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Benign Prostatic Hyperplasia (Prostate Gland Enlargement)
- An increase in the size of the prostate gland (a walnut-sized body part made of glandular and muscular tissue)
- The prostate surrounds part of the urethra, which is the tube that carries urine and sperm outside of the body
- Almost all men will develop some enlargement of the prostate as they grow older
- By age 60, 50% of men will have some signs of BPH
- By age 85, 90% of men will have signs of the condition
- Approximately 50% of men will develop symptoms that need to be treated
- Aging: Increased prostate cell growth from lower levels of testosterone and higher levels of estrogen and dihydrotestosterone (DHT)
- Urinary frequency
- Urinary urgency
- Slowness/dribbling of your urinary stream
- Hesitancy/difficulty starting to urinate
- Nocturia (Nighttime voiding)
- Pain after ejaculation/while urinating
- Urine that has a different odour/colour than usual
- The enlargement of the prostate can lead to blockage of the urethra, which can lead to:
- Bladder stones
- Bladder infection
- Blood in your urine
- Kidney damage from back pressure caused by retaining large amounts of extra urine in the bladder
- Medical history to address
- Symptoms
- Current health issues
- Over-the-counter and prescription drugs being taken
- Diet and liquid consumption
- Physical exam
- Digital rectal exam: To feel the prostate and estimate its size
- Urine flow study: May be conducted to measure how slow the urinary stream is compared with normal urine flow
- Ultrasound post-urination: To determine if there is any urine left in the bladder
- Cystoscopy: Bladder is looked at through a cystoscope
- Oral Medications
- Drugs that relax the muscle in the prostate (to reduce the tension on the urethra)
- Include doxazosin, tamsulosin, alfuzosin and silodosin
- Drugs that decrease the production of the hormone dihydrotestosterone (DHT), which affects the growth of the prostate gland
- Include finasteride and dutasteride
- To help treat symptoms and improve the flow of urine
- Dutasteride and tamsulosin combined
- Drugs that relax the muscle in the prostate (to reduce the tension on the urethra)
- Surgery
- Transurethral resection of the prostate (TURP): The tissue that blocks the urethra is removed with a special instrument
- Transurethral incision of the prostate (TUIP): Two small cuts are made in the bladder neck (where the urethra and bladder join) and in the prostate to widen the urethra to improve urine flow
- Transurethral electrovaporization: Electrical energy is applied through an electrode to rapidly heat prostate tissue, turning the tissue cells into steam. The enlarged tissue area can then be vaporized to relieve urinary blockage
- The GreenLight laser: Prostate tissue is removed with a laser
- Minimally Invasive Treatments
- Prostatic Urethral Lift: Separates the enlarged prostate lobes to make the urethra wider so that it is easier to urinate
- Water Vapour Therapy: Delivers very small amounts of steam to the enlarged prostate to damage the cells causing obstruction, thus reducing the overall size of the prostate
