by Dr. James Chin, CEO, Prostaderm
http://www.prostaderm.com
Benign prostatic hyperplasia (BPH) also known as Nodular hyperplasia, Benign prostatic hypertrophy or Benign enlargement of the prostate (BEP) refers to the increase in size of the prostate gland in middle-aged and elderly men. To be accurate, the process is one of hyperplasia which means proliferation of cells rather than hypertrophy (the increase of the size of an organ), but the nomenclature is often interchangeable. It is characterized by hyperplasia of prostatic stromal (supportive framework of an organ or gland ) and epithelial cells, resulting in the formation of large nodules in the region surrounding the urethral (a tube which connects the urinary bladder to the outside of the body) of the prostate. When the nodules becomes large, it compresses the urethral canal to cause partial, or sometimes complete obstruction of the urethra which interferes the normal flow of urine. This will lead to symptoms of urinary hesitancy, intermittency, incomplete voiding, weak urinary stream, straining, nocturia (frequent urination occuring at night time), frequent urination in the daytime, increased risk of urinary tract infections and urinary retention. It should be noted that prostate specific antigen (PSA) levels may be elevated in these patients, however, BPH is not considered to be a premalignant lesion.
Medications used to treat BPH consist of:
Alpha blockers such as doxazosin (Cardura), terazosin (Hytrin), alfuzosin (Uroxatral) and tamulosin (Flowmax). Alph blockers relaxes the smooth muscles in the prostate and bladder neck thereby decreasing the degree of blockage of urine flow. Some of the side effects include: dizziness, unusual weakness, drowsiness, trouble sleeping, runny nose, fainting, vision changes. Serious side effects include: sexual problems (difficulty ejaculating, decreased interest in sex), retrograde ejaculation (ejaculation back into the bladder), fast heartbeat. painful, prolonged erection lasting 4 hours or more (stop using this drug and seek immediate medical attention or permanent problems could occur). Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing.
The 5a reductase inhibitors such as finasteride (Propecia) and dutasteride (Avodart or Duprost) are other medications used to treat BPH. Side effects include: inability to have or maintain an erection, decrease in sex drive, difficulty ejaculating, breast tenderness or enlargement.
Herbal remedies include: Serenoa repens (saw palmetto) fruit extracts in alleviating mild-to-moderate BPH symptoms. However, a recent double-blind study did not demonstrate any efficacy greater than that of a placebo for moderate-to-severe symptoms. Other herbal remedies include: beta-sitosterol from Hypoxis rooperi (African star grass), pygeum (extracted from the bark of Prunus africana), Cucurbita pepo (pumpkin) seed, Urtica dioica (stinging nettle) root and rye flower pollen.
Surgical options if medical treatment fails include: transurethral resection of prostate (TURP). This involves removing (part of) the prostate through the urethra. Transurethral electrovaporization of the prostate (TVP), laser TURP, visual laser ablation (VLAP), TransUrethral Microwave ThermoTherapy (TUMT), TransUrethral Needle Ablation (TUNA), and ethanol injection. Newer techniques involving lasers in urology have emerged in the last 5-10 years.
Filed under: Enlarged Prostate
