves taking alpha blockers to make urination easier. These medications relax the muscles of the bladder as well as the muscle fibers in the prostate.
Another option is 5-alpha reductase inhibitors, which counter hormones to keep the prostate gland from growing larger. Sometimes doctors will prescribe a combination of these two types of medication to reduce symptoms as much as possible if one medication isn’t working well enough on its own.
Minimally invasive surgery is also available. The first type of procedure in this respect is called transurethral resection of the prostate, or TURP. In this procedure, a surgeon uses a lighted scope to remove everything but the outermost area of the prostate. The good thing about this procedure is that symptoms subside in an expedient manner, with urination beginning to return to normal almost immediately after the procedure is performed. However, a catheter is often needed, and activity is restricted until the body recovers.
Another option is called transurethral incision of the prostate, or TUIP. This treatment also involves a lighted scope, but for this procedure, the surgeon makes incisions in the prostate itself. This helps restore normal function of the urethra.
Further, some doctors choose transurethral microwave thermotherapy, or TUMT. This procedure involves an electrode. The electrode is inserted by way of the urethra, making its way into the prostate. Then, microwave energy is used to destroy the inside of the prostate, which shrinks it and makes it easier to urinate. That said, the Mayo Clinic says that this procedure is usually performed on smaller prostates and under “special circumstances” because it may need to be performed again later.
Yet another option is transurethral needle ablation, or TUNA. This is an outpatient procedure that also involves a scope, which is inserted into the urethra. In this procedure, doctors actually put needles in the prostate gland. Then radio waves are transmitted by way of the needles, which heats and abolishes excess tissue. This frees up blockages. That said, TUNA doesn’t deliver immediate results and may not fully eliminate symptoms.
Laser therapy also can be performed. This method of treatment may deliver immediate results with a lower risk of complications than other methods. Laser therapy is often recommended for those who rely on blood thinners.
Other methods of treatment include a prostate lift and embolization. A prostate lift is considered an experimental procedure because it hasn’t been studied over long periods of time. Embolization is also an experimental procedure, in which blood to and from the prostate is cut off in certain areas, which makes it shrink. Long-term effects have not been studied for this treatment, either.
The final option of treatment is called an open or robot-assisted prostatectomy. The procedure involves a cut in the bottom portion of the abdomen to remove prostate tissue. The Mayo Clinic says that this method is effective in those who have a large prostate or have experienced damage to the bladder. This isn’t an outpatient procedure and may require a hospital stay. Also, it has been linked to an elevated risk of the need for a blood transfusion.
Patients who undergo any of these procedures should follow the doctor’s orders to decrease the risk of complications.
Healthline.com advises strengthening the pelvic region and refraining from living a sedentary lifestyle. Further, limit alcohol and caffeine intake. And don’t wait to use the restroom. If you’ve gotta go, do so immediately.