BENIGN PROSTATIC HYPERPLASIA

ENLARGED PROSTATE (BPH)

An enlarged prostate -known as benign prostatic hyperplasia or BPH-is caused by an overgrowth of prostate cells.this enlargement constricts the urethtra so the flow of urine is reduced,making it increasingly difficult to empty the bladder.

BPH is very common ,affecting about one third of men over 50 years although it is not prostate cancer,the symptoms of BPH are similar to those of prostate cancer so you should see your doctor if you start to experience problems passing urine.

SYMPTOMS OF BPH

- hesitancy (difficulty starting to pass urine)

- a weak stream.

- the need to strain to pass urine.

- the feeling that your bladder is not empty after urination.

- the need to pass urine urgently.

- frequent trips to the toilet,including having to get up several times in the night.

- feeling a burning sensation or pain when passing urine.

DIAGNOSTIC STUDY

1.Digital rectal examination (DRE) to examine the size and consistency of prostate

2.Abdomen examination to find out if the bladder is distended.

3.Urine test to check for infection or blood

4.Blood test including a prostate specific antigen (PSA)

5.Other test-less common test may include:urine flow test,ultrasound abdomen and pelvis,urodynamic measurements using a catheter inserted into the bladder to measure the pressure of urine there, and TRUS and prostatic biopsy.

TREATMENT OF BPH

= Drug treatment.

1.Alpha-blockers-work by relaxing the muscles of the neck of the bladder and in the prostate.around 60% of men find symptoms improve significantly within the first 2-3 weeks of treatment with an alpha-blockers.the currently of alpha-blockers are alfuzosin (xatral), doxazosin (cardura), indoramin (doralese), prazosin (hypovase), terazosin and tamsulosin.

2.5-alpha-reductase inhibitors-these drug work by inhibiting the production of hormone called DHT,which contribute to prostate enlargement.Finasteride (proscar) is the most commonly used drug of this type for BPH.

= Surgery treatment.

1.TURP

Trunsurethtral resection of the prostate (TURP) is the most common operation of BPH.TURP is an effective procedure with over 90% of men reporting an improvement after the operation.however, as with any surgical procedure there is a risk of side effects and complications.a common side-effect of this procedure is retrograde ejaculation-where semen pass into the bladder during orgasm instead of out of the penis.

2.TUIP

Transurethral incision of the prostate (TUIP) may be appropriate for men who have a less enlarged proetate.it is a quicker operation than TURP and involves remiving less tissue.

3.Open prostatectomy

Open prostatectomy is only recommended for men whose prostate is very large.it is major operation and carried out under general anaesthesia.

4.Other treatment is laser therapy (using a laser probe to cut away prostate tissue) and transurethral microwave thermotherapy (using heat to remove some of the prostate tissue via a probe) are becoming more common in the treatment of BPH.

PREVENTION

Although it is not known why only some men develope BPH,it is clear that advancing age is the prime risk factor.Eating a diet that is low in fat and rich in fruit and vegetables (five portions perday) may well help to reduce the risk of prostate cancer and has been proven to bring other health benefits.

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