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Benign Prostatic Hyperplasia and Its Treatment

By Editorial Team (Y)
February 19, 2022

Benign prostatic hyperplasia (BPH), also known as enlarged prostate gland, is common in older men. Your prostate gland surrounds the portion of your urethra, the tube carrying urine and semen out of the penis. Enlarged prostate squeezes the urethra causing uncomfortable urinary symptoms. Benign prostatic hyperplasia may also result in the bladder, urinary tract, or kidney problems.

BPH causes

Prostate growth occurs throughout life for most men. However, in many men, the prostate continually enlarges enough to press on the urethra and cause urinary problems or significantly block the urine flow. The prostate enlargement cause is not clear. Perhaps the main reason for the growth of the prostate gland is the change in sexual hormones balance as men get older. However, not all prostate growth will lead to benign prostatic hyperplasia.

Other causes of urinary symptoms

Certain conditions may result in symptoms similar to those caused by benign prostatic hyperplasia. Such conditions include:

  • Urinary tract infection (UTI)
  • Stones in the bladder or kidneys
  • Prostatitis (inflammation of the prostate gland)
  • Scarring in the bladder neck resulting from previous surgery
  • Prostate cancer or bladder cancer
  • Urethral stricture (narrowing of the urethra)
  • Problems with nerves controlling the bladder

Benign prostatic hyperplasia symptoms

Patients with prostate gland enlargement may experience various symptoms, but symptoms typically worsen over time. However, the size of the prostate does not determine the severity of the symptoms. While some men with slightly enlarged prostates may experience significant urinary symptoms, others with very enlarged prostates may experience only minor symptoms. Common benign prostatic hyperplasia symptoms and signs include:

  • An urgent or frequent need to urinate
  • Difficulty to start urination
  • Inability to empty the bladder completely
  • Dribbling when you finish urination
  • A weak or intermittent urine stream

Your bladder has to work harder in order to push urine out when an enlarged prostate gland squeezes your urethra. With time, the bladder muscles weaken, making it harder for the bladder to empty. It can result in the following symptoms:

  • An excessive amount of urination is needed
  • Increased urination frequency at night (nocturia)
  • After peeing, you still feel like you have to pee
  • Incontinence (inability to control when you pee)
  • Urinary tract infections, bloody urine, inability to urinate, bladder damage, and bladder stones
  • A sudden urgent need to pee

Over time, some men experience symptoms stabilization and even improvement.

BPH treatment

Prostate enlargement can be treated with medication, minimally invasive therapies, and surgery. Your physician will prescribe you an appropriate treatment based on the size of your prostate, the severity of symptoms, your age, and your overall health. Depending on how tolerable your symptoms are, you may decide to postpone your treatment and monitor your condition instead. In some cases, enlarged prostate symptoms can improve without treatment.

Medications for BPH treatment

  • 5-alpha reductase inhibitors are designed to shrink your prostate gland by preventing hormonal changes occurring with aging that result in prostate growth. Such medications include dutasteride (Avodart) and finasteride (Proscar). The patient needs to take 5-alpha reductase inhibitors for up to six months. Side effects of these medicines include retrograde ejaculation (a harmless condition in which semen returns to the bladder instead of going out the tip of the penis).
  • Alpha blockers act by relaxing muscles of the bladder neck and prostate muscle fibers. It makes urination easier. Such medications include doxazosin (Cardura), silodosin (Rapaflo), tamsulosin (Flomax), and alfuzosin (Uroxatral). Alpha blockers tend to work quickly in men with relatively small prostates. However, dizziness and retrograde ejaculation are possible side effects of these BPH medications.
  • Tadalafil (Cialis) is a medication used for erectile dysfunction treatment. However, it can also treat enlargement of the prostate gland.
  • Combination drug therapy involves taking a 5-alpha reductase inhibitor and an alpha blocker at the same time if either medication alone does not help.

Minimally invasive or surgical therapy for BPH treatment

  1. Transurethral resection of the prostate (TURP). The physician inserts a lighted scope into your urethra and removes all but the outer portion of the prostate gland in this procedure. The TURP procedure generally relieves symptoms quickly, and most men experience a stronger urine flow soon afterward. After this procedure, the patient might temporarily need a catheter to drain the bladder.
  2. Transurethral microwave thermotherapy (TUMT). A special electrode is inserted through your urethra into your prostate area in this procedure. Microwave energy from the electrode shrinks and eases the urine flow by destroying the prostate gland’s inner portion. The results after TUMT may take time to appear, and you might notice only partial improvements. This surgical procedure is commonly used in exceptional circumstances only to treat small prostates because re-treatment might be necessary.
  3. Transurethral incision of the prostate (TUIP). The surgeon inserts a lighted scope into your urethra to make one or two tiny cuts in the prostate. After this procedure, it becomes easier for urine to pass through the urethra. If you have a mildly enlarged prostate gland and have health problems that make other surgical procedures too risky, this surgery might be an option for you.
  4. Transurethral needle ablation (TUNA). The doctor uses a scope to insert needles into your prostate gland through your urethra in this procedure. Radio waves pass through these needles to heat and destroy excess prostate tissue blocking urine flow. Transurethral needle ablation is rarely used any longer.
  5. Laser therapy. This therapy is used to destroy and remove overgrown prostate tissue with a high-energy laser. Laser therapy typically relieves prostate symptoms right after the procedure. Laser therapy can be used in men who are taking blood-thinning medications and therefore should not undergo other prostate procedures.
  6. Embolization. This is an experimental procedure where the blood supply from or to the prostate gland is selectively blocked. It results in the decreasing of the prostate gland. However, a long-term evaluation of the effectiveness of this procedure is not available.
  7. Prostatic urethral lift (PUL). In this procedure, special tags are used in order to compress the sides of the prostate gland to increase urine flow. You might be recommended to undergo the procedure if you have symptoms related to your lower urinary tract.
  8. Open or robot-assisted prostatectomy. An incision is made in your lower abdomen to reach the prostate and remove tissue in this surgical procedure. Open prostatectomy is recommended if the patient has a very large prostate gland, damage of the bladder, or other complicating aspects. Typically, the surgery requires a short hospital stay, and there is a higher risk of requiring a blood transfusion after the procedure.

Another BPH treatment methods 

The Khavinson peptide called Libidon can also improve your BPH symptoms. Libidon is a cytomax that contains peptide bioregulators isolated from the young animals’ prostate gland. By stimulating protein synthesis, Libidon normalizes the prostate parenchyma cells’ metabolism. As a result, this supplement helps restore prostate gland functions regardless of the cause of the prostate gland’s disorder, including inflammatory conditions or age-related conditions.

Click here to read more about Libidon.

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