BENIGN PROSTATIC HYPERTROPHY
Why does Benign Prostatic Hypertrophy occur ?
The cause for prostate enlargement is unknown. However, male hormones influence the enlargement of the prostate. It is rare to see enlargement of the prostate in men whose male hormone levels are very low. There is little difference between races, and environmental factors do not seem to be significant. Treatment Involved for Benign Prostatic Hypertrophy
The surgeon (urologist) must first prove that the prostatic enlargement is the cause of the symptoms. He may find it helpful to measure the urinary flow rate. This is a simple test: you pass urine into a large funnel and the time taken for a particular volume of urine to pass is calculated electronically. The urologist will also arrange an x-ray or ultrasound scan to make a picture of the bladder after an attempt at emptying. This will reveal whether the prostate is causing obstruction to the urethra. The ultrasound scan will also check that the kidneys are normal. In some hospitals, the size and the shape of the prostate can also be measured by ultrasound. An ultrasound probe, a little larger than an index finger, can be inserted into the rectum to make a more accurate picture of the prostate. This technique can also be used for taking specimens (biopsies) of the prostate, if there is any suspicion of cancer. The best method of treatment for most cases is by an operation called a transurethral prostatectomy. Sometimes when the prostate is small and the symptoms are mild, medical treatment can be helpful. At the present time, various drugs are available, including some which lower male hormone levels in the prostate. None of them have proved to be better than operation but they may be useful in some patients. Recently, a few hospitals have been testing a microwave heat treatment to shrink the prostate. Such treatment is not very successful, and it is difficult to predict which patients are most likely to benefit. Laser treatment for the prostate has also been developed. The use of the laser is attractive because there is very little bleeding and the hospital stay is reduced. At present the results of laser treatment are variable, and more research will be required before laser treatment can be recommended for more than a few cases. In most cases, a transurethral prostate operation (TURP) will be recommended. If symptoms get worse, or if bleeding occurs, consult your doctor. If Benign Prostatic Hypertrophy is Left Untreated
In about a quarter of patients, the symptoms remain unchanged. Often the symptoms gradually or suddenly worsen. The bladder may hardly empty at all or may cause back pressure on the kidneys, causing kidney failure. Such a complication may produce general unwellness and sickness, but may occur to quite an advanced degree without giving you any symptoms at all. If the bladder cannot empty properly, the urine may become infected, causing pain and fever. It is possible that you may be unable to pass any urine at all. This is usually painful and emergency hospital admission is required to drain the urine with a tube called a urethral catheter. If this happens, prostate operation will almost certainly be needed. Occasionally the bladder distends more slowly and without pain. Eventually the urine begins to leak. This is called chronic urinary retention and also requires treatment by bladder catheter and then operation. |
|
