Prostate gland enlargement is a problem commonly faced by the elderly males. It is found to cause profoundly troublesome symptoms related to urination however the important point to understand here is that benign prostatic hyperplasia (BPH) is a completely separate entity and it never progresses to prostate cancer. The epidemiologic data collected suggest that the risk of developing this condition is increased several folds with every decade of life after you turn to the age of 50 years.
Prostate Gland Anatomy
Prostate is a tiny gland roughly about the size of the walnut that is located just beneath the bladder. The anatomic location of the urethra or the tube that carries urine stored in the bladder and takes it out of the body at the penis is such that it passes right through the centre of this prostate gland. This is why any enlargement of the prostate gland exerts a pressure on the urethra, interfering with the smooth flow of urine through it, thus producing all the troublesome urinary symptoms associated with benign prostatic hyperplasia as we will see in a bit.
Symptoms of Benign Prostatic Hyperplasia
Initially the symptoms of benign prostatic hyperplasia are mild but with the advancement of age there is worsening of the symptoms. The symptoms commonly seen in patients with enlargement of prostate gland are summarized here
- Urinary frequency particularly at night
- Urinary urgency
- Weak urine stream
- Problem starting urination
- Inability to stop urination
- Dribbling of urine
- Inability to completely empty the bladder
- Recurrent urinary tract infections
One more thing, the severity of the symptoms is not related to the degree of enlargement of the gland. It may seem counter-intuitive but some patients with only moderate enlargement of the prostate gland can have significant symptoms while the other patients are usually stable with only few symptoms despite having a markedly enlarged gland.
Treatment of Benign Prostatic Hyperplasia
There are drugs as well as different surgical procedures available for the treatment of BPH.
There are alpha receptors located on the neck of urinary bladder. These receptors when stimulated by adrenaline causes constriction of the bladder neck and when the bladder neck constricts, urine cannot go out of the bladder. Alpha blocker inhibits the action of adrenaline on these receptors. Thus, the bladder neck no longer contract, rater it relaxes. This helps the passage of urine out of the bladder, thus providing relieve to the patient. The commonly included drugs in this group are erazosin, doxazosin tamsulosin , alfuzosin and silodosin.
5-Alpha Reductase Inhibitors
Benign prostatic hyperplasia is believed to be caused by excess of a chemical called dihyderotestosteron that is formed when an enzyme called 5-alpha reducatase acts on the testosterone. Thus, 5 alpha-reducatase inhibitors blocks the action of this enzyme and decrease the production of dihydrotestosterone that causes shrinkage of the prostate gland over the period of time, thereby relieving the symptoms of the patient.
The patient with benign prostatic hyperplasia at Downtown Medical Center may be advised one of the many available surgical procedures if he is not responding to the medical therapy.