Ask Your Pharmacist – Benign Prostatic Hyperplasia
A Capsular Moment
Photo from www.urology.ucla.edu
Benign Prostatic Hyperplasia (BPH)
By David Bodunde, RPh
Despite its jaw breaking name BPH is a term used to describe an enlarged prostate and is very common among men over the age of fifty. Medical science has not quite pinpointed the exact cause, but it is the result of small non-cancerous growths inside the prostate.
What exactly is BPH?
Not to worry, benign means non-cancerous, so BPH is not cancerous. It is just a swelling of your prostate gland. This gland is the size of a walnut that helps produce semen. It wraps around the tube that carries urine from your bladder and out through your penis (urethra). As a result, an inflamed prostate makes it very difficult to urinate and sometimes may completely cut off the flow of urine.
Signs and symptoms of BPH
The cause of these growths is unknown. but it is thought to be related to hormonal changes that occur with aging and possibly diet and environmental factors. By age sixty, more than half of all Canadian men would have microscopic signs of BPH, and by age seventy, more than 40% will have an enlargement that can be felt on examination
The first symptoms include difficulty in starting to urinate, then feeling like you are not quite “finished” even after the stream has stopped. Night time trips to the bathroom become more common. Other symptoms include incontinence, painful urination, unable to postpone urination and blood in urine. If you notice any of these symptoms contact your doctor right away.
Treatment of BPH
Treatment depends on how troublesome the symptoms are. If the symptoms are minimal, then treatment may be deferred with careful monitoring and regular check up to detect changes. This is sometimes referred to as “watchful waiting”.
Non-drug treatment
Avoid alcohol, over –the-counter decongestants, antihistamines, and caffeine, all of which tend to cause urine retention or cause dieresis. Don’t limit the amount of fluids you drink. Fluids are important to flush out the bladder and prevent kidney stones and bladder infections. Limit fluid intake in the evenings and close to bedtime.
Some urologists advocate frequent sex to temporary ease symptoms such as difficulty urinating and prostate pain. A small study found that 14 out of 18 sexually inactive men with prostatitis experienced at least moderate symptom relief after six months of ejaculating at least twice a week. One possible reason: Ejaculation stimulates muscles and nerves in the prostate region and eases pressure on the gland by releasing built up semen.
Over-the-Counter (OTC) treatment
Various herbal remedies including pumpkin seed, nettle root and pygeum bark have been used in the past to try to ease the symptoms of BPH but evidence for their effectiveness is limited. The best studied herbal remedy for this problem is saw palmetto. Early research indicated that the extract is well tolerated and suggested mild to moderate improvement in urinary symptoms and flow measures, but later well designed studies have shown that the benefits of saw palmetto where no better than placebo, in short , it does not work.
Prescription treatments
There are two types of medications used to treat BPH
Alpha blockers (doxazosin, terazosin, tamsulosin ) relax muscle tissue in and around the prostate and bladder neck thereby improving urination.
Finasteride – acts on the male hormone testosterone to shrink the prostate. If the medication is discontinued, the prostate will regrow.
Surgery
Surgery can also relieve symptoms. The most common type of procedure is called transurethral resection of the prostate (TURP) and it involves the removal of the inner part of the prostate.
There are various complications that are associated with this surgery, and they include bleeding, clot retention, urinary incontinence and retrograde ejaculation (redirection of semen into the balder instead of through the urethra) to name a few.
To speak with David Bodunde, Rph in person, visit the Manitouwadge Pharmacy, Unit 2, Hallmarket Square in Manitouwadge or call 826.3888
The opinions expressed on OntarioNewsNorth.com and by David Bodunde,Rph are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis and treatment. Please consult a local physician or other health care professional for your specific health care and/or medical needs or concerns.
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