Benign prostatic hyperplasia: Difference between revisions

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'''Benign prostatic hyperplasia''', or BPH, is very common in older men. The prostate is enlarged, but it is not cancerous. Over time, an enlarged prostate may press against the urethra, making it hard to urinate.
'''Benign prostatic hyperplasia''', or BPH, is very common in older men. The prostate is enlarged, but it is not cancerous. Over time, an enlarged prostate may press against the urethra, making it hard to urinate.



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Benign prostatic hyperplasia, or BPH, is very common in older men. The prostate is enlarged, but it is not cancerous. Over time, an enlarged prostate may press against the urethra, making it hard to urinate.

Diagnosis

BPH may cause dribbling after urinating or a need to urinate often, especially at night. A doctor will do a rectal exam to check for BPH. And he may suggest having special x-rays or scans to check the urethra, prostate, and bladder.

Treatment

If the symptoms are not too bad, the doctor may suggest "watchful waiting" before starting any treatment. This includes regular checkups. Treatment can start later on if symptoms get worse.

Medications

  • Alpha-blockers. These medicines can ease the symptoms. Side effects may include headaches, dizziness, or feeling lightheaded or tired.
  • Finasteride (Proscar®). This medicine lowers the amount of the male hormone (testosterone) in the body. The result is that the prostate shrinks and urinary problems get better. Side effects can include less interest in sex and problems with erection or ejaculation.
  • Saw palmetto plant extract (Serenoa repens). Despite initial positive reports[1], a more recent randomized controlled trial found no benefit.[2]

Surgery

An operation can improve the flow of urine but it can also cause other problems. Usually, men have surgery only if medicine hasn’t worked. This surgery does not protect against prostate cancer. Regular check-ups are important after BPH surgery. There are three kinds of surgery:

  • Transurethral resection of the prostate (TURP) is the most common type of surgery. The surgeon takes out part of the prostate through the urethra.
  • Transurethral incision of the prostate (TUIP) may be used when the prostate is not too large. The doctor makes a few small cuts in the prostate near the opening of the bladder.
  • Open surgery is used only when the prostate is very large. The doctor removes the prostate through a cut in the belly or behind the scrotum.

References

  1. Wilt TJ, Ishani A, Stark G, MacDonald R, Lau J, Mulrow C (1998). "Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review". JAMA 280 (18): 1604–9. PMID 9820264[e]
  2. Bent S, Kane C, Shinohara K, et al (2006). "Saw palmetto for benign prostatic hyperplasia". N. Engl. J. Med. 354 (6): 557–66. DOI:10.1056/NEJMoa053085. PMID 16467543. Research Blogging.