The Benign Prostatic Hyperplasia (BPH), also known as benign prostatic enlargement, is a common health issue, especially in older men. In this article, we will take a closer look at the causes, symptoms, and various treatment options for BPH/BPS, as well as relevant medications such as Tamsulosin and other alternatives.
What is Benign Prostatic Hyperplasia (BPH)?
Benign Prostatic Hyperplasia (BPH) refers to the non-cancerous enlargement of the prostate gland that occurs with age. The prostate is a gland in the male reproductive system that surrounds the urethra. When it enlarges, it can exert pressure on the urethra and cause various symptoms.
Symptoms of Benign Prostatic Hyperplasia
An enlarged prostate can cause various symptoms, including:
- Frequent urination, especially at night
- Difficulty urinating or starting and stopping the flow of urine
- Weak urine stream or the feeling that the bladder is not completely emptied
- Urgent need to urinate
- Dribbling or incontinence
These symptoms can affect the quality of life and should be medically examined.
Causes of Prostate Enlargement
The exact cause of benign prostatic enlargement is unknown, but it is believed that hormonal changes associated with aging and changes in hormone levels, especially the hormone dihydrotestosterone (DHT), could play a role.
Treatment Options for BPH
There are various treatment options for Benign Prostatic Syndrome, depending on the severity of the symptoms and the individual's health condition. These include:
Medical treatment for BPH
For the treatment of BPH, simple lifestyle changes can already be of great help. These include reducing the consumption of caffeine, carbonated, or alcoholic beverages to ease nighttime urination. Similarly, limiting or avoiding diuretics such as nicotine, caffeine, and spicy foods is advisable.
Additionally, chronic constipation and regular bowel movements can have a positive impact on the symptoms. Effective bladder training, where the urge to urinate is actively suppressed, can reduce the frequency of urination and positively influence bladder irritation. Our 'Urge Stop' menu offers various methods for suppressing the urge to urinate and is worth a try.
For dribbling, special techniques for emptying residual urine from the urethra or pelvic floor training can be helpful. This includes, for example, stroking the penis after urination. Applying pressure in the perineal area after urination can also contribute to complete emptying of the urethra. For men with frequent urination, we recommend a special bladder training.
It is important to consider the potential effects of commonly prescribed medications on BPH symptoms. Therefore, both prescription and over-the-counter medications should be checked for their side effects to ensure they do not worsen the symptoms. Before considering medication therapy, all non-pharmacological approaches should be exhausted, as you can learn in our 12-week therapy program. Kranus Lutera can also be used as a supplement to medication treatment to improve therapy outcomes and enhance the quality of life.
There are various therapy options for BPH. Herbal medicines, also known as phytotherapeutics, can alleviate mild symptoms. These include saw palmetto berries, pumpkin seeds, nettle root, as well as phytosterols and grass pollen. Studies have shown that saw palmetto extract (Serenoa repens) can improve urinary flow and nighttime toilet visits with prolonged use.
In cases of mild prostate enlargement, alpha-blockers (e.g., Tamsulosin, Alfuzosin, or Doxazosin) or the PDE-5 inhibitor Tadalafil are commonly prescribed standard medications. These medications relax the muscles in the lower urinary tract, facilitating urine flow. However, alpha-blockers can lead to low blood pressure, dizziness, and retrograde ejaculation. PDE-5 inhibitors can cause headaches, facial flushing, a stuffy nose, and digestive issues.
In cases of significant prostate enlargement, 5-alpha-reductase inhibitors (such as Finasteride and Dutasteride) can be effective. They inhibit the conversion of testosterone to the active dihydrotestosterone (DHT), which promotes prostate growth. Lowering DHT levels can counteract prostate growth but may also lead to decreased sexual desire and erectile dysfunction. These side effects may persist even after discontinuing the medication.
For irritative symptoms like constant urgency to urinate, anticholinergics can be added. They relax the bladder muscles but can cause side effects such as dry mouth, constipation, headaches, restlessness, and memory problems. The high rate of bothersome side effects often leads to discontinuation of the therapy, and in this case, switching to a different preparation may be advisable. Not all anticholinergics have the same side effects. Similarly, beta-3-adrenoreceptor agonists like Mirabegron relax the bladder and thus increase functional bladder capacity, but they can cause palpitations and more frequent bladder infections.
Surgical Treatment Options for BPH
If the symptoms do not improve despite medication or conservative measures, or if complications such as urinary retention occur, surgery to reduce the prostate size may be necessary. This can often be done minimally invasively through the urethra.
A commonly used surgical method is transurethral resection of the prostate, abbreviated as TUR-P. In this procedure, prostate tissue is endoscopically removed using an electric loop. As with any surgery, there are risks of complications, such as inflammation or bleeding. In rare cases, injury to the urethral sphincter can lead to incontinence. Nowadays, TUR-P is often successfully replaced by enucleation of the prostate. This can be done using various methods, including lasers (Holmium laser, Thulium laser, or Greenlight laser) or a bipolar power source. Alternatively, procedures such as prostate embolization, transurethral microwave therapy, steam or needle ablation are also options. For mild complaints, the use of tissue retractors (Urolift) without removing prostate tissue may be helpful.
For the treatment of an overactive bladder, Botox injection into the bladder muscle can also be helpful.
Important Questions about Benign Prostatic Syndrome
How does an enlarged prostate manifest?
An enlarged prostate manifests through symptoms such as frequent and urgent urination, difficulty urinating, and a weak urine stream. These symptoms can significantly affect the quality of life.
What happens if an enlarged prostate is left untreated?
Untreated, an enlarged prostate can lead to more serious complications such as urinary tract infections, urinary retention, bladder stones, or kidney damage. It is important to seek medical help and receive the appropriate treatment.
Is an enlarged prostate dangerous at all?
An enlarged prostate is not inherently life-threatening, but it can significantly affect the quality of life. If left untreated, complications can occur, causing serious health problems such as chronic kidney damage.
Overall, it is crucial to consult a doctor if you suspect an enlarged prostate and take appropriate steps for diagnosis and treatment.
Kranus Lutera and BPH
Benign Prostatic Hyperplasia (BPH) is a common condition in older men that can cause various bothersome symptoms. Fortunately, there are many treatment options, including medical therapies and various surgical procedures, to alleviate the symptoms and improve the quality of life. If symptoms persist or are distressing, seeking medical advice is essential. Kranus Lutera provides a sustainable and holistic treatment of the causes.