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Published: 2/25/2013

Living with benign prostatic hyperplasia

BY DR. MICHAEL RASHID
SPECIAL TO THE BLADE

You've always slept like a log. But now you're waking up once or twice a night to use the rest room. It's annoying and possibly a little worrisome.

For many men over the age of 50, this scenario might sound familiar, and the culprit could be benign prostatic hyperplasia, or BPH.

BPH is an enlargement of the prostate gland, which commonly occurs as men age. As the prostate grows, it can restrict the flow of urine through the urethra, putting increased pressure on the bladder. This pressure is what causes the sensation of needing to urinate even though flow might be weak or slow.

Is BPH the problem?

Often, the symptoms of BPH first become noticeable in men older than 50, and they become even more common as men reach their 70s and 80s. These symptoms might include frequent urination, a feeling of incomplete bladder emptying, a weak or slow urinary stream, difficulty starting urination, or straining to urinate.

When left untreated BPH can lead to more severe urinary retention, incontinence, or bladder or kidney damage. This damage is difficult to reverse and treatment options might become limited in such cases. Rarely, such symptoms could be caused by prostate cancer and should be taken eeeeeeeeeseriously.

Normally, BPH is quite treatable. Treatment options range from self-care to medication to surgery depending upon the severity of the symptoms.

Treatment options for BPH

Self-care for mild symptoms might include avoiding alcohol and caffeine, especially in the evening; limiting the use of over-the-counter cold and sinus medication; urinating when you first have the urge rather than waiting; and not drinking fluids within two hours of bedtime.

More commonly, medication may be prescribed to help reduce the size of the prostate or to allow for easier urination. One type of drug, alpha blockers, helps relieve symptoms by relaxing the muscles around the prostate and bladder neck so urine can flow more easily. The other type of drug, 5-alpha reductase inhibitors, will help shrink the prostate and allow increased urine flow through the urethra. Often the two drugs are taken in combination to provide more immediate relief of symptoms and allow time to reduce the size of the prostate.

In more severe cases of BPH, minimally invasive procedures or surgery might be the best treatment option for patients. Minimally invasive procedures often can be performed in a doctor's office or in an outpatient setting. These procedures either enlarge the opening of the urethra to improve urine flow, or they remove obstructing prostate tissue from around the neck of the bladder and the urethra.

Surgical options might be required to treat more severe symptoms or a very enlarged prostate. Typically they involve the removal of prostate tissue to relieve pressure but might require an overnight hospital stay.

Men who believe they are suffering from the effects of BPH should talk to their doctor about seeing a board-certified urologist. After careful examination and a discussion of your general health, the urologist can suggest the treatment option that will provide the best relief for your symptoms.

Dr. Rashid is a board-certified urologist with ProMedica Physicians in Toledo. For more information, visit promedica.org/doctors.



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