Benign prostatic hyperplasia

Enlargement of the prostate gland is a common condition, characteristic of older men.

The clinical condition is called benign prostatic hyperplasia /BPH/ and prostatic hypertrophy.

Prostate enlargement can cause unpleasant urinary symptoms.

When left untreated, the condition can block the flow of urine and can lead to functional disorders of the bladder, urinary tract or kidneys.

There are several effective treatments for enlarged prostate.

When deciding on the best treatment option, the patient and the doctor analyze the symptoms present, the degree of enlargement of the prostate gland and any other existing health problems of the affected person, taking into account his preferences.

Applicable therapies for enlargement include surgery, medications and lifestyle changes.

What are the symptoms?

Prostate enlargement manifests differently in affected men, with the prostate increasing in size over time in most cases.

The most characteristic manifestations of the condition are:

• Weak urinary stream;
• Difficulty starting to urinate;
• Sudden and involuntary interruptions in urinary flow;
• Excessive frequency or sense of urgency to urinate;
• Increased frequency of urination at night /nocturia/;
• Need to strain to urinate;
• Inability to completely empty the bladder;
• Urinary tract infection;
• Formation of stones in the bladder;
• Impaired kidney function;

A larger prostate does not necessarily mean more severe symptoms. For example, some men with a slightly enlarged prostate develop significant manifestations.

On the other hand, some people with an excessively enlarged prostate exhibit minor urinary symptoms.

What are the causes?

The prostate gland is part of the male reproductive system because it produces a milky fluid that forms the composition of sperm. The prostate is located below the bladder.

The tube through which urine is transported from the bladder outside the penis /urethra/ passes through the center of the prostate gland.

Therefore, when the prostate begins to enlarge, it may obstruct the release of urine.

For most men, prostate growth continues throughout life. But in some of them, the gland enlarges enough to cause urinary symptoms or to partially block urine output.

Doctors are not sure what causes the gland to enlarge. It has been suggested that it may be due to changes in hormonal balances as we age.

Treatment of benign prostatic hyperplasia

Most often for moderate symptoms drug therapy is applied.

Medications used to relieve the symptoms of enlarged prostate are:

Alpha blockers – work by relaxing the muscles of the bladder and the muscle fibers in the prostate itself, thus making urination easier.

The most commonly used drugs are terazonin, doxazosin, tamsulosin, alfuzosin and silodosin. Alpha blockers work quickly.

After about 1 or 2 days, an increase in urine flow will likely occur and the frequency of urination will decrease.

However, it is possible that this relaxation of the muscles has led to the occurrence of an unpleasant but harmless condition called retrograde ejaculation, in which the sperm flows in the opposite direction to the bladder instead of to the tip of the penis.

5-alpha reductase inhibitors – these medications work by causing the prostate to shrink, preventing the formation of dihydrotestosterone, which is thought to be the cause of prostate enlargement.

The drugs finasteride and dutasteride are most effective for very enlarged prostate

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