Enlargement of the prostate is a problem that men encounter as they age. This phenomenon is known as Benign Prostatic Hyperplasia (BPH). For a small little gland, the prostate can present some big problems for aging men. This walnut shaped gland is located between the rectum and the urinary bladder. It also surrounds the urethra, the tube which carries urine out of the body.
The prostate’s main function is in its role in the reproductive system. It squeezes fluid into the urethra during sexual climax. This fluid energizes the sperm and makes the vaginal canal less acidic and thus helps in the reproductive function.
The prostate grows in two phases. The first phase is during puberty, when it doubles in size. The second phase begins in the twenties. The gland starts to grow once more and this growth continues throughout a man’s lifespan. But as it grows extremely slowly, it becomes noticeable only in the later years of life when the enlarged prostate starts interfering with body functions. This condition is known as Benign Prostatic Hyperplasia.
It’s referred to more commonly as prostate enlargement. It’s important to understand though there is an increase in the size and number of cells in the prostate, BPH is non-cancerous.
Causes of Benign Prostatic Hyperplasia (BPH)
The causes for BPH are not very clearly understood as yet. It’s an area where research is ongoing. However, even though there isn’t complete clarity, research does point to a few causes why some men develop BPH.
- A study published in 2008 in the Andrologia, a reputed journal of andrology, reported the discovery of a new venous route. This venous route allowed testosterone to reach the prostate in concentrated doses. As a result, there is an increase in the venous pressure which causes hyperplasia.
- It’s known that as men age they have higher levels of the female hormone, estrogen. Men do produce both hormones and when they are younger; the system produces more of testosterone and a very small amount of estrogen. But as men grow older, testosterone production declines leading to a higher proportion of estrogen in the body. BPH is linked to the higher levels of estrogen in older males.
- It’s seen that there is a co-relation between prostate enlargement and the presence of dihydrotestesterone or DHT. DHT is supposed to help control the growth of the prostate. The accumulation of DHT could cause BPH in males.
Symptoms of BPH
The location of the prostate is such that when it enlarges, it causes an obstruction in the flow of urine. The symptoms are linked to problems regarding urination. These include:
- Men with BPH will feel the urge to urinate more often.
- The feeling is often uncontrollable and could lead to incontinence or leakages.
- The bladder may not empty completely, leading to dribbles after urination.
- Nocturia, or the need to urinate at night, is a common symptom.
- BPH can result in hesitant and weak stream of urine. Men with BPH find it difficult to start urinating.
Prostate cancer also results in similar symptoms. Therefore, it is important to consult a doctor as soon as any of these symptoms become visible.
Management of BPH
There are several levels of management as far as BPH are concerned.
- In mild cases of BPH, most doctors recommend doing nothing. This is backed up by research which shows that the symptoms of BPH clear up in one-third of the cases without any treatment. In case the BPH has caused urinary tract infection, the doctor may recommend antibiotics. He would also advise you to go in for regular check-ups.
- There are drugs available to stop the growth of the prostate. A recent study, The Medical Therapy for Prostatic Symptoms Trial, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases has come to the conclusion that the drugs, finasteride and doxazosin, used together are very effective in stopping prostate growth.
- In cases where drugs have not helped control prostate growth, minimally invasive surgery (MIS) may be recommended.
- The surgical option is taken when BPH is causing severe problems. The surgeon will go in for a transurethral or an open surgery.
Men who undergo treatment report improvement. So it makes sense not to ignore the condition and to approach the doctor for treatment.
