Benign Prostatic Hyperplasia Prostate Enlargement - عظم غدہ قدامیہ ( پروسٹیٹ گلینڈ کا بڑھ جانا)

Benign prostatic hyperplasia (BPH)  Symptoms, Causes, Preventions,  Unani / Herbal Medicine Treatment

Benign Prostatic Hyperplasia(BPH)

 عظم غدہ قدامیہ( پروسٹیٹ گلینڈ کا بڑھ جانا)

By: Hakeem Muhammad Rizwan Arshad.

What is benign prostatic hyperplasia?

Benign prostatic hyperplasi is also called BPH, also known as benign prostatic hypertrophy, is a condition in men in which the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man’s life. Benign prostatic hyperplasia often occurs with the second growth phase. As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retention—the inability to empty the bladder completely—cause many of the problems associated with benign prostatic hyperplasia. Benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate, leading to an enlarged prostate gland. Chronic bladder outlet obstruction (BOO) secondary to BPH may lead to urinary retention, impaired kidney function, recurrent urinary tract infections, gross hematuria, and bladder calculi.

What is the prostate?

The prostate is a walnut-shaped gland that is part of the male reproductive system. The prostate produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through which urine passes out of the body. Prostate fluid is essential for a man’s fertility. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.

Symptoms of Benign Prostatic Hypertrophy: 

The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:

Initial and later symptoms include:

• Weak urinary stream
• Sudden urge to urinate
• Incontinence, or leakage of urine
•  Frequency
• painful urination
• blood in the urine
• Bladder stone
• Kidney failure
• Frequent or urgent need to urinate
• Increased frequency of urination at night (nocturia)
• Difficulty starting urination
• Strain when urinating
• Weak urine stream or a stream that stops and starts
• Dribbling at the end of urination
• Inability to completely empty the bladder
• Nocturia, which is the need to urinate two or more times per night
• Less common signs and symptoms include:
• Urinary tract infection
• Inability to urinate
• Blood in the urine

The size of your prostate doesn't necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

In some men, symptoms eventually stabilize and might even improve over time.

Other possible causes of urinary symptoms:

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

• Urinary tract infection
• Inflammation of the prostate (prostatitis)
• Narrowing of the urethra (urethral stricture)
• Scarring in the bladder neck as a result of previous surgery
• Bladder or kidney stones
• Problems with nerves that control the bladder
• Cancer of the prostate or bladder

Causes of benign prostatic hyperplasia:

The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.

Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.

Another theory focuses on dihydrotestosterone (DHT), a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.

Enlarged Prostate: Early BPH Diagnosis:

The symptoms of BPH may mimic symptoms of other conditions, including tumors and infections. A digital rectal exam can detect BPH in many patients. If you have symptoms, you should see your doctor to rule out other possible causes of the symptoms.

Ruling Out Prostate Cancer:

Some of the symptoms of BPH are the same as those of prostate cancer, so many men are fearful of the symptoms. However, BPH is far more common than prostate cancer. Men with BPH are no more likely than other men to develop prostate cancer. However, it's important to have your doctor perform a thorough examination because the two conditions share symptoms and can even coexist.

Benign prostatic hyperplasia Tests:

•    A rectal examination to assess the size and          shape of the prostate
•    Ultrasound examination
•    Biopsy of the prostate
•    Urine flow studies
•   Cystoscopy, in which the doctor can see and         evaluate the inside of the bladder
•    A health care provider diagnoses benign             prostatic hyperplasia based on
•    a personal and family medical history
•    a physical exam

•    medical tests

Physical Exam:
A physical exam may help diagnose benign prostatic hyperplasia. During a physical exam, a health care provider most often examines a patient’s body, which can include checking for

1.  discharge from the urethra
2. enlarged or tender lymph nodes in the groin
3.   a swollen or tender scrotum
4. taps on specific areas of the patient’s body
5.  performs a digital rectal exam

A digital rectal exam, or rectal exam, is a physical exam of the prostate. To perform the exam, the health care provider asks the man to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to the rectum. The man may feel slight, brief discomfort during the rectal exam. A health care provider most often performs a rectal exam during an office visit, and men do not require anesthesia. The exam helps the health care provider see if the prostate is enlarged or tender or has any abnormalities that require more testing.

Many health care providers perform a rectal exam as part of a routine physical exam for men age 40 or older, whether or not they have urinary problems.

Risk factors for an enlarged prostate:

Factors that can increase the risk of an enlarged prostate include:

• age
• diabetes
• obesity
• family history of BPH
• heart disease

Most males have a 50% chance of having BPH by the age of 60 years and a 90% chance by the age of 85 years. Limited research has associated BPH with an increased riskTrusted Source of prostate cancer and bladder cancer, with the risk of prostate cancer being particularly high in Asian people with BPH. However, the limitations of the included studies mean that there is a need for additional prospective studies with a strict design to confirm the findings.

BPH Treatment: Lifestyle Changes:

Lifestyle changes may be able to help with symptom relief. Some important Lifestyle Changes to Relieve BPH Symptoms:

• Avoid alcohol and caffeine, stimulamts, Avoid sour, spicy, and curdy food, artificial sweeteners, nicotine, carbonated drinks, starchy, refined foods, red meat
• Avoid drinking fluids at bedtime, and drinking smaller amounts throughout the day
• Avoid taking decongestant and antihistamine medications, antidepressants, and diuretics
• maintaining a moderate body weight
•  avoiding or limiting products that cause dehydration, such as cold medications and decongestants
• using absorbent urinary pads or pants to absorb urine leaks and decrease wetness and discomfort
• using urinary sheaths, which are condom-shaped and fit over the penis, to drain urine into a small bag strapped to the leg
• following urination with a urethral massage, which involves gently pressing the fingers upward from the base of the scrotum to try to squeeze out any urine remaining in the urethra and prevent any leakage later
• limiting the intake of saturated fats, which are in red meat, fried foods, and dairy products
• eating plenty of natural plants, particularly those rich in beta-sitosterol, such as green leafy vegetables, rice bran, wheat germ, peanuts, corn oils, nuts, and soybeans
• avoiding dietary supplements or environmental exposures that may increase circulating hormone levels, such as pesticides, herbicides, and recombinant bovine growth hormone (rBGH)-rich dairy products
• avoiding drugs that include dehydroepiandrosterone (DHEA), androstenedione, testosterone, and human growth hormone
• get regular exercise
• training the bladder to hold more urine for longer periods
• exercising pelvic floor muscles
• preventing or treating constipation
• make a habit of going to the bathroom when you have the urge
• practice double voiding (empty the bladder, wait a moment, then try again)
•  practice stress management and relaxation techniques

How can benign prostatic hyperplasia be prevented?

Researchers have not found a way to prevent benign prostatic hyperplasia. Men with risk factors for benign prostatic hyperplasia should talk with a health care provider about any lower urinary tract symptoms and the need for regular prostate exams. Men can get early treatment and minimize benign prostatic hyperplasia effects by recognizing lower urinary tract symptoms and identifying an enlarged prostate.

Eating, Diet, and Nutrition:

Researchers have not found that eating, diet, and nutrition play a role in causing or preventing benign prostatic hyperplasia. However, a health care provider can give information about how changes in eating, diet, or nutrition could help with treatment. Men should talk with a health care provider or dietitian about what diet is right for them.

BPH Treatment: Medicine Combinations:

Saw palmetto is a supplement that showed benefit in some studies in managing BPH symptoms. In other studies, this effect was not seen. Because there is no clear benefit and a risk that supplements may interfere with the action of other drugs, the American Urological Association does not recommend saw palmetto or other herbal supplements for BPH.

Herbs for benign prostatic hyperplasia:

Herbs hold promise in the treatment of BPH. Serenoa repens, Pygeum africanum, Urtica dioica radix, and Cucurbita peponis semen are some of the botanical therapies used in the treatment of BPH.

Qarshi Prostnal: Effective for inflammation and growth of the prostate gland. Relieves inflammation of the urinary tract, and reduces bladder pain.

Hamdard  Gulmundene: Effective for BPH, urine retention and a frequent or urgent need to urinate

Note: Patients are urged to discuss the use of any complementary, herbal and/or home remedies for BPH with their doctors, Qualified Tabibs / Hakims before use.

Note: Always consult your physician before use of any medicine.

References:

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13. https://www.hamdard.com.pk
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