CONSULTANT
CONSULTANT
Jewel Urology Center, Mumbai
Nanavati Hospital, Mumbai
Saifee Hospital, Mumbai
DR. VIVEK VENKAT
Compassionate Evidence-Based Ethical Cancer Care
docvivek@gmail.com
WHAT ARE THE RISK FACTORS AND CAUSES?
The prostate gland is a walnut-sized organ just below the urinary bladder.
Benign prostate enlargement (BPE or BEP), also called benign prostate hyperplasia (BPH), is a non-cancerous growth of the prostate after the age of 40-50 years.
By 60 years of age, half of men will have the condition and this increases to 90% by age 85 years. Half of these men need some treatment.
Men over 50 years of age and those with symptoms should discuss a prostate check-up with their primary doctor or urologist.
BPH is due to a change in hormone concentrations within the prostate as a result of aging.
Positive family history, diabetes mellitus and obesity are risk factors to develop the condition.
The prostate gland is a walnut-sized organ just below the urinary bladder.
Benign prostate enlargement (BPE or BEP), also called benign prostate hyperplasia (BPH), is a non-cancerous growth of the prostate after the age of 40-50 years.
By 60 years of age, half of men will have the condition and this increases to 90% by age 85 years. Half of these men need some treatment.
Men over 50 years of age and those with symptoms should discuss a prostate check-up with their primary doctor or urologist.
BPH is due to a change in hormone concentrations within the prostate as a result of aging.
Positive family history, diabetes mellitus and obesity are risk factors to develop the condition.
WHEN SHOULD YOU SEE A DOCTOR?
- Reduced speed or flow of urine
- Taking a long time to start or stop urine
- Straining your muscles to empty the bladder
- Interrupted flow or dribbling urine
- Sense of incomplete emptying of urine
Difficulty in passing urine
- Increased frequency
- Waking up more than 1-2 times at night
- Urgency - difficulty in controlling urine
- Occasional leakage of few drops before reaching the bathroom
Difficulty in storing urine
- Inability to pass urine (retention) – a complete stoppage of urination associated with pain and discomfort is known as acute urinary retention. This is an emergency and usually needs a tube (catheter) inserted in the bladder to drain it.
- Chronic retention and kidney damage – If a large amount of urine remains in the bladder (>300ml) the drainage of the kidneys is blocked causing them to swell up and worsening kidney function.
- Others – repeated urinary infection, bladder stones and bleeding.
Complications of BPH/BEP
Even if the symptoms do not bother you it is important to understand their severity and monitor them to prevent complications.
- Symptom score - A questionnaire to grade symptom severity called the IPSS-AUA score.
- Prostate exam - A gloved lubricated finger is inserted into the rectum to feel the prostate size and detect any hard areas or nodules.
- Routine urine analysis – to detect infection or blood in the urine.
- Uroflowmetry – you will be asked to pass urine in a special bucket which has a sensor to measure the speed of urine flow to determine the presence and degree of obstruction.
- PSA test – blood test to assess your risk of prostate cancer.
- Ultrasound (Sonography) – assess prostate size and its protrusion into the bladder, the thickness of the bladder wall and the amount of urine left behind after urination (post-void residue). The ultrasound also determines the character of the kidneys and whether any swelling is noted (hydronephrosis) due to incomplete bladder emptying.
What are the lifestyle treatments for BPH?
Restricting fluid intake for about 2 hours before you sleep at night will help reduce the amount of times you need to wake up to pass urine.
Reduce caffeine intake and alcohol.
Training the bladder and other lifestyle changes can also help – for more details read our blog on the subject.
What are the medications available for BPH?
Medicines form the mainstay of initial treatment today. For those with mild-moderate symptoms which are bothersome medications are recommended.
Alpha blockers (Tamsulosin, Alfuzosin, Silodosin)
They relax the muscles around the opening of the bladder (bladder neck) and prostate thereby improving the ease and flow of urination.
5-alpha-reductase inhibitors (Finasteride, Dutasteride)
Block the hormonal changes causing prostate growth and shrink the prostate. And generally used in combination with alpha blockers
May take 3-6 months to show an effect.
Less common medications – Reduce bladder overactivitiy
Phosphodiesterase inhibitors (Tadalafil or Cialis)
Anticholinergics (Solifenacin, Darifenacin, Tolterodine, etc.)
Beta agonists (Mirabegron)
Natural agents (phytotherapy)
In use for a long time but exact composition and mechanism unknown Important to discuss with your urologist before taking these agents
Jewel Urology Center
No. 89, N. S. Road Number 1,
Navpada, JVPD Scheme,
Andheri West
Mumbai 400049, India
(m):+919136041545
Visiting Hours : Mon-Sat 4.30 - 6 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Nanavati Max Hospital
S.V road, Vile Parle west
Mumbai 400056, India
Visiting Hours : Mon-Sat 2 - 4.30 pm
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Saifee Hospital
15/17, Maharshi Karve Rd,
Opposite Charni Road Station East,
Mumbai 400004, India
(m):+919136041545
Visiting Hours : Thursday 11am - 1 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
