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need to urinate urgently and difficulty starting the urinary stream. More serious problems include urinary tract infections and complete blockage of the urethra, which may be a medical emergency and can lead injury to the kidneys.
Watchful waiting is often chosen by men who are not bothered by symptoms of BPH. They have no treatment but get regular checkups and wait to see whether or not the condition gets worse.
Medical treatment of BPH is usually reserved for men who have significant symptoms. The available drugs include
alpha blockers relax the smooth muscles of the prostate, and the bladder neck, which helps to relieve urinary obstruction caused by an enlarged prostate in BPH. Side effects can include headaches, fatigue, or lightheadedness. Commonly used alpha blockers in BPH include tamsulosin (Flomax), alfuzosin (Uroxatral), and older medications such as terazosin (Hytrin) or doxazosin (Cardura). These drugs generally will lead to improvement in symptoms within several weeks and have no effect on prostate size; and 5-alpha reductase inhibitors block the conversion of the male hormone testosterone into its active form in the prostate (DHT). The prostate enlargement in BPH is directly dependent on DHT, so these drugs lead to an approximate 25% reduction in prostate size over six to 12 months. For this reason, improvement in urinary symptoms most commonly takes this long to occur. Examples of 5-alpha reductase inhibitors include Finasteride (Proscar) and dutasteride (Avodart). Side effects of finasteride may include declining interest in sex, problems getting an erection, and problems with ejaculation.
Surgery or office procedures may also be used to treat BPH, most commonly in men who have not responded satisfactorily to medication or those who have more severe problems, such as a complete inability to urinate.
Transurethral resection of the prostate (TURP) has been used for the longest period of time. After the patient is given anesthesia, the doctor inserts a special instrument into the urethra through the penis. With the instrument, the doctor then shaves away part of the inner prostate to relieve the outflow of urine from the bladder.
Laser procedures: A number of laser procedures are available, some of which can be performed in the doctor's office with minimal anesthesia. These procedures
also involve the removal of obstructing prostate tissue. They are generally associated with less bleeding and quicker recovery than TURP but may not be as effective over the long term in some men.
Microwave therapy: This procedure is generally performed in the office and involves the use of microwave energy delivered to the prostate to kill some of the cells leading eventually to shrinkage of the prostate.
Men should carefully weigh the risks and benefits of each of these options. Prostate surgery has traditionally been seen as offering the most benefits for BPH but unfortunately carries the most risks.
difficulty in urinating, or
dribbling of urine.
Regular checkups are important even for men who have had surgery for BPH. BPH surgery does not protect against prostate cancer because only part of the prostate is removed. In all cases, the sooner a doctor finds a problem, the better the chances that treatment will work.
Benign Prostatic Hyperplasia At A Glance
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The prostate gland makes a fluid that becomes part of the semen. Benign prostatic hyperplasia (BPH) involves enlargement of the prostate gland. The prostate enlargement in BPH is not malignant. BPH can impede the flow of urine. Symptoms include frequent urge to urinate, difficulty urinating and dribbling of urine. The treatment of BPH is usually reserved for men with significant symptoms. Medical and surgical approaches are available to treat BPH.
The prostate is the gland below a man's bladder that produces fluid for semen. Prostate cancer is the second most common cause of death from cancer in men of all ages. It is rare in men younger than 40. Levels of a substance called prostate specific antigen (PSA) is often high in men with prostate cancer. However, PSA can also be high with other prostate conditions. Since the PSA test became common, most prostate cancers are found before they cause symptoms. Symptoms of prostate cancer may include
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Problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling Low back pain Pain with ejaculation
Prostate cancer treatment often depends on the stage of the cancer. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. Treatment may include surgery, radiation therapy, chemotherapy or control of hormones that affect the cancer.