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BPH

What is BPH?

Benign Prostatic Hyperplasia, or BPH, is a condition associated with the enlargement of the prostate gland. The prostate gland in males is located below the urinary tract surrounding the urethra. The condition is referred to as benign, suggesting it is not cancerous. The term ‘prostatic’ is associated with the prostate gland, and ‘Hyperplasia’ refers to the enlargement of the gland.

The primary function of the prostate gland is to produce the fluid that nourishes and transports sperm (seminal fluid). However, people with an enlarged prostate find it difficult to empty their bladder properly due to the narrowing of the urethra. This results in the frequent urge to urinate, especially at night. It is estimated that more than 70% of men are likely to have an enlarged prostate over 50 years, out of which 25% require surgical procedures. 

Benign Prostatic Hyperplasia formation

How does BPH occur?

The leading cause of BPH or enlarged prostate is still under debate. However, prostate gland enlargement mainly occurs due to hormone changes that trigger prostate cell growth. Some studies have revealed that high levels of dihydrotestosterone (DHT), which is found mostly in men older than 50 years supports prostate development. Other reasons for BPH can be lifestyle, eating disorders, obesity, heredity, etc.

Causes

  • Aging
  • Infection in the urinary tract
  • Inflammation of the prostate
  • Change in male sex hormones
  • Damage or injury to the testicles

Symptoms

  • Increased frequency of urination at night (nocturia)
  • Difficulty starting urination
  • Inability to urinate (in severe cases)
  • Weak urine stream
  • Blood while urinating
  • Dribbling at the end of urination
  • Inability to completely empty the bladder

Diagnosis

The doctor will recommend the following tests to rule out the possibility of enlarged prostate due to other conditions. Some of the diagnostic tests include – 

  • Ultrasound – Doctors generally recommend an ultrasound of the prostate gland to detect any abnormal growth within the prostate using 3D imaging. This test helps determine the amount of enlargement around the prostate. 
  • Prostate-specific antigen (PSA) blood test – Doctors usually recommend a PSA blood test to check for any increased PSA levels in an enlarged prostate. This helps the urologists to detect signs of prostate cancer. 
  • Urinary flow test – This test is done to measure the strength and amount of your urine flow and determine if the condition is stable or getting worse with time. 
  • Postvoid residual volume test – Sometimes, when the patient is unable to empty the bladder completely, this test is recommended to measure the amount of urine left in your bladder after the urination. This is done via ultrasound or inserting a catheter into your bladder. 
  • 24-hour voiding diary – The doctors recommend this test to record the frequency and amount of urine expelled, especially if more than one-third of your daily urinary output occurs at night.
  • Urine test – The doctor analyzes a sample of your urine to rule out any signs of infection or other conditions that can lead to similar symptoms. 
  • Blood tests – Blood tests indicate any infections in the kidneys and indicate abnormal functioning. 
Test of Benign Prostatic Hyperplasia

SEVERITY

The severity of BPH is categorized into three grades based on the comprehensive review of the lower urinary tract symptoms, digital rectal examination, urinalysis, and PSA measurement. The scores are given with respect to AUA (American Urological Association) symptom index after careful observation.

Risks & Complications

The surgical procedures for BPH surgery are safe and efficient to treat enlarged prostate. However, like any other surgery, there are several risks involved with the procedure that can lead to several complications. It all depends on the medical condition of the patient and the surgical expertise of the surgeon.

 

Some of the risks associated with the different surgical procedures of BPH are as follows –

  • Abnormal bleeding during the surgery that may require transfusion
  • Improper fluid absorption 
  • Retrograde ejaculation; when semen flows into your bladder
  • Erectile dysfunction
  • Infection around the surgical site
  • Urinary incontinence
  • Urethral stricture that results in ‘split-stream’ of urine
  • Post TURP syndrome; symptoms include shortness of breath, seizures, and coma

  • Prevention of Benign Prostatic Hyperplasia

    PREVENTION:

    Prevention of Benign Prostatic Hyperplasia

    There are several lifestyle changes that can help you prevent BPH and keep your prostate healthy. These include several lifestyle changes and dietary restrictions. Here are some measures that can prevent BPH – 

    • Avoid supplements
    • Keep a healthy body weight
    • Avoid red meat and processed meat
    • Encourage consumption of fruits and vegetables

When to consult a Urologist for BPH treatment?

It is important to seek medical attention if you’re having issues related to the urinary tract. Patients who experience symptoms associated with an enlarged prostate, such as improper emptying of the bladder, nocturia, or any obstruction in the urinary tract, are at risk of BPH. Consult a urologist if you are experiencing the following symptoms – 

  • Nocturia 
  • Frequent urination
  • Blood in urine
  • Erectile dysfunction
  • Having trouble urinating

Questions to ask your Enlarged Prostate Doctor

Will I need medication for my treatment?
What is the chance of recurrence of BPH?
I am currently suffering from a (health condition). How can I manage them together?
How often do I need a follow-up visit?
How many surgeries have you performed?
Should I get a second opinion?
How long does it take to recover fully after the treatment?

Treatment overview

Non-surgical methods for BPH include various medications, dietary changes, and lifestyle modifications. However, these medications mostly reduce symptoms associated with the enlarged prostate and do not cure the disease. 

Insurance coverage for Benign Prostatic Hyperplasia

Insurance coverage

The surgeries for BPH are done to reduce symptoms that cause great discomfort due to enlarged prostate. Lack of treatment can cause severe complications that may require surgical procedures. Therefore, a surgical procedure to treat BPH is deemed a medical necessity.

So, some medical insurance companies cover the cost of surgical procedures for BPH partially or entirely. However, the insurance claim will depend on the type of your insurance policy and the terms and conditions set by the insurance provider. There are also other payment options to pay for the BPH surgery. A few of the insurance providers that may cover the cost of enlarged prostate are as follows:

  • Star Health Insurance
  • New India Health Insurance
  • Bajaj Allianz
  • Religare
  • ICICI Lombard
Insurance coverage for Benign Prostatic Hyperplasia
Recovery rate of Benign Prostatic Hyperplasia

Recovery rate

The recovery from enlarged prostate surgery can vary depending on the patient’s health condition and the surgical expertise of the surgeon. The post-recovery tips provided by the doctor also depend on the type of surgical technique used for the procedure. However, it is important to consult with your doctor regularly to avoid any complications and ensure a faster recovery. Some of the post-operative care after your BPH surgery are-

  • Do not lift heavy equipment for around a week after your surgical procedure. 
  • Restrict heavy exercises for about 6 weeks after prostatectomy. 
  • Drink plenty of fluid during the first 2 weeks after the surgery to flush any new bleeding from the bladder.
  • Avoid alcohol and coffee for the first few weeks after the procedure. 
  • Avoid food that can cause constipation or force you to strain during bowel movements.
Recovery rate of Benign Prostatic Hyperplasia

FAQ

How can BPH affect my life?

BPH can get worse with age leading to improper emptying of the urinary bladder. This can result in infection, bladder damage, and blood in urine which can cause kidney damage. 

What are the risk factors that can lead to an enlarged prostate?

Some risk factors that contribute towards the progression of enlarged prostate are- 

  • Diabetes 
  • Obesity 
  • Age factor 
  • Heredity 
  • Erectile dysfunction
What is the difference between prostatitis and BPH?

Prostatitis refers to the inflammation of the prostate due to traumatic injury to the prostate or due to the bacteria that entered the prostate from urine or during sex. Benign prostate hyperplasia or BPH refers to the enlargement of the prostate gland that squeezes the urethra, making it hard to empty the bladder completely.

What medications should I avoid if I have BPH?

Inform your doctor of any pre-existing medications before your BPH treatment. These medicines can worsen your BPH symptoms. Avoid following medications if you have any symptoms related to an enlarged prostate – 

  • Diuretics
  • Antidepressants
  • Antihistamines
  • Decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
What are the complications of an untreated BPH?

If left untreated, BHP has the potential to lead to serious complications, ranging from UTIs, stone in bladder to kidney damage and complete renal failure.

Is Prostate Cancer the same as BPH?

An enlarged prostate or BPH is completely benign meaning it is not cancerous. It is not a precursor to prostate cancer.

Is Prostate Cancer the same as BPH?

An enlarged prostate or BPH is completely benign meaning it is not cancerous. Prostate cancer occurs when the cells in the prostate gland start to grow out of control. 

What foods and drinks should I avoid to prevent BPH?

Avoid following foods and drinks to prevent enlargement of the prostate gland – 

  • Soda 
  • Coffee
  • Alcohol 
  • Saturated fats