After the age of 40 years, the prostate glands in males start to become larger in size. The condition is medically termed as benign prostatic hyperplasia (BPH). The condition is not cancerous, neither has it elevated the risk of developing cancer.
Usually, Benign Prostatic Hyperplasia (BPH) is confused with a condition wherein the male body develops too many prostate cells. On the contrary, BPH is a non-treatable condition, and once the growth of the prostate starts it continues to take place until and unless medical therapy is given to the patient. In this condition, the growth of the cells expedites, squeezing the urethra. Another prostate growth is in the middle region in which the cells start developing into the urethra and the bladder outlet area. This condition is treatable by a surgical process.
There is no known reason behind prostate enlargement. The experts believe that aging factors and the testicles themselves are responsible for the abnormal growth of the gland. In the case of any testicle removal surgery in men at an early age (for treatment of testicular cancer), there is no risk of developing BPH.
A male body produces a large amount of testosterone (male hormone) as well as a small amount of estrogenic (female hormone). As men age, the levels of testosterone in the blood decreases, which results in higher levels of estrogenic. As per the studies conducted on animals, the experts have derived that the high levels of estrogen may cause the enlargement of the gland.
Reports suggest that dihydrotestosterone (DHT), a substance extracted from testosterone in the prostate, may be helpful in controlling the growth. As animals age, the ability to produce DHT gradually decreases. However, contrary to the studies, some research work suggests that the presence of even a drop of testosterone in the male body is enough to keep the DHT levels high in the prostate. The high levels of DHT are considered as a possible reason for the growth of cells. It has also been noted that when there is no DHT in the male body, the chances of developing BPH is zero.
Usually, there are no symptoms in the case of men with an enlarged prostate. However, some of the common symptoms may include:
In the case of severe BPH, a more complex symptom develops known as Acute Urinary Retention, which is the inability to urinate. Acute Urinary Retention is a painful condition that promotes discomfort in the body. The doctors use a catheter to allow the body to drain urine from the bladder.
The doctor would recommend a physical examination through a digital rectal examination (DRE) and evaluation of symptoms via AUA Symptom Index results to diagnose Benign Prostatic Hyperplasia.
In the case of BPH with symptoms, it is important to avail of some kind of treatment in due time. However, there are several doubts about availing treatment in case of early identification and mild enlargement of the gland. The results of several studies indicate that early treatment is not mandatory as in one-third of the cases of mild enlargement, the BHP condition is auto treated. The experts, however, suggest to avail regular check-ups to watch for early problems. The treatment is recommended in cases when the condition poses a danger to the patient’s health or develops major inconvenience.
Before the treatment of BPH, the doctors offer antibiotic treatments as in most of the cases there are chances of urinary tract infection.
The most modern modality used in the management of an enlarged prostate is HOLEP. The procedure uses a 550-micron fiber attached to a 100-Watts holmium laser machine that removes obstructive prostatic tissue and then seals the blood vessels. Once the procedure is done, the enucleated gland is placed back into the bladder. The procedure takes around 45-90 minutes.
The doctors install a catheter to allow the patient to urinate. The entire procedure is completely bloodless.
Key Factors | HOLEP | TURP |
---|---|---|
Size of Prostate | 200 gms | Not >80 gms |
Patients on anticoagulants | Can be done | Contraindicated |
Irrigation | Not needed | Usually required |
Catheterization | Short | Long |
Blood Transfusion | 1 in 10000 | 10-15 in 100 |
Recovery | Very soon | Few weeks |
Hospital stay | 36-48 hrs. | 4-7 days |
Risk of Stricture, Bladder | Insignificant | High Risk |
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