Benign Enlarged Prostate

Benign Prostatic Hyperplasia, commonly known as an enlarged prostate, is a non-cancerous increase in the size of the prostate gland. The prostate is located just below the bladder and surrounds the urethra, the tube through which urine passes.

Causes of BPH

• Aging: Hormonal changes related to aging, particularly involving testosterone and dihydrotestosterone (DHT), play a significant role.
• Genetic Factors: Family history of BPH can increase the risk.
• Lifestyle Factors: Diet, physical activity, and overall health can influence the development of BPH.

Symptoms of BPH

• Frequent urination, especially at night (nocturia)
• Difficulty starting urination
• Weak or interrupted urine stream
• Inability to completely empty the bladder
• Urgency to urinate
• Dribbling at the end of urination

Complications of BPH

• Acute urinary retention (inability to urinate)
• Urinary tract infections (UTIs)
• Bladder stones
• Bladder damage
• Kidney damage

Diagnosis of BPH

• Medical History and Physical Exam: Including a digital rectal exam (DRE).
• Urine Tests: To check for infection or other problems.
• Blood Tests: To check for kidney problems.
• Prostate-Specific Antigen (PSA) Test: To screen for prostate cancer.
• Imaging Tests: Ultrasound or MRI to visualize the prostate.
• Urodynamic and Pressure Flow Studies: To measure bladder pressure and urine flow.

Treatment of BPH

1. Lifestyle Changes

1. • Reducing fluid intake before bedtime
   • Limiting caffeine and alcohol
   • Regular exercise
   • Bladder training techniques

2. Medications

1. • Alpha Blockers: Relax the muscles of the prostate and bladder neck (e.g., tamsulosin, alfuzosin).
   • 5-Alpha Reductase Inhibitors: Shrink the prostate by blocking hormonal changes (e.g., finasteride, dutasteride).
   • Combination Therapy: Using both alpha blockers and 5-alpha reductase inhibitors.

3. Minimally Invasive Procedures

1. • Transurethral Microwave Thermotherapy (TUMT): Uses microwave energy to destroy prostate tissue.
   • Transurethral Needle Ablation (TUNA): Uses radiofrequency energy to shrink prostate tissue.

4. Surgical Options

1. • Transurethral Resection of the Prostate (TURP): Removal of part of the prostate through the urethra.
   • Laser Surgery: Uses lasers to remove prostate tissue.
   • Open or Robotic Prostatectomy: Removal of the prostate through an incision.

Proper management of both diabetes and BPH involves regular medical check-ups, lifestyle modifications, and adherence to prescribed treatments to improve quality of life and prevent complications.