Do you know Benign prostatic hyperplasia (BPH) [TEZI DUME in Swahili]?


Benign prostatic hyperplasia (BPH) is an enlarged prostate gland . The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.

BPH occurs in almost all men as they age. BPH is not cancer. An enlarged prostate can be a nuisance. But it is usually not a serious problem. About half of all men older than 75 have some symptoms.
Benign prostatic hyperplasia is also known as benign prostatic hypertrophy.


BPH is benign. This means it is not cancer. It does not cause nor lead to cancer. But BPH and cancer can happen at the same time. Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth.

BPH causes urinary problems such as:
  • Trouble getting a urine stream started and completely stopped (dribbling).
  • Often feeling like you need to urinate. This feeling may even wake you up at night.
  • A weak urine stream.
  • A sense that your bladder is not completely empty after you urinate.
Benign prostatic hyperplasia (BPH), also called benign enlargement of the prostate (BEP or BPE), adenofibromyomatous hyperplasia and benign prostatic hypertrophy (technically incorrect usage), is a benign (noncancerous) increase in size of the prostate. BPH involves hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the transition zone of the prostate. When sufficiently large, the nodules impinge on the urethra and increase resistance to flow of urine from the bladder. This is commonly referred to as "obstruction," although the urethral lumen is no less patent, only compressed. Resistance to urine flow requires the bladder to work harder during voiding, possibly leading to progressive hypertrophy, instability, or weakness (atony) of the bladder muscle. 
BPH involves hyperplasia (an increase in the number of cells) rather than hypertrophy (a growth in the size of individual cells), but the two terms are often used interchangeably, even among urologists. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH does not lead to cancer or increase the risk of cancer.

Adenomatous prostatic growth is believed to begin at approximately age 30. An estimated 50% of men have histologic evidence of BPH by age 50 and 75% by age 80; in 40–50% of these men, BPH becomes clinically significant.[4] BPH was one of the ten most prominent and costly diseases in men older than 50 years of age in a study in the United States.


SYMPTOMS AND SIGNS
Many men with benign prostatic hyperplasia (BPH) have no symptoms. When symptoms (known as lower urinary tract symptoms, or LUTS) occur, they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement is not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms. And some men with a great deal of enlargement have few symptoms.

Your symptoms may become worse during cold weather or as a result of physical or emotional stress. Some medicines can make your symptoms worse. These include over-the-counter cold medicines such as diphenhydramine (Benadryl, for example), pseudoephedrine (such as Sudafed), oxymetazoline spray (such as Afrin), and prescription medicines such as antidepressants, water pills (diuretics), testosterone (gels, implants, or injections), and pain medicines (narcotics).


The symptoms of BPH may involve problems emptying the bladder or problems with bladder storage.

Symptoms related to bladder emptying include:
  • Difficulty starting a urine stream (hesitancy and straining).
  • Decreased strength of the urine stream (weak flow).
  • Dribbling after urination.
  • Feeling that the bladder is not completely empty.
  • An urge to urinate again soon after urinating.
  • Pain during urination (dysuria).
CAUSES
BPH is considered a normal condition of male aging, and it’s estimated that over half of men over the age of 80 have BPH symptoms. Although the exact cause is unknown, changes in male sex hormones as you age may be a factor. Any family history of prostate problems or any abnormalities with your testicles may raise your risks for BPH. Men who’ve had their testicles removed at a young age don’t develop BPH.


Scientists and medical professionals tend to say it’s not known why the prostate gets bigger as we get older. When a man asks a physician what causes the enlargement he is usually told that it is just a natural process associated with aging.

Fortunately there are some sincere physitians and scientists who feel obliged to find and reveakl the truth about possible causes of the benign enlargement of the prostate gland. One of them is Prof. Parsons who on the basis his own research wrote the following statement:

“Although age, genetics, and sex steroid hormones play prominent roles in the cause of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms, recent epidemiological studies suggest that modifiable lifestyle factors also contribute substantially to the pathogenesis of these conditions. Lifestyle and metabolic factors include obesity, diabetes, and meat and fat consumption. Factors associated with decreased risks include physical activity and vegetable consumption.”

TREATMENT
Recognizing BPH
Gentlemen, if trips to the restroom require sudden dashes or are marked by difficulty urinating, your prostate may be enlarged. You’re not alone — the Urology Care Foundation estimates that 50 percent of men in their 50s have an enlarged prostate. The prostate is the gland that produces the fluid that carries sperm. It grows larger with age. An enlarged prostate, or benign prostatic hyperplasia (BPH), can block the urethra from transporting urine from the bladder and out of the penis.


Keep reading to learn about traditional treatments for BPH


BPH Treatment Options
Don’t resign yourself to living with BPH. Addressing your symptoms now can help avoid problems later. Untreated BPH may lead to urinary tract infections, acute urinary retention (you can’t go at all), and kidney and bladder stones. In severe cases it can lead to kidney damage.
Treatment options include medications and surgery. You and your doctor will consider several factors when you evaluate these choices. These factors include:
  • how much your symptoms interfere with your life
  • the size of your prostate
  • your age
  • overall health
  • any other medical conditions
Medication Combo
Taking a combination of an alpha blocker and a 5-alpha reductase inhibitor provides greater symptom relief than taking either one of these drugs alone, according to an article in Current Drug Targets. Combination therapy is often recommended when an alpha blocker or 5-alpha reductase inhibitor aren’t working on their own. Common combinations that doctors prescribe are finasteride and doxazosin or dutasteride and tamsulosin (Jalyn). The dutasteride and tamsulosin combination comes as two drugs combined into a single tablet.


Stand the Heat
There are minimally invasive surgery options when drug therapy isn’t enough to relieve BPH symptoms. These procedures include transurethral microwave thermotherapy (TUMT). Microwaves destroy prostate tissue with heat during this outpatient procedure.
TUMT will not cure BPH. The procedure does cut down urinary frequency, makes it easier to urinate, and reduces weak flow. It doesn’t solve the problem of incomplete emptying of the bladder.


TUNA Treatment
TUNA stands for transurethral needle ablation. High-frequency radio waves, delivered through twin needles, burn a specific region of the prostate in this procedure. TUNA results in better urine flow and relieves BPH symptoms with fewer complications than invasive surgery.
This outpatient procedure can cause a burning sensation. The sensation can be managed by using an anesthetic to block the nerves in and around the prostate.

 
Traditional Treatment Methods for Enlarged Prostate
by Treacy Colbert and Tricia Kinman Medically Reviewed by George T. Krucik, MD, MBA on April 8, 2015

Part 1 of 12
Recognizing BPH
Gentlemen, if trips to the restroom require sudden dashes or are marked by difficulty urinating, your prostate may be enlarged. You’re not alone — the Urology Care Foundation estimates that 50 percent of men in their 50s have an enlarged prostate. The prostate is the gland that produces the fluid that carries sperm. It grows larger with age. An enlarged prostate, or benign prostatic hyperplasia (BPH), can block the urethra from transporting urine from the bladder and out of the penis.

Part 2 of 12
BPH Treatment Options
Don’t resign yourself to living with BPH. Addressing your symptoms now can help avoid problems later. Untreated BPH may lead to urinary tract infections, acute urinary retention (you can’t go at all), and kidney and bladder stones. In severe cases it can lead to kidney damage.
Treatment options include medications and surgery. You and your doctor will consider several factors when you evaluate these choices. These factors include: how much your symptoms interfere with your life
  • the size of your prostate
  • your age
  • overall health
  • any other medical conditions
Part 3 of 12
Alpha Blockers for BPH
This class of medications works by relaxing the bladder neck muscles and the muscle fibers in the prostate. The muscle relaxation makes it easier to urinate. You can expect an increase in urine flow and a less frequent need to urinate within a day or two if you take an alpha blocker for BPH. 

Part 4 of 12
5-Alpha Reductase Inhibitors for BPH
This type of medication reduces the size of the prostate gland by blocking hormones that spur the growth of your prostate gland. Dutasteride (Avodart) and finasteride (Proscar) are two types of 5-alpha reductase inhibitors. You’ll generally have to wait three to six months for symptom relief with 5-alpha reductase inhibitors.

Part 5 of 12
Medication Combo
Taking a combination of an alpha blocker and a 5-alpha reductase inhibitor provides greater symptom relief than taking either one of these drugs alone, according to an article in Current Drug Targets. Combination therapy is often recommended when an alpha blocker or 5-alpha reductase inhibitor aren’t working on their own. Common combinations that doctors prescribe are finasteride and doxazosin or dutasteride and tamsulosin (Jalyn). The dutasteride and tamsulosin combination comes as two drugs combined into a single tablet.

Part 6 of 12
Stand the Heat
There are minimally invasive surgery options when drug therapy isn’t enough to relieve BPH symptoms. These procedures include transurethral microwave thermotherapy (TUMT). Microwaves destroy prostate tissue with heat during this outpatient procedure.
TUMT will not cure BPH. The procedure does cut down urinary frequency, makes it easier to urinate, and reduces weak flow. It doesn’t solve the problem of incomplete emptying of the bladder.

Part 7 of 12
TUNA Treatment
TUNA stands for transurethral needle ablation. High-frequency radio waves, delivered through twin needles, burn a specific region of the prostate in this procedure. TUNA results in better urine flow and relieves BPH symptoms with fewer complications than invasive surgery.
This outpatient procedure can cause a burning sensation. The sensation can be managed by using an anesthetic to block the nerves in and around the prostate.

Part 8 of 12
Getting in Hot Water
Hot water is delivered through a catheter to a treatment balloon that sits in the center of the prostate in water-induced thermotherapy. This computer-controlled procedure heats a defined area of the prostate while neighboring tissues are protected. The heat destroys the problematic tissue. The tissue is then either excreted through urine or reabsorbed in the body.

Part 9 of 12
Surgical Choices
Invasive surgery for BPH includes transurethral surgery, which doesn’t require open surgery or an external incision. According to the National Institutes of Health, transurethral resection of the prostate is the first choice of surgeries for BPH. The surgeon removes prostate tissue obstructing the urethra using a resectoscope inserted through the penis during TURP.
Another method is transurethral incision of the prostate (TUIP). During TUIP, the surgeon makes incisions in the neck of the bladder and in the prostate. This serves to widen the urethra and increase urine flow.


Part 10 of 12
Laser Surgery
Laser surgery for BPH involves inserting a scope through the penis tip into the urethra. A laser passed through the scope removes prostate tissue by ablation (melting) or enucleation (cutting). The laser melts excess prostate tissue in photoselective vaporization of the prostate (PVP).
Holmium laser ablation of the prostate (HoLAP) is similar, but a different type of laser is used. The surgeon uses two instruments for Holmium laser enucleation of the prostate (HoLEP): a laser to cut and remove excess tissue and a morcellator to slice extra tissue into small segments that are removed.

Part 11 of 12
Open Simple Prostatectomy
Open surgery may be required in complicated cases of a very enlarged prostate, bladder damage, or other problems. In open simple prostatectomy, the surgeon makes an incision below the navel or several small incisions in the abdomen via laparoscopy. Unlike prostatectomy for prostate cancer when the entire prostate gland is removed, in open simple prostatectomy the surgeon removes only the portion of the prostate blocking urine flow.


Part 12 of 12
Self-Care May Help
Not all men with BPH need medication or surgery. These steps may help you manage mild symptoms:
  • Do pelvic-strengthening exercises.
  • Stay active.
  • Decrease alcohol and caffeine intake.
  • Space out how much you drink rather than drinking a lot at once.
  • Urinate when the urge strikes — don’t wait.
  • Avoid decongestants and antihistamines.
  • Talk with your doctor about the treatment approach that best suits your needs.
PREVENTION
The urination problems caused by benign prostatic hyperplasia (BPH) cannot be prevented. Some people believe that regular ejaculations will help prevent prostate enlargement. But there is no scientific proof that ejaculation helps.
Fifty percent of men over the age of 60 suffer from an enlarged prostate or benign prostatic hyperplasia (BPH), according to Mayo Clinic. By the age of 85, over 95 percent of men will live with BPH.


The good news is that a diet rich in certain vitamins and minerals can keep your prostate healthy and lower your risk of BPH. And because being overweight is another risk factor for BPH, making nutritious food choices is a great way to lower both your weight and your risk.

1. Sesame Seeds
Sesame seeds are rich in zinc, a mineral essential to the health of the prostate, according to a study in the Indian Journal of Urology. Men with either BPH or prostate cancer have lower levels of zinc in their bodies -- sometimes up to 75 percent lower than healthy prostates.


Zinc that comes from food is easier to absorb than zinc supplements. Help your body by  snacking on sesame seeds. Or try oysters, adzuki beans, pumpkin seeds, and almonds, which are all high in zinc.



2. Salmon
Salmon is rich in omega-3 fatty acids. These are healthy fats that can protect you from cardiovascular disease, cancer, and rheumatoid arthritis. Fatty acids also help in the synthesis of prostaglandin. Fatty acids deficiency may lead to prostate problems, according to a study published in the Alternative Medicine Review.  

If you’re not a fan of fish, you can get your omega-3s from walnuts, ground flax seeds, canola oil, and kidney beans.


3. Soybean
A study published in The Journal of Urology showed that Asian men have a lower risk of developing BPH than Western men. One possible reason is that Asian men eat more soy. Soybean isoflavones have been linked to a lower risk for an enlarged prostate, according to a study published in The Prostate. Eating more soy might even reduce the risk of developing prostate cancer.
For other sources of soybean isoflavones, try low-fat soymilk, tempeh, roasted soybeans, soy yogurt, and meat substitutes made with soy.



4. Bell Peppers
Vitamin C is an antioxidant that might play a role in fighting BPH. Not all vitamin C is the same, however. According to Mayo Clinic, only vitamin C obtained from vegetables lowers your risk of an enlarged prostate. Fruits don’t offer the same benefit.


Bell peppers contain more vitamin C than any other vegetable. One cup of raw bell peppers contains 195 percent of your daily requirement intake of vitamin C. Other vegetables to try include broccoli, cauliflower, kale, and Brussels sprouts.



5. Tomatoes
Tomatoes are rich in lycopene, the bright carotenoid that gives tomatoes its red color. Lycopene may lower the risk of developing prostate cancer. It can also help men with BPH, according to the National Cancer Institute. Lycopene also helps lower the blood level of antigen, a protein connected to prostate inflammation and BPH.

Tomatoes and tomato products (such as tomato sauce and tomato juice) are the best source of lycopene. You can also get this carotenoid from watermelon, apricots, pink grapefruit, and papaya.



6. Avocadoes
Avocadoes are rich in beta-sitosterol, a plant sterol. According to the Cochrane Database of Systematic Reviews, beta-sitosterol can help reduce symptoms associated with BPH. Men taking beta-sitosterol supplements have better urinary flow and less residual urine volume.


Beta-sitosterol can help strengthen the immune system. It can reduce inflammation and pain, as well. Besides avocadoes, other foods rich in beta-sitosterol include pumpkin seeds, wheat germ, soybeans, and pecans.



7. Vegetables
Eating more vegetables can help lower your risk of BPH. Green leafy vegetables are especially important because they are rich in antioxidants. Cruciferous vegetables like broccoli also reduce the risk of prostate problems, including BPH and prostate cancer.

People who eat onion and garlic regularly might also have a lower risk of BPH, according to research published in Urology. Onions and garlic are often used in natural medicine to fight infection and help strengthen the immune system.



Posted by: Lusubilo A. Mwaijengo

4 Comments

  1. good guidance of prostatic cancer

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