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BENIGN PROSTATIC HYPERPLASIA
|
| What is
BPH? |
|
Benign prostatic
hyperplasia (BPH) is a condition that often begins at about
40-45 years, due to hormonal changes that result in prostatic
enlargment . The word “benign” means that the enlargement
is not caused by cancer or infection. The word “hyperplasia”
means enlargement.
|
| What is the prostate gland ? |
It is a walnut sized gland that is part of the male reproductive system.
|
| Where
is the prostate gland located ? |
|
It
is located below the bladder (the organ where urine is
stored) and surrounds the upper portion of the urethra
(the tube that carries urine out of the body)
|
|
| What
is the function of the prostate gland ? |
| It
produces part of the semen in which sperm travel. |
|
| What
are the reasons for this enlargement ? |
|
The
reasons are not entirely clear but ageing and hormonal
changes appear to play an important role.
|
|
| What
are the common problems faced due to this ? |
|
As
the prostate gland increases in size it causes the
gland to pinch against the urethra like a clamp on a
garden hose.As a result it can lead to the following
problems. It can put pressure on the urethra and slow
down or cut off the flow of urine.The bladder wall
becomes thicker and irritable leading to contraction
of bladder even when it contains small amounts of
urine, causing more frequent urination.Eventually, the
bladder weakens and loses the ability to empty itself.
|
|
| Symptoms
of BPH |
Weak
urine stream
Dribbing after voiding.
Frequent urination, particularly at night (i.e
nocturia)
Feeling of incomplete emptying of the bladder.
Hesitancy – leakage of urine (i.e. overflow
incontinence)
Straining or pushing to begin urination.
Blood in the urine (i.e. haematuria ) caused by
straining. |
 |
| What
are the complications that can develop if symptoms are
ignored ? |
Urine
retention
Strain on the bladder
Bladder stones, UTI, Bladder or Kidney damage,
Incontinence.
|
|
| Does
the size of the prostate determine severity of
symptoms ? |
|
The
size of the prostate does not always determine how
severe the obstruction or the symptoms will be. Some
men with greatly enlarged glands have little
obstruction and few symptoms while others whose glands
are less enlarged, have more blockage and greater
problems.Sometimes a man may not know that he has any
obstruction until he suddenly finds that he is unable
pass urine at all called acute urinary retention.
|
|
| Diagnosis
of prostate problems |
|
Medical
evaluation will include a
History
Physical examination
Preliminary tests.
The following universal symptoms chart helps you to
evaluate your symptoms by yourself.- AUA SYMPTOM SCORE
Physical Examination
A physical examination helps your doctor evaluate your
general health. Your doctor will also assess you
prostate with a digital rectal examination, preformed
by insuting a finger into the rectum and feeling the
prostate to enable your doctor to detect an enlarged
prostate or other abnormalities.
Laboratory Investigations
Urine investigations like urine culture to rule out
urinary tract infection.PSA (Prostate specific
antigen) blood test is used to detect abnormally high
levels of a Protein substance in your blood that may
indicate prostate cancer.
|
Diagnostic
tests |
|
These
test serve as a baseline for comparsion to future
tests and to follow your response to treatment.
Uroflow :- Metering how quickly or slowly your
urine flows can show a blockage.
Ultrasound :-
Ultrasound uses sound waves to create a
two-dimensional image of your prostrate, bladder or
kidneys.
|
|
| Treatment
options |
| If
other conditions have been ruled out through testing
your doctor may determine that you have BPH. A Variety
of treatment approaches can help solve BPH problems. |
 |
| Medication |
|
To
provide relief for your symptoms, medications may be
needed to relax the muscles of your prostate to block
hormones that cause prostatic growth, or to relax your
bladder and improve continence.
|
|
| Surgery |
|
There
are two types of surgery to remove excess prostate
tissue.
1. Trans-urethral resection of prostate (TURP)
a. Is the most commonly employed method.
b. During this procedure an instrument is inserted
through the penis to sallow your doctor to see &
remove any tissue blocking your urethra and bladder.
2. Open prostatectomy
a. May be done when a large amount of tissue must be
removed or when the size, shape or position of the
prostrate makes it necessary.
b. An incision is made in the abdomen or the area
between the anus and scrotum and the excess tissue is
removed.
|
|
| Complications |
- Retrograde
ejaculation - If during surgery the muscle that is
involved in ejaculation may be cut, semen may
travel backward into the bladder during an orgasm,
instead of traveling out of the body through the
urethra.
-
Infection.
- Pneumonia
- Blood
clots
- Excessive
bleeding.
- Impotence
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| Paediatric Urology Related Disease info |
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