Some Experience & Gained Practical Medical Advice for Benign Prostatic Hyperplasia (B P H)

WHAT SHOULD YOU DO ABOUT IT?

I personally suffered from BPH for over 30 years. I would like to share my personal experience about BPH, which may be different from routine recommendations with my readers.

As I see it, BPH is an evolution determined design, just like menopause in women, to limit reproductive function of our species to the younger generation.

A normal prostate is a walnut size glandular and muscular tissue that surrounds the urinary outflow tract (Urethra) at the base of urinary bladder. Its main function is to make ejaculation fluid and ejaculate it at the climax of a sexual activity.

Hyperplasia of the prostate, in every man, stars in form of adenomatous nodules, as early as age 35 – 45, and Its incidence, gradually increases with age. At the age 80, more than 80% of men have BPH.

The real reason (etiopathogenesis) of BPH is not known. Hyperplasia starts in the center of the prostate and causes the enlargement of the prostate and narrowing of the urethra, thereby causing the urinary bladder out flow obstruction, and the following urinary symptoms:

1-     Urinary urgency

2-     Frequent urination, especially at night (nocturia)

3-     Difficulties starting urinary flow

4-     Urinary stream becomes very thin and sometimes it forks

5-     Bearing down while urinating

6-     It takes longer to finish urinating

7-     Urinary flow reduces to drips at the end urination

8-     Having occasional bloody urine is common

9-     Feeling that the bladder is not completely empty after urination

10-  Erectile dysfunction (ED) often associated with BPH

11-  BPH symptoms get worse after sexual activities.

When you have any or combination of these symptoms, the best thing to do is to see a Urologist. Because the symptoms of prostate cancer and urinary bladder cancer are the same symptoms as BPH. The urologist does the necessary examinations and imaging studies to eliminate these malignancies in the urinary tract, including cystoscopy and possibly prostate biopsies. If malignancy eliminated, you are left with the diagnosis of BPH, and you have four coping and/or management options:

1-     Do nothing, try to live with minor inconveniences of BPH.

2-     Take recommended medications on daily basis for many years to come.

3-     Have non-surgical, minimally invasive, office procedures directed to reduce the obstruction.

4-     Have prostate surgery either in form of TURP (trans urethral resection on the inner part of the prostate) or open surgery with removal of the whole prostate.

I have selected not to do anything for personal reasons. I recommend the followings for those of you who think like me:

1-     Do not cut down water or liquid intake after 8 PM, as recommended. It causes concentrated urine that promotes infections in the urinary tract and, bladder stone formation. Instead drink sips of water when awakened with a dry mouth, at night to urinate, every time.

2-     Urinate standing up to help gravity to empty your bladder.

3-     Prevent constipation. Constipation makes BPH symptoms worse.

4-     Cut down on red meat and processed meat consumption and follow a vegetarian diet. Avoid spices. Spices excreted in the urine and cause burning, and irritation in bladder.

5-     Hormonal therapy for BPH for me, is nothing more than chemical castration. And drugs given to reduce bladder and prostate muscle contractions, prevent the emptying of the bladder. While they abolish muscle contractions of the bladder and, they can cause cardiac arrhythmias, low blood pressure and dizziness.

6-     Minimally invasive procedures like Needle ablation, Heat ablation, Urolift are office procedures that I have tried, and all provided only partial and temporary relief, except prostatic ureteral lift procedure. I benefited from it but it is only good if the middle lobe of the prostate is not enlarged. It could be repeated if necessary.

7-     All medications and non-invasive office procedures can cause sexual disfunction like ED, dry ejaculation or retrograde ejaculation.

8-     Do not delay TURP (Trans Urethral Resection Prostate) surgery, if the quality of your life and you sleep pattern is affected and if you develop frequent urinary tract infections, bladder stone formation, kidneys dysfunctions, or complete obstruction of urinary flow. TURP is still considered gold standard for the treatment of BPH.