Benign prostate enlargement or Benign Prostatic Hyperplasia (BPH) is benign prostate enlargement (not cancer) that blocks the flow of urine through the urethra. In men, urine flows from the bladder through the urethra. Prostate cells gradually multiply, forming an enlargement that causes pressure on the urethra, the path where urine and semen exit the body.
Because the urethra narrows, the bladder must contract more strongly to push urine out through the body. Over time, the bladder muscle gradually becomes stronger, thicker, and too sensitive; so it’s easy to contract even when it only contains a small amount of urine, which causes you to urinate frequently. Finally, the bladder muscle cannot overcome the effects of the narrowed urethra so that urine remains in the bladder and the bladder is not completely emptied.
Symptoms of Benign Prostate Enlargement
These symptoms are caused by pressure on the bladder and urethra when the prostate gland is enlarged. The following are some of the symptoms of prostate enlargement, including:
- Urine flow is weak or slow.
- An incomplete empty bladder feeling is emptied.
- Difficulty starting urinating.
- Frequent urination.
- Urgency/must to always urinate (often dying for a pee).
- Get up often at night to urinate.
- Straining to urinate.
- Dripping urine at the end of urination.
- The presence of urine that comes out again some time after voiding is complete.
When the bladder is not completely empty, the patient is at risk for urinary tract infections. Other serious problems also occur from time to time such as bladder stones, blood in urine, incontinence, and acute urinary retention (inability to urinate), and also inguinal hernias due to straining. Meanwhile, the sudden inability to urinate is a medical emergency, so you need to immediately visit a health service center to install a hose to remove urine.
Handling Benign Prostate Enlargement
Various treatments using drugs, minimally invasive procedures, and surgery can relieve symptoms of prostate enlargement. Each individual has a different way to deal with benign prostate enlargement depending on symptoms, how severe, and whether there are other medical diseases.
The size of the prostate gland (which can be measured by ultrasound), age, and overall patient health will also influence treatment decisions. What’s best for a man in his 50s is unlikely to be optimal for an 80-year-old man.
Older men may want to get rid of symptoms immediately through drugs or surgery, while younger men may lean towards minimally invasive treatment. According to the American Urological Association, surgery is indeed the best effort to relieve symptoms, but also has a higher risk than other treatments.
If the symptoms are really annoying or if the patient has complications such as urinary retention (urine cannot come out), maybe treatment with medication alone is not enough. Minimally invasive treatment has more benefits than surgery and recovery time is also fast. However, sufferers may require further procedures. There is also a risk of serious side effects from minimally invasive treatments such as incontinence or long-term erections, although this case is rare if the prostate is operated on.
In addition, doctors will usually use the BPH Index to measure how patients respond to drugs. If the size of the prostate shrinks, it means that drug consumption can provide a good response to the disease.
Treatment for Benign Prostate Enlargement
Treatment is generally not necessary unless benign prostate enlargement causes symptoms that are especially irritating or complications (such as urinary tract infections, impaired kidney function, blood in urine, gravel in the bladder). Some treatment options for benign prostate enlargement are:
- Alpha Blocker
These drugs do not reduce prostate size, but they are very effective in reducing urine symptoms that are difficult to pass. This drug works by relaxing the muscles around the prostate and bladder neck, so urine can flow more easily. This drug works quickly, so symptoms improve within a day or two. This drug is most effective for men with enlarged prostate glands but have not blocked the urinary tract. These drugs are: Flomax (tamsulosin), Uroxatral (alfuzosin), Hytrin (terazosin), Cardura (doxazosin), and Rapaflo (Silodosin).
Dizziness, stomach irritation and nasal congestion are the most common side effects. It should be noted, this drug is not given to men with significant urine retention and recurrent urinary tract infections.
- 5-Alpha Reductase Inhibitor
This drug can shrink the prostate by reducing the level of male hormone called dihydrotestosterone (DHT), which is involved in prostate growth. This drug takes longer than alpha blockers, but there is an increase in urine flow after three months. This drug can reduce the risk of acute retention (inability to urinate) and also reduce the tendency for prostate surgery. This drug may need to be taken for 6 to 12 months to see the effect of the medicine. These drugs are: Proscar (finasteride) and Avodart (dutasteride).
Possible side effects that occur are erectile problems, decreased sexual desire and decreased sperm count. These side effects are generally mild and can disappear when the patient stops taking medication or after the first year of taking the drug.
There is also drug combination therapy, which may be effective against symptoms related to BPH. Some examples of combined drugs include alpha-blockers and 5-alpha-reductase or alpha-blockers and anticholinergic inhibitors. If the use of drugs is not able to overcome prostate enlargement, then minimally invasive therapy procedures until surgery can be performed.