The benign prostatic hyperplasia is in the true sense is not a problem as long as the men affected have no problems with urination. Only when the prostate, due to the benign cell proliferation, presents too great a drainage resistance for the urinary bladder and consequently problems with urination arise, the pressure on the urinary bladder can become a real suffering for the patient.
What is benign prostatic hyperplasia?
Abbreviated as BPH by Abbreviationfinder, benign prostatic hyperplasia describes the benign enlargement of the prostate gland as a result of cell proliferation in men, which is widespread and mainly affects older men.
From a statistical point of view, it can be said that the likelihood of an enlarged prostate increases with advancing age. In the group of men over 65 years of age, 65 percent have an enlarged prostate and in men over 90 years it is even 90 percent.
The biggest problem with an existing benign prostatic hyperplasia is usually the so-called micturition disorder, a problem with urination, which in a greatly enlarged prostate can even lead to urinary retention, a complete inability to empty the bladder.
Causes
It is still not clear what exactly the causes of benign prostatic hyperplasia are, but there are indications that age-related changes in the male hormone balance are the cause of the increase in cells.
The discussion is about the shift in the ratio of male and female hormones with increasing age. As the testosterone level decreases and the level of estrogen remains constant, over the years an excess of estrogen develops, which could slow down the natural death of prostate cells.
The overgrowth of glandular tissue could be caused by an increased concentration of the steroid hormone dihydrotestosterone (DHT), which is synthesized from testosterone with the help of a specific enzyme, 5-alpha reductase. Apart from DHT, there are numerous other growth factors that can be the cause of benign prostatic hyperplasia.
Symptoms, ailments & signs
Benign prostatic hyperplasia does not cause any symptoms by itself. These arise exclusively from the displacement processes due to the enlargement of the prostate. The extent to which the existing symptoms are of medical importance depends on the current stage of the disease.
In stage I, there are often nocturnal urges to urinate and difficult urination. When urinating, it comes to voiding disorders and irritation symptoms. The urine stream is weakened. It takes longer for the bladder to empty again.
The symptoms of irritation are manifested by pain when urinating and the frequent need to urinate. However, no residual urine remains in the bladder at this stage. A disease value does not yet exist, but the quality of life is often already restricted. In stage II there is already residual urine formation with more than 50 milliliters of urine.
Urination begins late and is constantly interrupted. In the third stage, the bladder overflows. By bladder stones can even lead to a urinary leading to a Stauungsniere. Urinary congestion is a medical emergency that requires immediate treatment. With prolonged persistence, the kidneys fail. The veins accumulate in the bladder exit area.
They can tear and cause macrohematuria (blood in the urine). Urinary tract infections are also favored. In the case of prolonged urination disorders, the so-called bar bladder is created by strengthening the bladder muscles. Since the bladder is no longer fully contractible, urinary incontinence then develops.
Diagnosis & course
In order to be able to diagnose benign prostatic hyperplasia, a digital examination of the prostate is indicated first. In this context, “digital” stands for the Latin word “digitus”, which translates as “finger”. The scanning examination of the prostate is carried out from the rectum with the aid of the finger. An ultrasound examination is then often carried out, whereby the ultrasound device is also brought to the prostate via the rectum.
The urinary tract and its constriction are of particular interest in benign prostatic hyperplasia, because an excess of residual urine in the bladder can cause infections of the urinary bladder and also the kidneys. With the help of uroflowmetry, a method in which the patient urinates in a special funnel with a measuring device, the urine flow can be measured per unit of time when urinating. If the value is too low, this indicates an obstruction of the urine flow, as the enlarged prostate on the one hand constricts the urinary bladder and on the other hand represents an increased drainage resistance.
In the case of a demonstrably enlarged prostate, the tumor marker is determined by means of a blood test in addition to some other markers in order to rule out a malignant change in the prostate gland. If this is increased, however, a tissue sample should be taken from the prostate, which can generally be taken quite easily, similar to an ultrasound examination of the organ.
If the increase in cells is benign, an operation may still be indicated later if the organ does not respond to drug therapy or urinary retention threatens due to the mass of the prostate.
Complications
Benign prostatic hyperplasia can have various complications. The enlarged prostate always leaves a certain amount of residual urine in the bladder and urethra. This increases the risk of inflammation and urinary tract infections. In the worst case, the pathogens can spread into the bloodstream and attack the entire body.
Urosepsis occurs, which, if left untreated, leads to death in over 50 percent of cases. Furthermore, the formation of urinary stones is favored. This causes urine to build up up to the kidneys and the kidneys can become inflamed as a result. It can lead to a kidney failure occur (renal failure), which affects the quality of life.
The kidneys can no longer fulfill their functions and substances that are subject to urine are no longer excreted. This can lead to blood poisoning (uremia), which can result in a coma and ultimately death. The fluid and salt balance is also thrown upside down. Edema develops and the person concerned suffers from high blood pressure (hypertension).
In addition, the hormones produced in the kidney are missing, the body suffers from a disruption of blood formation and thus anemia. The benign prostatic hyperplasia can also lead to a bar-like thickening (hypertrophy) of the urinary bladder wall, resulting in a bar bladder. This further increases the risk of urinary tract infections and urinary obstruction with subsequent kidney failure.
When should you go to the doctor?
Benign prostatic hyperplasia is, as the name “benign” already suggests, a basically benign disease which, however, should lead to a doctor in order to rule out cancerous tumors of the prostate if it is suspected. Thereafter, visits to the doctor are often not necessary, as the hyperplasia usually progresses very slowly and the typical symptoms such as difficult emptying of the bladder due to the narrowing of the urine stream only slowly become clearer.
Even after a confirmed initial diagnosis, it is quite possible to allow a longer time to pass before the next doctor’s visit or a possible operation if the symptoms are still within an acceptable range and the quality of life of the person concerned is not noticeably impaired.
However, a visit to the doctor should be pending if there are significant urination restrictions. If benign prostatic hyperplasia is at this stage, surgical treatment should be considered in order to avoid the risk that residual urine remaining in the urinary tract can lead to bacterial infections. The family doctor or treating urologist should also be consulted with new or severe complaints.
Such signs are, for example, pain or burning sensation when urinating, blood in the urine and a feeling of pressure or pain in the abdomen or back, the connection with fever and a general feeling of illness being particularly serious. In addition, a visit to the doctor makes sense if a patient with benign prostatic hyperplasia suffers from impotence.
Treatment & Therapy
From a medical point of view, an enlarged prostate alone is not a reason for therapy. Therapeutic measures are only indicated if the enlargement leads to micturition disorders that limit the patient’s quality of life.
First, an attempt can be made to improve the symptoms with the help of herbal preparations. Products with saw palmetto or pumpkin extract, as well as rye pollen and pine or spruce extracts are often used here.
If the enlargement has progressed too far, so-called alpha-receptor blockers can be used. These drugs relax the prostate, which reduces drainage resistance and makes urine flow easier. On the one hand, this means that less residual urine remains in the urinary bladder, which reduces the risk factor of infections, and on the other hand, the improved urine excretion also leads to a decrease in the frequency of urination.
5-alpha reductase inhibitors are also available. These are able to shrink the organ by up to 30 percent. However, temporary erectile dysfunction must be expected while taking the drug.
Of course, there is also the option of surgical intervention using a scalpel or modern laser surgery, which is unavoidable in the event of impending urinary retention, not only because of the risk of kidney failure.
Outlook & forecast
The chances of recovery from benign prostatic hyperplasia are based on the severity of the disease. In many patients, no further health complaints are found in everyday life, so that neither treatment nor lifestyle impairment occurs.
If the prostate continues to enlarge, sexual and urination disorders occur. In this phase of the disease, patients are usually supported with natural aids. Drug treatment can also be used. So far, however, the natural remedies have established themselves as more tried and tested. They work well and are free from side effects. The benign prostatic hyperplasia does not heal despite the therapy. The alleviation of the sequelae is achieved to a considerable extent and is often sufficient.
In severe cases, the growth of the prostate cannot be stopped. Surgical intervention is necessary in order not to further damage the organism or to endanger health. It reduces the symptoms. The condition most commonly affects older men. The likelihood that they will suffer from other diseases is very high in people over 60 years of age. Despite the operation, this worsens the chances of freedom from symptoms and increases the risk of possible complications.
Prevention
In order to prevent benign prostatic hyperplasia, due to the fact that the exact causes are not yet known, only general tips for a healthy lifestyle can be given. Healthy food, little alcohol and avoiding tobacco products are just as much a part of this, as is sufficient exercise.
From the age of 50, an annual preventive examination of the prostate is advisable. Although this cannot prevent benign prostatic hyperplasia, malignant changes in the organ can be detected at an early stage.
You can do that yourself
If the prostate has not yet enlarged very much and the symptoms are only mild, natural substances to support the prostate function are available on the market. However, a positive effect of pumpkin seeds and Co. on the prostate has not yet been proven. The only exception are dried saw palmetto fruits, which are taken in the form of capsules. A sufficiently high testosterone level is important for the healthy functioning of the prostate.
A balanced diet with many amino acids (in particular contained in tuna, quark, eggs, oat flakes and nuts) and enough sleep are sufficient for this. Scientific studies have also confirmed that frequent ejaculations improve prostate function. Getting enough exercise and a normal body weight also contribute to a healthy prostate.
After a prostate operation, spicy food, carbon dioxide, cigarettes and alcohol should be avoided, as these make the urine more “acidic” and thus delay healing as it flows through the wound. Alcohol abstinence improves the intensity of the urine stream, so that a negative effect of high alcohol consumption on the prostate can generally be assumed.