Benign Prostatic Hyperplasia is when a man’s prostate becomes enlarged. It’s not cancer but a common condition that causes the prostate to grow and puts resulting pressure on the bladder and urethra. This leads to difficulties with urinating and sometimes in gaining an erection.

Prostate

Picture: Normal and enlarged prostate – cancer.gov

What Is The Prostate?

It’s the gland that creates and stores seminal fluid. It’s located in between the penis and bladder.

Who Does The Condition Affect?

It’s a fairly common condition that is thought to affect 4 out of 10 men over 50. Men over 70 have a higher occurrence with approximately 75% affected.

Symptoms

The physical symptoms of BPH are life-changing in some men and can cause considerable emotional upset, particularly in men with an active work or social life who find they can no longer go for a period of time without the urge to urinate. Although the severity of prostate symptoms varies, they will usually worsen over time.
An enlarged prostate can place pressure on the bladder and urethra resulting in:

  • Difficulty in urination – often ending with a dribble of urine
  • Inability to empty the bladder

  • Waking in the night to urinate

  • A slow start to urination and difficulty keeping the flow

  • Feeling as though the bladder is never properly emptied.

  • Intense urge to urinate

  • Difficulty gaining and maintain an erection

The symptoms can creep up with urinary difficulties becoming gradually worse over time. An ever-increasing urge to urinate may develop from an inability to empty the bladder and a dripping, weak flow.

The physical symptoms of BPH are life-changing in some men and can cause considerable emotional upset, particularly in men with an active work or social life who find they can no longer go for a period of time without the urge to urinate.

What Are The Causes?

The cause is not yet known. It’s thought to be part of the normal aging process in men, with some experts suggesting it’s related to age and hormonal changes.

Studies in BPH have thrown up some interesting suggestions. For example, a study in 2005 looked at connections between stress and the prostate.

Researchers took at 83 men with an average age of 68 all suffering from BPH. They found that long-term stress didn’t affect the ability to urinate, but those who underwent recent stress or hostility had trouble emptying their bladders. The prostate and bladder reacts to adrenaline that stimulates their smooth muscle cells – when they contract they narrow the urethra and slow down urination.

What Are The Treatments?

There are a number of treatments for BPH starting with lifestyle changes that don’t involve medical help through to surgical options in severe cases.

Lifestyle Changes

Men suffering from the need to constantly urinate, or those who have a weak flow, should see their doctor for a check-up. If BPH is suspected then the prostate will be monitored.

There are also a number of strategies and lifestyle changes that may help a man to cope with an enlarged prostate:

  • Limiting fluid intake. Spread fluids out over the day, sipping rather than drinking a whole glass of fluid in one go. Cut down on drinks before travelling and during the evening before bedtime. It’s important not to skimp on fluids though. Dehydration causes it own set of problems.
  • Avoid caffeine and alcohol, which can increase the need to urinate because they are diuretics.

  • Regular exercise improves full body health and can help reduce symptoms of BPH
  • Bladder training by holding on for a little while longer each time the urge to urinate appears.
  • Double-voiding technique, which means urinating, waiting a while and trying to urinate again.

  • Exercises to strengthen the pelvic floor such as tensing and squeezing the muscles that support erections and cut off urine flow.
  • Avoiding constipation.
  • Practising a form of stress relief such as yoga or meditation.

Medications

Medication is used to control symptoms of BPH. Many block the hormone dihydrotestosterone from the prostate. This can reduce its size and minimise symptoms.

Alpha blockers may also be prescribed. They make it easier to pass urine by helping to relax bladder muscles. Tamsulosin and Alfuzosin are two commonly used to treat BPH.

Men who are suffering from erection problems may find that erectile dysfunction medication can help. Although mostly well known as treatments used by men experiencing erection problems, these medicines such as Cialis (tadalafil), have been known to have secondary benefits, which include reducing high blood pressure levels, and symptoms in men with enlarged prostates.

Surgery

Surgery may be an option if other methods have not had the desired effect and symptoms are particularly distressing. Surgeons remove some of the prostate tissue to alleviate symptoms. It doesn’t cure the problem but can make it more manageable.

How To Cope With BPH

Some men worry that BPH will lead to cancer, but BPH is not cancer, nor does it does it lead to an increased risk of cancer. BPH is simply an increase in prostate size – it is not a tumour.

Prostate cancer

Picture: Prostate Cancer Stats – NHS

It’s worth checking out other medications to see if they might have an impact on symptoms of BPH. High blood pressure medicine is often a diuretic, which increases the body’s volume of urine. Anti-spasmodics can bring on symptoms, as can allergy medication and particular drugs for Parkinson’s disease, depression and other neurological issues.

Men with BPH need to be prepared. Urinate before leaving the house or work, and always carry something to urinate into during car journeys. Traffic jams, and the fear of getting stuck in traffic, can be distressing.

Family members and friends can help by locating toilets and remaining neutral on the subject. Criticism is not helpful; it may lead to stress and worsening symptoms. BPH is a medical condition not an inconvenience brought on by drinking too much.

Men with benign prostatic hyperplasia should regularly visit their doctor for a prostate check and to chat over symptoms. The condition can worsen, so it’s important to make sure all the correct steps are in place to improve quality of life.

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