Description

Benign prostatic hyperplasia (BPH) is a health problem that becomes more common with age. It is also called an enlarged prostate. The prostate is a small gland that helps to form the semen. It is located just below the bladder. And often gets bigger as you get older.

An enlarged prostate gland can cause symptoms that can disturb you, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.

Many treatments that can help BPH . These include medications, surgery and other procedures. Your health care provider can help you choose. The right option depends on such things as:

  • Their symptoms.
  • The size of the prostate.
  • Other health problems that you may have.

Symptoms

The common symptoms of BPH include:

  • Frequent or urgent need to urinate, also called micturition.
  • To urinate more often at night.
  • Difficulty starting to urinate.
  • Weak urine stream, or a stream that stops and starts.
  • Dribbling at the end of urination.
  • Not being able to empty the bladder completely.

Less common symptoms include:

  • Urinary tract infection.
  • Not being able to urinate.
  • Blood in the urine.

The symptoms of BPH tend to slowly get worse. But sometimes the same room, or even improve with time.

The size of the prostate does not always determine the severity of the symptoms. Some people with an enlarged prostate can have major symptoms. Others who have very enlarged prostate can have minor problems. And some people with the enlargement of the prostate does not have any symptoms at all.

Other possible causes of urinary symptoms

Some other health problems can cause symptoms that are similar to those caused by the enlarged prostate. These include:

  • Urinary tract infection.
  • Inflammation of the prostate.
  • Narrowing of the urethra, the tube that carries urine out of the body.
  • The formation of scars on the neck of the bladder due to a surgery in the past.
  • Bladder or kidney stones.
  • Problems with the nerves that control the bladder.
  • The cancer of the prostate or bladder.

Some medications can also cause symptoms similar to those caused by BPH . These include:

  • Able to relieve the pain of medicines called opioids.
  • Cold and allergy medications.
  • Older drugs for depression called tricyclic antidepressants.

When to see a doctor

Talk with your health care provider about your symptoms, even if you don't mind. It is important to find out if there are any causes that can be treated. Without treatment, the risk of a dangerous obstruction to the urinary tract can upload.

If you are unable to urinate, get medical help right away.

Causes

The prostate gland is located below the bladder. The tube that carries urine from the bladder to the outside of the penis is called the urethra. This tube passes through the center of the prostate. When the prostate enlarges, it begins to block the flow of urine.

The prostate is a gland that normally continues to grow throughout life. This growth is often enlarges the prostate enough to cause symptoms or block the flow of urine.

It is not clear what causes the prostate becomes larger. It could be due to changes in the balance of sex hormones as it grows.

Risk factors

Risk factors for an enlarged prostate include:

  • Aging. An enlargement of the prostate gland rarely causes symptoms before age 40. After that, the possibility of having an enlarged prostate and related symptoms starts to rise.
  • The history of the family. Having a blood relative with prostate problems makes you more likely to have problems with their prostate.
  • Diabetes and heart disease. Studies show that diabetes can increase the risk of BPH . Might as well diseases of the heart.
  • The style of life. Obesity increases the risk of BPH . The exercise can help reduce the risk.

Complications

The complications of an enlarged prostate can include:

  • Not being able to urinate. This is also called urinary retention. You might need to have a tube called a catheter into the bladder to drain the urine. Some people with an enlarged prostate who need surgery to get relief.
  • Urinary tract infections (Uti). Not being able to empty the bladder completely can increase the risk of infection in the urinary tract. If you often get utis , you might need surgery to remove part of the prostate.
  • Stones in the bladder. These are most often caused by being unable to empty the bladder completely. Stones in the bladder can cause illness, irritation of the bladder, blood in the urine and blocks the flow of urine.
  • Damage in the urinary bladder. A bladder that does not empty completely, they can stretch and weaken over time. As a result, the muscle wall of the bladder as not tightened properly, the force of the urine. And this makes it more difficult to empty the bladder completely.
  • The kidney damage. The pressure in the bladder not being able to urinate can cause damage to the kidneys or let bladder infections reach the kidneys.

The treatment of BPH, reduces the risk of these complications. But urinary retention and kidney damage can be serious threats to health.

Having an enlarged prostate is not thought to increase the risk of developing prostate cancer.

Mayo Clinic Men's Health Center

For more information about the benign prostatic hyperplasia treatment at the Mayo Clinic, the visit of the Mayo Clinic, Men's Health Center .

Diagnosis

Your doctor will likely begin by asking questions about your symptoms. It will also have a physical exam. This review is likely to include:

  • Digital rectal exam. The doctor inserts a finger into the rectum to check if the prostate is enlarged.
  • Urine test. A laboratory examines a sample of your urine to find out if you have a disease or other problems that can cause the same symptoms as BPH .
  • Blood test. The results can show if you have kidney problems.

After that, you may need other tests that can help confirm an enlarged prostate. These tests include:

  • Prostate-specific antigen (PSA) in the blood. PSA is a protein produced in the prostate. The levels of PSA increases when the prostate is enlarged. But higher levels of PSA can also be due to the recent procedures, diseases, surgery, or prostate cancer.
  • The flow of urine test. Urinate in a container attached to a machine. The machine measures how strong the flow of urine and the amount of urine. The results of the test may show over time if their condition is improving or getting worse.
  • Postvoid residual volume of the test. This test measured if you can empty your bladder completely. The test can be performed using an imaging test called an ultrasound. Or they can make with a tube called a catheter is placed in the bladder after urinating to measure the amount of urine left in the bladder.
  • 24-hour voiding diary. This implies indicates how often, and how much you urinate. This could be very useful if you do that more than a third of their daily urine at night.

If your health problem is more complex, you may need tests, including:

  • The Transrectal ultrasound. A device that uses sound waves to make images is inserted into the rectum. Measure the size of the prostate.
  • The biopsy of the prostate. This test uses ultrasound imaging to guide the needle to take a sample of tissue from the prostate. Check in the tissue of the prostate can help your doctor determine if you have prostate cancer.
  • Urodynamic pressure and flow studies. A catheter is inserted through the urethra into the bladder. Water — or, less commonly, air is slowly sent to the bladder to measure the pressure of the bladder and check how well the bladder muscles work when you try to pass urine.
  • The cystoscopy. A lighted, flexible tool that is placed in the urethra. This allows the doctor to see the inside of the urethra and the bladder. Before this test, you may be given a topical medication that numbs the urethra.

Tests and diagnosis Mayo Clinic

Mayo Clinic specialists have experience in the diagnosis of complex conditions that involve the enlargement of the prostate. You will have access to the latest diagnostic tests, including urodynamics and pressure-flow studies.

Treatment

There are many available treatments for the enlarged prostate. These include medicines, surgery, and procedures involving the smaller, less or no cuts. The best treatment option for you depends on:

  • The size of the prostate.
  • Of his age.
  • Your health in general.
  • The seriousness of the symptoms.

If your symptoms do not get in the way of your life, you may decide to postpone the treatment. Instead, you can expect to see if your symptoms change or get worse. For some people, the symptoms of BPH can ease without treatment.

Medications for enlarged prostate

Taking the medication is the most common treatment for mild to moderate symptoms of an enlarged prostate. The options include:

  • Alpha blockers. Alpha-blockers work by relaxing the smooth muscle of the bladder neck and prostate. This makes urination easier. Alpha blockers include alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax), silodosin (Rapaflo), and terazosin. Tend to work quickly in people with a smaller prostate. Side effects may include dizziness. You can also include a harmless issue in which the semen goes into the bladder instead of out the tip of the penis. This is called retrograde ejaculation.
  • 5-alpha-reductase. These drugs shrink the prostate. They do this by preventing hormonal changes that cause the prostate to grow. Examples include finasteride (Proscar) and dutasteride (Avodart). It can take up to six months to work well and can cause sexual side effects.
  • The combination therapy. Your health care provider may suggest that you take an alpha blocker and 5-alpha reductase, which is at the same time, if the medication does not help enough.
  • Tadalafil (Cialis). This medicine is often used to treat erectile dysfunction. Studies suggest that it can also treat an enlarged prostate.

Surgery and other treatments for the enlarged prostate

Surgery or other procedures that could help with the symptoms of BPH if:

  • We do not get enough relief from medications.
  • Prefer not to try medicine.
  • You are not able to pee.
  • Have kidney problems.
  • Keep getting bladder stones, blood in the urine or urinary tract infections .

Surgery or other procedures may not be an option if you have:

  • Treating the infection of the urinary tract.
  • The urethral stricture disease.
  • A history of prostate radiotherapy or surgery of the urinary tract.
  • A neurological disorder, such as Parkinson's disease or multiple sclerosis.

Any type of prostate procedure can cause side effects. Depending on the procedure you choose, health problems after of this might include:

  • Semen flows backward into the bladder instead of out through the penis during ejaculation.
  • The output of the urine by accident.
  • Urinary tract infection.
  • The bleeding.
  • Erectile dysfunction.

There are many types of surgeries and other procedures that can treat an enlarged prostate.

Transurethral resection of the prostate (TURP)

A thin tool with a light, a flame of a scope that is inserted into the urethra. The surgeon removes all but the outer part of the prostate. TURP often relieves the symptoms quickly. Some people have an increased flow of urine shortly after the procedure too. After TURP , you may need a catheter to drain the bladder for a short time.

Transurethral incision of the prostate (TUIP)

A lighted scope is inserted into the urethra. The surgeon makes one or two small incisions in the prostate gland. This makes it easier for the urine through the urethra. TUIP could be an option if you have a small or slightly enlarged prostate gland. It can also be an option if you have health problems that make surgery too risky.

Transurethral microwave thermotherapy (TUMT)

A special catheter that is placed through the urethra in the prostate area. The energy of the microwave probe destroys the inner portion of the enlargement of the prostate gland. This reduces the prostate and facilitates the flow of urine. TUMT may relieve only some of your symptoms. You can also take some time before you notice results. In general, this surgery is used only in the small of the prostate in special situations because the treatment may need to be re.

Laser therapy

A high-energy laser destroys or eliminates the overgrowth of prostate tissue. Laser therapy has a lower risk of side effects that are not nonlaser surgery. Can be used on people who should not have other procedures of prostate because they take blood-thinning medications.

Laser therapy options include:

  • Ablative procedures. These destroy the tissue of the prostate that blocks the flow of urine. Types of these procedures include the photoselective vaporization of the prostate (PVP) and holmium laser ablation of the prostate. Ablative procedures can cause irritating symptoms after surgery. In rare cases, another procedure to remove tissue from the prostate may be necessary at some point.
  • Enucleative procedures. These treatments include the holmium laser enucleation of the prostate (HoLEP). In general, it removes all the tissue of the prostate by blocking the flow of urine and prevent the tissue to re-grow. The removed tissue can check that the prostate cancer and other health problems.

The prostate elevator

Special tags are used to compress the sides of the prostate. This can improve urine flow. A prostate lift might be an option if the middle section of the gland of the prostate does not get in the way of the flow of urine. It is less likely to cause sexual side effects of which there are many other surgical treatments.

The water vapor thermal therapy (WVTT)

A device that is placed in the urethra. It converts the water into steam. This leads to the excess tissue from the prostate. WVTT can relieve the symptoms of an enlarged prostate. It is less likely to cause sexual side effects in comparison with many other surgical treatments.

Robotic water jet, treatment of

This procedure uses imaging tests and robotic tools to guide a device within the urethra. The device releases a small, powerful jets of water to remove the excess tissue from the prostate. This can relieve the symptoms of an enlarged prostate. Robotic water jet, the treatment can cause some of the same side effects than TURP can cause.

Open or robot-assisted prostatectomy

One or more cuts in the lower part of the stomach. This allows the surgeon to reach the prostate and remove the tissue. In general, this type of surgery is performed if you have a large or very large prostate. A short stay in the hospital is often needed after. The surgery is linked with a greater risk of needing donated blood due to bleeding.

Prostate artery embolization (PAE)

We can offer prostate artery embolization as a treatment option for BPH . In this procedure, the blood supply to the prostate is locked in chosen areas. This causes the prostate to become smaller. The evidence suggests that it may be both short-term and long-term benefits of this procedure, including the improvement of urinary symptoms, for certain people with BPH .

It is important to talk with your health care team about the risks and benefits of this procedure. PAE should only be performed by a health care professional who has been specially trained to perform PAE procedures. This type of health care professional is called an interventional radiologist. This is a doctor with special training in the performance of procedures performed using imaging methods such as X-rays, magnetic resonance imaging, or ultrasound, to guide them.

The follow-up care

Your follow-up care will depend on the technique used to treat enlargement of the prostate. Your health care provider will tell you what activities to stay away from, and for how long.

The treatment at the Mayo Clinic

From the Mayo Clinic, experts have training in a wide range of state-of-the-art technology for the treatment of enlarged prostate. You have access to the latest non-invasive laser treatments, including HoLEP and PVP laser. Your Mayo Clinic care team will explain the range of treatments available and help you choose the best approach based on the symptoms.

Lifestyle and home remedies

You can make things at home to help control the symptoms of an enlarged prostate.

Try to make healthy diet and exercise changes:

  • Drinking less in the evening. Do not drink anything for an hour or two before bedtime. This helps to avoid trips to the bathroom during the night.
  • Limit your consumption of caffeine and alcohol. You can make your body produce more urine, irritate the bladder and worsen symptoms.
  • Careful with what you eat. Foods with a lot of seasonings can irritate the bladder.
  • Be more active. The exercise can help reduce urinary problems caused by an enlarged prostate.
  • Stay at a healthy weight. Obesity is associated with an enlargement of the prostate.

Also try these bathroom habits:

  • Go the first time you feel the urge. Wait too long you can stretch the muscle of the bladder too much and cause damage.
  • Plan to go to the bathroom. Try to urinate on a regular schedule, for example every couple of hours during the day. This can be useful if you need to urinate frequently and urgently.
  • Pee and then urinate again, after a few moments. This practice is known as double voiding.

Other things that may help are:

  • The limitation of decongestants or antihistamines. These medications tighten the band of muscle around the urethra, which control the flow of urine. This makes it more difficult to urinate.
  • Stay warm. Colder temperatures can cause retention of urine, and increased urge to urinate.

Alternative medicine

In the united States, not the herbal supplements are approved for the treatment of enlarged prostate.

The guidelines of the American Urological Association say that many of the studies on supplements used for BPH have weaknesses, such as not being studied for a long enough time. Two more strong studies of people with BPH found that saw palmetto had no benefits of more than a harmless treatment that contained no drug, called a placebo.

Other herbal supplements are beta-sitosterol extracts, pygeum and rye grass. These have been suggested by some as useful for relieving the symptoms of an enlarged prostate. But the safety and long-term effectiveness of these supplements has not been proven.

If you are taking any of the herbal remedies, tell your health care provider. Certain herbal products could increase the risk of bleeding or affect other medicines that you take.

Preparing for your appointment

For an enlarged prostate, you may be referred to a doctor who specializes in urinary problems, which is called a urologist.

What you can do

  • Take note of the symptoms, including any that may seem unrelated to the reason why you made the appointment.
  • Keep track of the frequency and the time of urination, if you feel that you are fully emptying the bladder, and the amount of liquid that you drink.
  • Make a list of medical information, including other health problems that you may have.
  • Make a list of all medications, vitamins or supplements you take.
  • Write questions to ask their health care provider.

Questions to ask your doctor

For BPH , some questions to ask your health care provider are:

  • I have an enlarged prostate, or could something be the cause of my symptoms?
  • What kinds of tests do I need?
  • What are my treatment options?
  • How can I control other health problems, together with an enlargement of the prostate?
  • Are there any restrictions on sexual activity?

Feel free to ask questions during your appointment.

What to expect from your doctor

Your provider is likely to ask you some questions. Be prepared to respond to them. I could give more time to talk about your concerns.

Will probably ask you questions about your symptoms, such as:

  • When did the symptoms begin? Do you often or once in a while? And that is that they have gotten worse over time?
  • How often do you urinate during the day? And how often do you need to get up at night to urinate?
  • Do you ever leak urine?
  • Do you have a frequent or urgent need to urinate?
  • Is it difficult for you to start urinating? Can you start and stop when you urinate, or you feel like you have to strain to urinate?
  • Do you ever feel that you haven't emptied your bladder?
  • There is a burning sensation when urinating, pain in the area of the bladder or blood in the urine? Has had urinary tract infections?

You may also have questions about your health history and diet, such as:

  • Have any family members had an enlarged prostate, prostate cancer or kidney stones?
  • Have you ever had trouble getting and keeping an erection? Do you have any other type of sexual problems?
  • Have you ever had a surgery or other procedure involving a medical device is placed through the tip of your penis into the urethra?
  • Do you take blood-thinning medications, such as aspirin, warfarin (Jantoven) or clopidogrel (Plavix)?
  • How much caffeine you have each day? What fluids, and how much of them do you drink?
Symptoms and treatment of Benign prostatic hyperplasia (BPH)