PROSTATE ENLARGEMENT (Benign Prostatic Hyperplasia)
Benign Prostatic Hyperplasia or BPH refers to the gradual enlargement of prostate glands noted in men. The enlargement may be minimal in some men and quite massive in others. The set of symptoms associated with BPH are decreased urinary stream, difficulty in starting a urinary stream, frequent urination, strong urgency to urinate and the need to awake from sleep in order to urinate. Even though these symptoms are usually chalked up to a large prostate, the actual size of the gland does not necessarily correlate with severity of symptoms. In fact, many women have similar symptoms and they don’t have a prostate gland. So it’s important to focus on the symptoms and not just the size of the prostate gland.

If your doctor has ruled out other important issues such as blood in the urine and infection, then the initial therapy may be behavior modification for mild cases. This includes decreasing irritating foods such as caffeine and trying to limit fluid intake before bedtime. By trying to take in your fluids more during the morning and less before bed, you reduce the amount of urine production at night. Herbal supplements such as Saw Palmetto offer some relief.

Medical therapy usually involves a class of medicines called alpha blockers. Additionally, medications such as Avodart or Proscar can be used to help reduce the size of the prostate gland and can be helpful in men with larger glands.

If medical therapy is not successful surgical therapy is used. This may include minimally invasive procedures where microwave energy or radio-frequency energy is used to heat the prostate in order to cause shrinkage of the prostate gland. Some patients with more obstructive problems may require a removal of tissue through the urethra. This procedure is called a transurethral resection of the prostate or TURP. Certain lasers can also be used to vaporize prostate tissue using the same endoscopic technique through the urethra. For very large glands an open surgery may be required which removes the enlarged obstructive tissue inside the prostate and the capsule of the prostate is sutured closed again. This is different than the radical prostatectomy, which removes the entire prostate gland in cases of prostate cancer.