Health Conditions

BPH – Benign Prostatic Hyperplasia	Share | Bookmark
General Description Symptoms Causes Traditional Treatments Misdiagnosis of Symptoms Changes to Make Vitamins & Supplements Talk With Your Doctor Wellness Plan Remedies
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General Description

What is
Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia, also known as BPH, is a men’s health condition
caused by the enlargement of the prostate gland.  While several of the symptoms of BPH mimic
those of prostate cancer, the condition is not malignant; however, it can cause
a variety of uncomfortable symptoms that, if left untreated, can lead to
kidney, bladder, or urinary tract problems. Bladder stones and kidney stones
are also potential long term effects of the condition. Untreated BPH may also
lead to incontinence, which is a permanent condition.  It is widely acknowledged that the enlargement
of the prostate occurs as the result of aging, but what specifically triggers
this growth is yet unknown.

The National Institutes of
Health estimate that 50% of men in their 60s experience BPH, and up to 90% of
men in their 70s and older experience some degree of BPH-related symptoms.

Symptoms

Thanks to cutesy commercials for prostate medications and
joke material used by many aging comics, the symptoms of benign prostate
hyperplasia have been turned into a shoulder-shrugging punch line about men
getting older. Yet the symptoms of the condition can progressively deteriorate
the quality of a man’s life as he ages, both physically and emotionally.

While BPH is considered to be a completely physical
condition, the stress and emotional strain the symptoms of the condition can place
on a man often lead to greater incidences of anxiety, irritability, depression,
and other mental symptoms.  Therefore,
when considering the symptoms of BPH, it is important to treat all aspects of
the condition.

The classic physical symptoms of early stage BPH include the
following:

• Difficulty initiating urination
• Urine stream starts and stops during urination
• Urine drips or dribbles out of the penis after
  urination is complete

Some serious potential results of leaving BPH untreated
include the development of renal failure, blood in the urine, bladder
infections and urinary tract infections.

The symptoms of BPH can not only disrupt an individual’s
ability to perform daily activities as normal, but can also cause serious
emotional symptoms as well. In the February 2009 edition of WholeFoods magazine, health writer Katie
Agin notes that in men who experience BPH, “impotence and other sexual troubles
develop, often leading to emotional, psychological, and relationship dilemmas.”

Anxiety is a common emotional symptom of men who suffer from
BPH, especially those who have had an experience of not being able to control
their bladder in public or private situations. A study published in the October
2004 edition of the International Journal
of Urology reported that men who are diagnosed with a condition related to
their urinary tract, such as BPH, are likely to experience feelings of anxiety
and depression. Ironically, these emotional conditions can lead to impotence or
inability to sexually climax which will cause more depression and anxiety.

For more
valuable information on the symptoms of BPH, check out our full length report!

Causes

BPH is estimated to affect up to 90% of the male population over 70 years of
age; however in spite of its prevalence, the medical community has not been
able to identify one specific cause of the condition. There are a variety of
theories as to what causes the gland to enlarge over time, most of which focus
on hormonal triggers.

• Dihydrotestosterone
  – Dihydrotestosterone (DHT) is a metabolic derivative, or sub-type, of
  testosterone.  DHT is more concentrated than
  testosterone and is responsible for the formation of male genitalia, including
  the prostate, testes, and penis. It is produced throughout a man’s life. DHT
  build-up has long been seen as a cause of BPH, however, there is growing
  concern in the medical community that DHT’s role in prostate enlargement has
  been misunderstood and that DHT may potentially reduce the size of the prostate.

• Estradiol
  – Estradiol is the main form of estrogen found in humans; it is produced
  from an enzyme reaction with testosterone. As a man ages, more of his
  testosterone becomes converted to estradiol, which can cause other biological
  chemicals to accumulate in the prostate.  
  In a 1994 report published in the Proceedings of the National Academy
  of Sciences, it was concluded that increased estradiol levels led to an
  enlarged prostate due to a rapid accumulation of cAMP, a common cellular
  messenger.

• Estrogen
  Dominance – Estrogen dominance occurs in men when the levels of estrogen
  surpass the levels of testosterone, becoming the governing hormone in the body.
  This causes several hallmark symptoms, including loss of muscle mass, reduced
  libido, and weight gain, particularly around the belly. The role of estrogen in
  the prostate and other male reproductive glands is still not fully understood,
  and many questions remain. The hormone is currently under serious scrutiny by
  myriad researchers around the world and is likely to emerge as an even more
  significant player in BPH in the coming years.

• Additional
  Causes – In addition to hormonal shifts, several other theories regarding
  the cause of BPH have been postulated over the past twenty years. One
  interesting theory asserts that heavy metals, such as nickel, play a role in
  the enlargement of the gland. Heavy metals like nickel do not belong in the
  body, and when it is present attracts bacteria which lead to an enlarging of
  the prostate. Heavy metals are not the only damaging substances that accumulate
  in the prostate. Environmental toxins, such as xenoestrogens, also build up in
  the gland. Xenoestrogens are foreign estrogens that enter the human body and
  act in the same way naturally produced estrogen would, leading to a surplus of
  estrogen and estrogen dominance. These toxins can affect the hormonal shift men
  naturally experience as they age and enhance the effects estrogen has on the
  body. Click
  here for more information on Estrogen Dominance

For more
valuable information on the causes of BPH, check out our full length report!

Traditional Treatments

Traditional treatment options for an enlarged prostate
include everything from prescription medications to surgery. However, while it
is important to review all possible options for treating your enlarged
prostate, we here at Health911 would like to emphasize that over the last 10
years there has been a considerable shift among members of the medical
community toward alternative therapies for this condition due to the broad
range of side effects associated with most traditional treatments. If your
health care professional suggests any of the following treatments, be sure you
are clear on the potential side effects as some are irreversible.

• Prescription
  Medication – There are several prescription medications available to treat
  a mildly to moderately enlarged prostate gland. In 2006, the National Institute
  of Diabetes and Digestive and Kidney Diseases (a division of the National
  Institutes of Health) reported that using these two types of drugs together
  “reduced the risk of BPH progression by 67 percent, compared with 39 percent of
  [the alpha blocker] alone and 34 percent of [the 5-alpha reductase inhibitor]
  alone.”

• Alpha
  blockers – Alpha blockers are
  characterized by their ability to help muscles relax. The benefit of alpha
  blockers is that patients will notice an improvement in comfort and ability to
  urinate within a few days. Most patients also notice a reduced need to urinate.
  Alpha blockers can cause a variety of side effects, including headache, weight
  gain, and irregular or “pounding” heartbeat. After the first few doses, a
  patient may experience a rapid drop in blood pressure, which can cause
  dizziness and fainting. Men who take alpha blockers may experience retrograde
  ejaculation, a condition that occurs when semen backs up into the bladder
  instead of ejaculating out of the penis during an orgasm. Some popular brand
  name alpha blockers used for BPH include Hytrin, Rapaflo, Uroxatral, and
  Flomax.

• 5- alpha
  reductase inhibitors– 5-alpha
  reductase inhibitors are a type of medication that can help decrease the size
  of the prostate by reducing the amount of dihydrotestosterone (DHT) in the
  gland. This class of medication, most commonly prescribed under the brand names
  Proscar and Avodart, can take several months to improve symptoms. They also
  cause several sexual side effects, including reduced libido, erectile
  dysfunction, and retrograde ejaculation. 
  

• Transurethral
  Microwave Procedures – Transurethral Microwave Procedures, also known as
  Transurethral Microwave Thermotherapy, utilizes a machine that focuses
  microwaves heated to at least 111 degrees Fahrenheit to burn off and destroy
  enlarged prostate tissue. The procedure does not require any anesthesia and are
  performed on an outpatient basis.

• Transurethral
  Needle Ablation – During the procedure, two needles are inserted into the
  pelvis and directed at the areas of abnormal prostate growth. Low levels of
  radio frequency energy are shot through the needles to destroy portions of the
  prostate to help relieve symptoms of bladder pressure and strained urine flow.
  This procedure is considered effective for reducing specific portions of the
  gland, unlike the transurethral microwave procedure which is harder to focus on
  a particular area. Local anesthesia is typically utilized during this
  procedure and it does not cause incontinence and impotence. However, in 2007 a
  study published in The Journal of Urology noted that the procedure has a
  high rate of failure and the majority of patients are required to undergo it
  again immediately to correct the first attempt.

• Surgical
  Options – If other prescription
  or minimally invasive outpatient procedures are unable to reduce the size of
  the prostate due to size or continued regrowth, a medical professional may
  suggest a man undergo surgery to handle the issue. The point of the surgery is
  not to remove the entire prostate, but simply remove the enlarged tissue that
  is placing pressure on the urethra or bladder.

• Transurethral
  Resection of the Prostate – This procedure is used in approximately 90% of
  all prostate surgeries related to BPH annually in the United States. During
  this surgery, the patient in placed under general anesthesia, and a
  resectoscope, a device that contains a light, camera, and irrigation system, is
  inserted through the opening at the end of the urethra. The resectoscope, which
  is approximately one foot long and .5 inches in diameter, also has a cutting
  utensil attached which can cut tissue and also clot it shut with extreme heat.
  Small pieces of enlarged tissue are cut off and allowed to collect in the
  bladder to be voided with urine after the procedure is completed. No incisions
  need to be made on the patient, as the entire procedure is conducted through
  this opening.

• Transurethral
  Incision of the Prostate – Transurethral Incision of the Prostate (TUIP)
  requires additional incisions to be made to widen the urethra channel and
  bladder neck to relieve urination problems. 
  The goal of this procedure is to improve symptoms without placing the
  patient at risk for retrograde ejaculation; however, this procedure has not
  been used for long enough to note long term effects. Open surgery, where an
  external incision is made in the lower pelvis, is only used in instances where
  success is not achieved with TURP or TUIP or there are additional medical
  complications.

• Laser Surgery
  – The gland is sliced off and “vaporized” with Nd: YAG lasers. It is perceived
  to be the next generation in prostate surgeries by many in the medical field
  because it allows for a quicker recovery time than TURP and reduces blood loss.
  However, like TUIP, the procedure has not been performed for long enough to
  observe long term effects or its effectiveness on non-typical glands or larger
  glands.

For more
valuable information on the tradition of BPH, check out our full length report!

Misdiagnosis of Symptoms

Talking with a doctor frankly about sexual problems,
urinating issues, or other concerns about your genitals can be uncomfortable,
embarrassing, and feel “unmanly” – men are supposed to suck it up and deal with
whatever discomfort they are feeling. However, the difference between BPH and
some other condition can be as slight as one symptom; to receive the proper
diagnosis and avoid misdiagnosis, you need to volunteer every symptom you are aware
of to your health care professional. If you feel uncomfortable talking to your
health care provider about your symptoms, check out Talking About Your Prostate Health for
tips on making the most of your appointment.

• Prostatitis
  – Prostatitis is a term used for a group of disorders of the prostate that
  include bacterial infection, inflammation, and a chronic form unrelated to
  infection. If left untreated, there is some evidence that prostatitis can
  increase a man’s risk for developing prostate cancer. Symptoms of prostatitis
  include painful urination, difficulty passing urine, dribbling urination,
  frequent nighttime urination, painful ejaculation, pain in the lower back and
  groin region. Prostatitis can be distinguished from BPH by pain. While men who
  are suffering from BPH may experience a sensation of pressure or discomfort due
  to their swollen prostate pressing against the urethra or bladder, they
  typically do not report pain in the back, groin, during urination, or during
  ejaculation. A urine and semen analysis can be conducted to verify the proper
  diagnosis.

• Urinary
  Tract Infection – A urinary tract infection (UTI) can indicate a bacterial
  infection of any part of the urinary tract, including the urethra, bladder, or
  kidneys. Symptoms of UTIs typically include painful urination, burning when
  urinating, frequent need to urinate, strong smelling urine, and cloudy urine.
  As the infection gets worse, an individual may experience lower back pain and a
  fever. The symptoms of a UTI tend to come on suddenly and increase in severity
  at a rapid rate. A simple urine analysis can alert your health care provider to
  a UTI.  

• Depression
  – Depression is an emotional state characterized by persistent and
  pervasive low mood. It may be triggered by a traumatic event, such as death,
  loss, or pregnancy, or a chemical imbalance in the brain. It is treatable
  through a variety of traditional medications and alternative practices.
  Depression is often a symptom of BPH and can, from the perspective of a medical
  professional, mask the original condition due to a heightened social
  sensitivity to depression and classic signs. Sexual dysfunction, inability to
  sleep, anxiety over not being near a bathroom, and even problems urinating can
  fit into a diagnosis of depression if the health care provider sees other
  signs. To avoid a misdiagnosis, be sure you emphasize your urinary problems as
  vehemently as any sexual symptoms you are having. Also, don’t feel afraid to
  ask for your prostate to be checked.

• Prostate
  Cancer – From the perspective of most health care professionals, it is hard
  to tell just based on reported symptoms whether a man has BPH or prostate
  cancer. Further testing of the prostate is almost always performed, which may
  include a digital rectal exam or an ultrasound. A blood test which measures
  levels of PSA (prostate-specific antigen) is typically also performed. The
  health care professional may decide to take a sample of the prostate tissue and
  examine it further. Based on the results of these tests, it should be clear if
  an individual is suffering from BPH or prostate cancer.  

For more
valuable information on the misdiagnosis of BPH, check out our full length
report!

Changes to Make

BPH – Benign Prostatic Hyperplasia