Living with Benign Prostatic Hyperplasia

BPH is one of the most frequent causes of lower urinary tract symptoms in middle age and older men. Although it may not be life-threatening, but it causes significant distress. People living with BPH have issues of urinary inconsistency, difficulty in emptying the bladder, frequent urge to urinate, nocturia, and much more.

Before any treatment, doctors would generally try to estimate the severity of the condition. However, medical tests are essential as signs and symptoms are not essentially the indicator of BPH severity.

When it comes to estimating the severity of the condition, physical examination still holds importance. Thus, doctors would often start with digital rectal examination. However, experts say that it is not reliable to assess its enlargement.

Other tests that are an essential part of a patient’s assessment are urine test, blood test, and Prostate-specific antigen (PSA) blood test to exclude prostate cancer.

Doctors may use tests like transrectal ultrasound, prostate biopsy, cystoscopy, and other tests if the condition is more complex.

Treatment options for BPH

There are many treatment options for BPH. However, all treatments are broadly divided into three categories, use of phytotherapy (natural supplements), medications, and surgical treatment. Generally, doctors would recommend treatment by keeping in mind the severity of the conditions, prostate size, age, and overall health.

Phytotherapy of BPH

In recent years, there has been increasing interest in phytotherapy due to the perceived safety of such a treatment. Many herbal remedies are available, like saw palmetto, African plum tree, pumpkin seeds, rye pollen extracts, and many more.

Phytotherapy may be especially good for mild to moderate cases. It is also good in the way that BPH is a diagnosis for the rest of your life. Phytocompounds are generally safe for prolonged use.

When it comes to phytocompounds, the most extensively tested is Saw Palmetto. It is even approved as a medication in many nations. Furthermore, studies show that it could be as good as medical drugs in many cases. Thus, a systemic review published in the journal JAMA found that it can improve urinary flow, BPH symptoms and have very few side effects. Not only that, it appears to be as effective as some of the commonly used drugs like finasteride.

Pharmacological therapy

At present, doctors may prescribe drugs belonging to three classes of drugs. Sometimes they might also use combination drug therapy;

  • Alpha-blockers primarily work by relaxing the bladder sphincter and thus helping improve urinary flow. Therefore, these drugs primarily help relieve urinary symptoms. However, these medications would not slow down the progress of the condition.
  • 5-alpha reductase inhibitors – drugs like finasteride or dutasteride are often used as a first-line treatment of BPH by doctors. These medications are good in the way that they help shrink the prostate by reducing its sensitivity to testosterone. However, on the downside, they might cause sexual dysfunction in some.
  • PDE5 inhibitors – these drugs are mainly for managing erectile dysfunction. However, the latest studies show that among various PDE5 inhibitors, tadalafil is quite suitable for treating BPH.

Surgical intervention

There are many minimally invasive surgical options these days. However, they are generally reserved for more severe patients or those who do not respond to medications well. These surgical treatments generally remove an enlarged prostate in various ways.

To conclude, BPH is a common problem among men of middle age and older adults. It is among the easy to diagnose conditions. Nevertheless, it is always good to see a doctor, to exclude more severe conditions like prostate cancer or even urinary tract infection. There are many options like phytotherapy, medications, and surgery when it comes to treatment.

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