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What is the Best Treatment for an Enlarged Prostate?

Urinary Incontinence Due To Benign Prostatic Hyperplasia

 

The enlargement of the prostate gland can be attributed to several causes. These are prostatitis, cancer, and benign prostatic hyperplasia (BPH). This article will present information on the more common condition in elder men, benign prostatic hyperplasia (BPH). Although this website focuses on items related to urinary incontinence, the management & symptoms of benign prostatic hyperplasia are similar to those of urinary incontinence. This ailment effects all areas in a man’s life. It is obvious from a physical perspective, yet, social, emotional and psychological aspects are impacted as well. Information on this topic may arouse hopes for a resolution of physical symptoms as well as dissolution from the distress endured living with this ailment.

 

What Is Benign Prostatic Hyperplasia?

 In this condition, an increased growth rate of cells within the prostate gland may cause pain, symptoms of urinary incontinence, blockage in the outflow path of the urethra or other discomfort. The word benign means noncancerous. Hyperplasia defines growth faster than normal or usual.

 

What is the Prostate Gland?

The prostate gland is a component of the male reproductive system. Its primary function is production of seminal fluid essential for sperm cell viability and mobility. Prostate glands are located below the bladder and above pelvic floor muscles. In situ at the neck of the bladder, this walnut sized gland wraps around the urethra. During voiding urine passes through the
​prostate gland to exit the body.

 

How Does the Prostate Gland Enlarge?

It is normal for the prostate gland to begin growing during puberty. As men age, inner cells lining the prostate gland increase more rapidly impinging on the urethra’s lumen. Reduced space hinders urine outflow and causes symptoms men experience from an enlarged prostate gland.

Contemplative Man

 

How Many Men Are Affected with BPH?

A low percentage of men may experience mild symptoms of Benign Prostatic Hyperplasia by the time they are thirty. Many men have notable symptoms before they are sixty years of age. The percentage of men affected with an enlarged prostate and urinary incontinence symptoms may be up 90% at age eighty. Individual researchers include variable factors within their parameters supporting their findings. All agree benign prostatic hyperplasia is an aging ailment many men experience.

 

What Are Risk Factors For BPH?  

  1. Familial Factor – Members of your family experiencing Benign Prostatic Hyperplasia increases your risk for developing BPH also.
  2. Medical History – Conditions such as diabetes and cardiovascular disease may present conditions contributing to or aid in the development of an enlarged prostate gland.
  3. Medications – A category of medications relax bladder neck muscles and the prostate’s fiber muscles to make voiding easier. These are known as Alpha Blockers. A second category is 5-Alpha Reductase Inhibitors. These drugs inhibit or reduce the production of the hormone know to initiate prostate cell growth. These medications have side effects. Thorough consultation with your medical practitioner is advised for a decision on the best intervention.
  4. Lifestyles – Due to the extra weight of obese men BPH occurs from pressure of abdominal structures on the bladder
  5. Aging – The most deciding factor for developing BPH is age. Deterioration in the integrity and youthful vigor of individual cells is the primary cause. These changes are inevitable.

Although these risk factors present conditions that may precipitate the onset of BPH, its inception can be delayed. All factors, except family history and age, can be influenced by changes in lifestyle and/or decisions in medical care. Consider and determine efforts to perform regular healthy practices. Decide on consistent exercises to maintain optimal weight, diligent control of medical conditions and consultation with your primary care medical professional regarding medication use. These interventions may prolong early onset of enlarged prostatic symptoms in the lower urinary tract system (LUTS).

What Are Symptoms of BPH?

 An enlarged prostate places pressure on the bladder and urethral muscles. Portions of an enlarged gland encroaches into the lumen of the outflow urinary tract, through the urethra, voiding is hindered and symptoms often occur.

There is no correlation between the size of a man’s prostate gland and the symptoms he may experience. A man with small enlargement may have several symptoms while another with an enlarged prostate gland has none. Symptoms of BPH are variable and individualized. No generalizations can be made. Symptoms are not dependent on the degree and severity of the enlarged prostate. Pain is not a common symptom of BPH.

BPH Symptoms

  • Frequent nocturnal urination
  • Straining to urinate
  • Weak urine stream
  • Slow onset
  • Dribbling after voiding
  • Difficulty starting urine stream
  • Start and stops during urination
  • Frequency or urgency
  • Incomplete urination

Occasionally difficulty urinating or the inability to urinate at all may occur for some men with an enlarged prostate. Pain due to a full bladder prompts immediate medical attention. The inability to urinate is known as acute urinary retention (AUR). Precipitating factors include, exposure to cold, medications preventing normal bladder muscle contractions to urination and excessive alcohol consumption. AUR may occur after surgical treatment for BPH. Prostatitis, a bacterial infection or a viral infection of the prostate gland may be another cause for acute urinary retention (AUR) to develop.

How Do Men Manage This Condition?

 There is no standard approach to treat symptomatic benign prostate hyperplasia. The size of a prostate gland does not determine treatment. Men with large glands may have minimum symptoms while a small prostate gland causes several, uncomfortable or inconvenient symptoms. A general consensus for treatment is the designated term “watchful waiting.” Men are urged to employ conventional noninvasive methods for control and monitor their condition with yearly follow up visits to your practitioner. As the condition deteriorates, symptoms begin to escalate home management becomes a chore. Unbearable discomfort may prompt the decision to seek intervention. The decision for treatment is dependent on age, discomfort, inconvenience, lifestyle interruption, and the size of the prostate gland. Consultation with your urologist provides information and answers for an agreed treatment plan.

 

 What Treatment Options Are Available?

There are two different avenues of treatment commonly known, conventional allopathic and natural holistic methods. Conventional allopathic methods are discussed first. Several categories of treatment will be presented. They are medications, minimally invasive therapies, Laser therapy, surgeries and open prostatectomy. Considerations for treatments include age, discomfort, general overall health and the size of the prostate gland. Natural holistic methods include lifestyle changes, diet, exercises and home remedies.

 

Conventional Allopathic Methods

Medications:

 Medications are used to treat mild to moderate symptoms.

  • Alpha blockers –Uroxatral, Cardura, Flomax, Rapaflo are effective in men with small prostate glands. Side effects dizziness due to lowering blood pressure and semen directs backward into the bladder instead of going out through the urethra (retrograde ejaculation)
  • 5-alpha reductase inhibitors – Proscar and Avodart may require up to six months for effects to be noted. Sexual side effect may include reduced libido, orgasm difficulties, breast enlargement and retrograde ejaculation
  • Combination drug therapy – may include a medication from both of the above medication types.
  • Tadalafil (Cialis) – a drug known for erectile dysfunction, also treats prostate enlargement.

 

 Minimal Invasive Therapies:

Minimal invasive therapies are recommended for men with moderate to large prostates presenting with mild to moderate symptoms. The treatments below often

A Medical Office Appointment

are performed as an outpatient procedure.

  • Transurethral Needle Ablation (TUNA) –A scope inserted into the urethra, allows doctors to place needles into prostate tissue. Radio waves are passed through the needles, heating and eventually destroying prostate tissue blocking the outflow path.
  • Transurethral Microwave Therapy (TUMT) – Special electrodes passed through the urethra are inserted into the prostate gland. The electrodes direct microwave energy into the center of the prostate gland, destroying the tissue. Shrinkage of the gland is a result permitting unhindered outflow of urine.
  • Prostate Lift or “UroLift” Procedure – A procedure for men with small or moderate sized prostate glands. Implants are placed within prostate tissue preventing the growth of excess tissue obstructing the outflow of the urethra.

 

Surgeries:

Surgical procedures recommended for men with moderate to large prostates presenting moderate to severe symptoms.

  • Transurethral Resection of the Prostate (TURP) – With a lighted scope inserted into the penis, the surgeon removes the intruding prostate tissue creating a clear outflow path. This procedure relieves symptoms quickly.
  • Transurethral Incision of the Prostate (TUIP)

    A Surgery in Progress

    With a lighted scope inserted into the penis, the surgeon makes a couple of slash cuts into the prostate gland to allow urine to flow more easily. This procedure may be used for small or moderate sized prostate glands or if conventional surgical procedures an ill advised due to health concerns.

 

Laser Therapy: 

These are surgical procedures using high laser energy to destroy or obliterate prostate tissue causing obstruction in the urethra. Symptomatic relief is immediate without side effects.

 

  • Ablative Procedures –vaporize obstructive prostate tissue clearing the outflow path to facilitate urine passage through the urethra. Two types of laser processes are available, photosensitive vaporization of the prostate (PVP) and holmium laser ablation of the prostate (HoLAP). Both remove offending prostate tissue creating an unobstructed path for urine outflow.
  • Enucleative Procedures –A holmium laser enucleation of the prostate (HoLEP) removes excess prostate tissue blocking urine flow. In this procedure core prostate gland tissue is excised thus preventing regrowth.

 

Open Prostatectomy:

 Some surgical procedures require a comprehensive design to treat symptomatic enlargement of the prostate gland. Objectives for best results from the procedure include a planned surgical approach for access to the area to be operated on and special instruments necessary for the intended outcome to be successful. Some surgeries use a robotic arm for precision applications or for accessibility.

The treatment options available for men are numerous. Consider review on other procedures such as Transurethral Dilation of the prostate gland (TUBD), High-Intensity Focused Ultrasound (HIFU), Interstitial Laser Therapy (ILT), Focal Laser Ablation (FLA), Prostate Artery Embolization (PAE) are a few procedures currently in practice. Consult your urologist for procedure distinctions, clarity and additional information.

 

Are There Other Effective Treatments?

Natural Holistic Methods

 Natural Treatments: 

Included here are activities the individual can incorporate as part of their daily routine and suggested herbal and home remedies.

 Lifestyle Improvements and Diet:

  •  Limit fluid intake in the evening hours before bedtime
  • Limit ingestion of caffeine and alcohol
  • Heed the call of nature on first notice
  • Schedule regular toilet visits, every 3-4 hours
  • Practice double voiding
  • Eat health beneficial foods including healthy fats
  • Institute a body exercise plan and perform several times weekly
  • Keep your body warm
  • Review and reconsider use of medications. Decongestants and antihistamine medications. These may contain ingredients that exacerbate urinary incontinence symptoms. The purpose for diuretics is removal of water from the body. Its use stimulates frequent urination and may also escalate urinary incontinence symptoms.

Pelvic Floor Muscle Exercises: See Kegel Exercises

In men the benefits from strengthening the pelvic floor muscles include:

  • Improvement in control of bowel and bladder functions
  • Faster recovery from prostate surgery
  • Improved orgasm and sexual satisfaction
  • Enriched social ability for confidence in public 

Yoga posture:

The postures of yoga are another low impact practice to strengthen pelvic floor Man in Yoga Posture muscles. Yoga stretches are designed for the development, control and flexibility of muscles in the pelvic region. A practice of yoga provides relaxation and reduction of stress.

 

 Herbal Remedies:

  • Saw Palmetto – has been known for centuries as a treatment for enlarged prostate symptoms of urinary incontinence
  • Beta-sitosterol– plant based fats reported to relieve BPH caused urine incontinence 
  • Pygeum– an ancient treatment improves bladder emptying and aids urine flow
  •  Rye Grass Pollen Extractreports of improved nighttime symptom
  • Stinging Nettle– some believe this product relieves some symptoms when combined with other alternative

 Regarding home remedies, a word of caution with their use. The items presented here are plant based, not regulated by the FDA. If you plan to use one of these items review each to learn its properties and potential side effects. Both naturopaths and homeopaths are trained in the health benefits and potential side effects from plant based medicine. Consult with one of them for a thorough understanding on the item of choice before use.

 

 A Conclusion For Resolved

Regarding health care practices and medicine, the twenty first century has produced many new advances, disciplines, innervations, methods, specialties, modalities, practitioners and more. The plethora of information related to health and care, range of possibilities and desire for effective resolution compels us to become knowledgeable and proactive in choosing our plan of care.

 

Men Playing Chess

Men Playing Chess

Challenges and changes related to aging appear in forms of physical, mental emotional, social, financial and psychological for many people. The inability to manage one’s life erodes the sense of who they once were. Changes of lifestyle necessitated by symptoms of BPH can diminish one’s self worth. To uproot an established daily routine due to urinary incontinence may have a direct impact on social encounters. Suddenly, a senior must rely on help from a relative, family member or a friend; their independence obliterated.

This article is a comprehensive inclusion on the major components related to benign prostatic hyperplasia known as BPH. A note on areas affected for a senior suggests the multi-impact on the individual as a whole. It is a view meant as an adjunct to current information. Resolution for comfort in any health situation is a major concern and goal. I sincerely hope you have gained understanding on this health condition and encouragement to select a modality for your best resolution for urinary incontinence symptoms.

 

Please share your thoughts or comments below. I am happy to hear your concerns or questions and I’ll address them promptly.

 

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