Benign Prostatic Hyperplasia (BPH, Prostate Enlargement)

Benign prostatic hyperplasia (BPH), a noncancerous growth of the prostate gland, makes urination difficult and uncomfortable. The expanding prostate squeezes the urethra, the channel that carries urine from the bladder. BPH affects only men. Symptoms usually develop around age 50. At age 60, you'll most likely have BPH. At age 80, you'll have an 80 percent chance of experiencing urination problems caused by BPH.

Signs and Symptoms

The need to urinate frequently
Inability to sleep through the night without getting up to urinate
Difficulty starting urine stream or complete inability to urinate
Decreased strength and force of the urine stream
Dribbling after urination ends
Blood in the urine (BPH can cause small blood vessels to burst)

What Causes It?

Nobody knows the basic cause of BPH. Research shows that testosterone, the male hormone, or dihydrotestosterone, a chemical produced when testosterone breaks down in a man's body, may cause the prostate to keep growing. Since it surrounds the urethra, the prostate gland squeezes the urethra as it expands. Some over-the-counter medications for colds or allergies can drastically worsen BPH.

What to Expect at Your Provider's Office

Your health care provider will feel your prostate gland directly by putting a gloved finger in your rectum. He or she will also order blood tests and possibly a urine sample. Your health care provider may also ask you to urinate into a device that measures the flow of urine. In intravenous pyelography, your health care provider injects a dye into a vein to make the flow of urine visible on an X ray. In cystoscopy, your provider uses a small probe, passed through your urethra, to directly view the inside of your urethra and bladder. Your penis will be numbed before this procedure.

Treatment Options

Treatment Plan
Treatment will depend on your age, overall health, and the severity of the disease. BPH clears up by itself in one-third of mild cases. It is important to receive regular check-ups to monitor the disease. Treatment will begin as soon as your symptoms become bothersome. There are various nonsurgical procedures for BPH. They include microwave and laser treatments. There are also several types of surgery to correct the condition. Balloon urethroplasty uses a balloon to widen the urethra and improve urine flow. Prostatic stents do the same thing with a spring-like effect. Transurethral resection, or removal of a part of the urethra, is done in 90% of BPH surgeries.

Drug Therapies

Antibiotics — clear any infections prior to BPH treatment
Alpha blockers — relieve symptoms by relaxing tissue in the area of the prostate
Finasteride — a drug that can shrink the prostate; can take up to three months to work

Surgical Procedures

Balloon urethroplasty uses a balloon to widen the urethra and improve the flow of urine. Prostatic stents do the same thing with a spring-like device. Transurethral microwave therapy and transurethral hyperthermia are new treatments that use microwaves or heat to destroy prostate tissue.

Transurethral resection of the prostate, used on 90 percent of patients undergoing BPH surgery, removes pieces of the enlarged prostate through the urethra. A less invasive method, transurethral incision of the prostate, makes small cuts in the prostate and the neck of the bladder. Laser surgery vaporizes excess tissue in the prostate.

Complementary and Alternative Therapies

Your health care provider may want to keep a close eye on your condition as part of the management of BPH. Nutrition

Zinc (60 mg per day)—to reduce the size of the prostate
Selenium (200 mcg per day)—antioxidant in the prostate
Essential fatty acids (1,000 to 1,500 IU one to two times per day)—anti-inflammatory, for optimum prostaglandin concentrations
B6 (100 to 250 mg per day)—reduces the elevated levels of prolactin found in people who have BPH
Amino acids glycine, glutamic acid, and alanine (200 mg per day of each)—provide relief from symptoms
Avoid alcohol, especially beer, and saturated fats
Pumpkin seeds can help maintain a healthy prostate

Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

Saw palmetto (Serenoa repens)—160 mg twice a day is difficult to achieve in tea or tincture; extract standardized for 85 percent to 95 percent of fatty acids and sterols is recommended. Saw palmetto is widely used in Europe.
Stinging nettle root (Urtica dioica)—Increases urinary flow and volume. Daily dose of 4 to 6 g of drug or equivalent preparation.

Homeopathy
Some of the most common remedies used for this condition are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your symptoms get better.

Chimaphila umbellata is specific for retention of urine with an enlarged prostate
Conium for BPH with a feeling of heaviness in the pelvic area, especially with premature ejaculation
Pareira for urinary retention with BPH, especially with painful urging or pain in the bladder
Selenium for BPH with dribbling, impotence, and constipation
Thuja occidentalis, specifically if there is a forked stream of urine

Physical Medicine

Kegel exercises (contracting and releasing the pelvic muscles)
Contrast sitz baths. You will need two basins that can be comfortably sat in. Sit in hot water for three minutes, then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets per day, three to four days per week.

Following Up

Whatever your treatment, have regular checkups. After prostate surgery, drink plenty of water, eat a balanced diet, avoid heavy lifting and operating machinery, and don't strain when you move your bowels.

References

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