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Benign Prostatic Hyperplasia (Enlarged Prostate) in the Elderly

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Benign prostatic hyperplasia (BPH), or Enlarged Prostate, refers to the abnormal enlargement of the prostate gland. The prostate is a walnut-sized gland In front of the rectum and below the bladder. This gland releases fluids that protects and aids in the development of sperm. The prostate naturally grows larger as you age, but can cause urinary problems if it grows past a certain size. When the gland grows unusually large, it squeezes the urethra, which thickens the bladder wall and causes urinary problems.

Benign prostatic hyperplasia (BPH) enlarged-prostate

Causes

The exact cause of BPH is unknown. It may be related to natural hormonal growth and changes and we age. For example, some common hormones produced by males are testosterone and estrogen (more testosterone), but the amounts of each vary for everyone over time. These are some factors that may increase the risk of BPH:

  • Obesity
  • Lack of exercise
  • Type 2 Diabetes
  • Over the age of 40
  • A family history of BPH
  • Current heart or cardiovascular diseases
  • Erectile Dysfunction

Symptoms

As the urethra is squeezed, it becomes narrower and causes in the bladder needing to use more force to transport urine. This results in the muscles in the bladder to become thicker, stronger, and more sensitive, which leads to more frequent urination due to the need to contract even for small amounts of urine. It will reach a point when the bladder muscle is not able to empty out all of the urine in the bladder. Some symptoms are:

  • Frequent urges to urinate
  • Weak urinary stream
  • Hard to start continue urinating
  • Often need to urinate immediately after urinating
  • Frequent visits to the bathroom during the night
  • Feeling of your bladder not being completely emptied after urinating

 

Benign prostatic hyperplasia (BPH)

 

Treatment

There are various methods used to treat BPH. Some drugs known as alpha blockers, relax prostate and bladder muscles, which makes it easier to urinate. They have immediate effect on the symptoms, but cause side effects like dizziness, sleepiness, and difficulty ejaculating. Here are some examples:

  • Flowmax (tamsulosin)
  • Hytrin (terazosin)
  • Cadura (doxazosin)
  • Uroxatral (alfuzosin)

 

Another method to treat BPH, where more severe symptoms like bladder stones, tract infections, or incontinence are present, surgery is another treatment. The most common surgical treatment is called transurethral resection of the prostate (TURP). In this method, a device is inserted into the urethra to cut off pieces of the enlarged prostate with wire.

Other surgical methods include:

  • Prostatic stent (tube inserted into urethra to keep it open)
  • Transurethral microwave thermotherapy (uses microwaves to destroy extra tissue)
  • Transurethral microwave ablation (shrinks extra tissue)
  • High-intensity ultrasound (destroys extra tissue with heat)
  • Water-induced thermotherapy (uses hot water to destroy extra tissue)

 

If not treated, there are some serious complications that could develop as a result of BPH:

  • Urinary tract infections
  • Bladder/kidney damage
  • Blood in urine
  • Urinary retention (Unable to completely empty bladder)
  • Bladder stones
  • Urinary Incontinence (Unable to control bladder)

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