Benign Prostatic
Hyperplasia |
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Also Listed As: |
BPH; Prostate
Enlargement |
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Benign prostatic hyperplasia (BPH), a noncancerous growth of the prostate
gland, makes urination difficult and uncomfortable. The expanding prostate
squeezes the urethra, the channel that carries urine from the bladder. BPH
affects only men. Symptoms usually develop around age 50. At age 60, you'll most
likely have BPH. At age 80, you'll have an 80 percent chance of experiencing
urination problems caused by BPH. |
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Signs and Symptoms |
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- The need to urinate frequently
- Inability to sleep through the night without getting up to
urinate
- Difficulty starting urine stream or complete inability to
urinate
- Decreased strength and force of the urine stream
- Dribbling after urination ends
- Blood in the urine (BPH can cause small blood vessels to
burst)
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What Causes It? |
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Nobody knows the basic cause of BPH. Research shows that testosterone, the
male hormone, or dihydrotestosterone, a chemical produced when testosterone
breaks down in a man's body, may cause the prostate to keep growing. Since it
surrounds the urethra, the prostate gland squeezes the urethra as it expands.
Some over-the-counter medications for colds or allergies can drastically worsen
BPH. |
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What to Expect at Your Provider's
Office |
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Your health care provider will feel your prostate gland directly by putting a
gloved finger in your rectum. He or she will also order blood tests and possibly
a urine sample. Your health care provider may also ask you to urinate into a
device that measures the flow of urine. In intravenous pyelography, your health
care provider injects a dye into a vein to make the flow of urine visible on an
X ray. In cystoscopy, your provider uses a small probe, passed through your
urethra, to directly view the inside of your urethra and bladder. Your penis
will be numbed before this procedure. |
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Treatment Options |
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Treatment Plan |
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Treatment will depend on your age, overall health, and the severity of the
disease. BPH clears up by itself in one-third of mild cases. It is important to
receive regular check-ups to monitor the disease. Treatment will begin as soon
as your symptoms become bothersome. There are various nonsurgical procedures for
BPH. They include microwave and laser treatments. There are also several types
of surgery to correct the condition. Balloon urethroplasty uses a balloon to
widen the urethra and improve urine flow. Prostatic stents do the same thing
with a spring-like effect. Transurethral resection, or removal of a part of the
urethra, is done in 90% of BPH surgeries. |
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Drug Therapies |
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- Antibiotics—clear any infections prior to BPH
treatment
- Alpha blockers—relieve symptoms by relaxing
tissue in the area of the prostate
- Finasteride—a drug that can shrink the
prostate; can take up to three months to
work
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Surgical Procedures |
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Balloon urethroplasty uses a balloon to widen the urethra and improve the
flow of urine. Prostatic stents do the same thing with a spring-like device.
Transurethral microwave therapy and transurethral hyperthermia are new
treatments that use microwaves or heat to destroy prostate tissue.
Transurethral resection of the prostate, used on 90 percent of patients
undergoing BPH surgery, removes pieces of the enlarged prostate through the
urethra. A less invasive method, transurethral incision of the prostate, makes
small cuts in the prostate and the neck of the bladder. Laser surgery vaporizes
excess tissue in the prostate. |
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Complementary and Alternative
Therapies |
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Your health care provider may want to keep a close eye on your condition as
part of the management of BPH. |
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Nutrition |
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- Zinc (60 mg per day)—to reduce the size of
the prostate
- Selenium (200 mcg per day)—antioxidant in
the prostate
- Essential fatty acids (1,000 to 1,500 IU one to two times per
day)—anti-inflammatory, for optimum prostaglandin
concentrations
- B6 (100 to 250 mg per day)—reduces the
elevated levels of prolactin found in people who have BPH
- Amino acids glycine, glutamic acid, and alanine (200 mg per day of
each)—provide relief from symptoms
- Avoid alcohol, especially beer, and saturated fats
- Pumpkin seeds can help maintain a healthy
prostate
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Herbs |
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Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Unless otherwise
indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep
covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
Drink 2 to 4 cups per day.
- Saw palmetto (Serenoa repens)—160 mg
twice a day is difficult to achieve in tea or tincture; extract standardized for
85 percent to 95 percent of fatty acids and sterols is recommended. Saw palmetto
is widely used in Europe.
- Stinging nettle root (Urtica
dioica)—Increases urinary flow and volume. Daily
dose of 4 to 6 g of drug or equivalent
preparation.
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Homeopathy |
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Some of the most common remedies used for this condition are listed below.
Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four
hours until your symptoms get better.
- Chimaphila umbellata is specific for retention of urine with an
enlarged prostate
- Conium for BPH with a feeling of heaviness in the pelvic area,
especially with premature ejaculation
- Pareira for urinary retention with BPH, especially with painful
urging or pain in the bladder
- Selenium for BPH with dribbling, impotence, and
constipation
- Thuja occidentalis, specifically if there is a forked stream of
urine
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Physical Medicine |
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- Kegel exercises (contracting and releasing the pelvic
muscles)
- Contrast sitz baths. You will need two basins that can be comfortably
sat in. Sit in hot water for three minutes, then in cold water for one minute.
Repeat this three times to complete one set. Do one to two sets per day, three
to four days per
week.
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Following Up |
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Whatever your treatment, have regular checkups. After prostate surgery, drink
plenty of water, eat a balanced diet, avoid heavy lifting and operating
machinery, and don't strain when you move your bowels. |
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Supporting Research |
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Berkow R, Beers MH, et al., eds. Merck Manual of Medical Information: Home
Edition. Whitehorse Station, NJ: The Merck Publishing Group; 1997.
Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic
Guide to Herbal Medicines. Boston, Mass: Integrative Medicine
Communications; 1998:201.
Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms.
Albany, Calif: Hahnemann Clinic Publishing; 1993:119, 141, 286, 341,
388-389.
Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed.
Rocklin, Calif: Prima Publishing; 1998:480-486.
Prostate Enlargement: Benign Prostatic Hyperplasia. The National
Kidney and Urologic Diseases Information Clearinghouse. NIH publication no.
91:3012.
Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats
Publishing; 1988:82-84. |
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Review Date:
August 1999 |
Reviewed By:
Participants in the review process include: R.
Lynn Shumake, PD, Director,
Alternative Medicine Apothecary, Blue Mountain Apothecary & Healing Arts,
University of Maryland Medical Center, Glenwood, MD; Tom Wolfe, P.AHG, Smile
Herb Shop, College Park, MD.
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