Benign prostatic hyperplasia is not really a problem as long as the affected men have no urinary problems. Only when the prostate, because of the benign cell proliferation, too much drainage of the urinary bladder and as a result leads to problems in urination, the pressure on the bladder can be a real suffering for the patient.

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia itself does not produce symptoms. These arise exclusively through the displacement processes due to prostate enlargement.
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Benign prostatic hyperplasia refers to the benign enlargement of the prostate gland as a result of cell proliferation in men, which is widespread and mainly affects older men.

Statistically, it can be said that with increasing age also the probability of an enlargement of the prostate increases. In the group of men over the age of 65, 65 percent have an enlarged prostate, and 90 percent of men over the age of 90.

The biggest problem with existing benign prostatic hyperplasia is usually the so-called micturition disorder, a urination problem that can even lead to urinary retention in a severely enlarged prostate, a complete inability to empty the bladder.

causes

It is still unclear what the causes of benign prostatic hyperplasia are, but there is evidence to suggest that age-related changes in the male hormone balance are causally responsible for cell growth.

In the discussion is the shift in the ratio of male and female hormones with age. Through the decrease in the testosterone level and a constant constant estrogen level over the years, an excess of estrogen, which could lead to a slowdown of the natural death of prostate cells.

The proliferation of glandular tissue could be due to an increased concentration of the steroid hormone dihydrotestosterone (DHT), which is synthesized from testosterone using a specific enzyme, 5-alpha reductase. Apart from DHT, however, numerous other growth factors are considered to be the cause of benign prostatic hyperplasia.

Symptoms, complaints & signs

Benign prostatic hyperplasia itself does not produce symptoms. These arise exclusively through the displacement processes due to prostate enlargement. The extent to which the existing symptoms are of medical significance arises from the current stage of the disease.

In stage I, nocturnal urinary urgency and difficult urination often occur. Urination leads to emptying disorders and irritation symptoms. The urinary stream is weakened. It takes longer for the bubble to be empty again.

The irritant symptoms are expressed by pain when urinating and frequent urination. However, no residual urine remains in the bladder at this stage. Although not yet a disease value, the quality of life is already often limited. In stage II, residual urine formation with more than 50 milliliters of urine already occurs.

The urination begins late and is constantly interrupted. In the third stage, the bladder overflows. Bladder stones can even lead to a urinary blockage leading to a stasis kidney. Urinary retention is a medical emergency requiring immediate treatment. After prolonged use, the kidneys fail. The veins are blocked in the blister outlet area.

They can rupture and cause gross hematuria (blood in the urine). It continues to benefit from urinary tract infections. In longer urinary drainage disorders, the so-called Balkenblase arises by strengthening the bladder muscles. Since the bladder is no longer completely contractible, urinary incontinence develops.

Diagnosis & History

In order to diagnose benign prostatic hyperplasia, a digital examination of the prostate is first indicated. "Digital" in this context stands for the Latin word "digitus", which means "finger" means. The scan of the prostate is made from the rectum using the finger. Subsequently, an ultrasound examination is often performed, wherein the ultrasound device is also introduced via the rectum to the prostate.

In particular, the urinary tract and the narrowing of the same are in the interest of benign prostatic hyperplasia of interest, because an excess of residual urine in the bladder can be cause for infections of the bladder and the kidneys. By uroflowmetry, a method in which the patient urinates in a special funnel with a measuring device, the urine outflow can be measured per unit time during urination. If the value is too low, this indicates a hindrance to urinary flow, because the enlarged prostate restricts the urinary bladder on the one hand and on the other hand represents an increased drainage resistance.

In a demonstrably enlarged prostate, the tumor marker is determined by means of a blood test in addition to some other markers in order to rule out a malignant change in the prostate gland. However, if this is increased, the prostate should be taken a tissue sample, which is generally quite easy, similar to the ultrasound examination of the organ, can be removed.

If cell growth is benign, surgery may still be indicated in the later stages if the organ is unresponsive to drug therapy or is threatened with urinary retention by the prostate gland.

complications

Benign prostatic hyperplasia can cause various complications. The enlarged prostate always leaves some residual urine in the bladder and urethra. As a result, the risk of inflammation is great and there are urinary tract infections. In the worst case, the pathogens can spread into the bloodstream and attack the entire body.

It comes to urosepsis, untreated leads in more than 50 percent of cases to death. Furthermore, the formation of urinary stones is favored. This leads to the urine accumulation to the kidney and this can also ignite as a result. It can lead to kidney failure (renal insufficiency), which severely affects the quality of life.

The kidney can no longer fulfill its functions and urinary substances are no longer excreted. This can lead to a poisoning of the blood (uremia), which can end in a coma and finally death. The fluid and salt balance is also thrown upside down. It causes edema and the person suffering from high blood pressure (hypertension).

In addition, the hormones produced in the kidney are missing, the body suffers a disorder of blood formation and thus anemia. Benign prostatic hyperplasia can also lead to a bar-like thickening (hypertrophy) of the urinary bladder wall, resulting in a bladder blister. This again increases the risk of urinary tract infection and urinary retention with subsequent kidney failure.

When should you go to the doctor?

Benign prostatic hyperplasia, as the term "benigne" implies, is a benign disease at the core, which should, however, lead to a doctor if suspected to rule out cancer of the prostate. After that, doctor visits are often not necessary, as hyperplasia usually progresses very slowly and the typical symptoms such as difficulty in emptying the bladder due to narrowing of the urinary stream are only slowly apparent.

Even after a confirmed initial diagnosis, it is quite possible to allow a longer time to elapse until the next visit to the doctor or a possible surgery, if the symptoms remain within a reasonable range and the quality of life of the person affected is not significantly limited.

However, a doctor's visit should be scheduled when significant urinary restrictions occur. If benign prostatic hyperplasia is at this stage, surgical treatment should be considered to avoid the risk of residual urine remaining in the urinary system favoring bacterial infections. Even with new or severe complaints of the family doctor or treating urologist should be visited.

Such signs include, for example, pain or burning on urination, blood in the urine, and a feeling of pressure or pain in the abdomen or back, the connection with fever and a general feeling of illness being particularly serious. In addition, a visit to a doctor is useful if a patient with benign prostatic hyperplasia suffers from impotence.

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Treatment & Therapy

An enlarged prostate alone is not a medical reason for therapy. Only when micturition disturbances occur as a result of the enlargement, which restrict the quality of life of the patient, therapeutic measures are indicated.

First of all, an attempt can be made to improve the symptoms with the help of herbal supplements. Often used here are products with saw palmetto or pumpkin extract, as well as rye pollen and pine or spruce extracts.

If the enlargement is already too advanced, so-called alpha-receptor blockers can be used. These medications relax the prostate, reducing drainage and facilitating urine flow. On the one hand, this leaves less residual urine in the bladder, which reduces the risk factor of infections, and on the other hand, the improved urine excretion also leads to a decrease in the frequency of urination.

Furthermore, 5-alpha reductase inhibitors are available. These are able to shrink the organ by up to 30 percent. However, transient erectile dysfunction must be expected while taking the drug.

Of course, there is also the possibility of surgical intervention by means of a scalpel or modern laser surgery, which is inevitable in the case of imminent urinary retention, not only because of the risk of kidney failure.

Outlook & Forecast

The cure for a benign prostatic hyperplasia is based on the severity of the disease. In many patients, no other health problems are detected in everyday life, so that it comes neither to treatment nor to a deterioration in the lifestyle.

If the prostate enlarges further, it leads to disorders of sexuality and urination. Patients are usually assisted with natural remedies during this phase of the disease. A drug treatment can also be claimed. However, the natural remedies have so far prevailed as proven. They have a good effect and are free of side effects. A cure of benign prostatic hyperplasia does not occur despite the therapy. The alleviation of the sequelae is achieved to a considerable extent and is often sufficient.

In severe cases, the growth of the prostate is unstoppable. Surgery is necessary in order not to further damage the organism or to endanger the health. Through him, a reduction of the complaints takes place. Older men are most often affected by the disease. The likelihood that they will suffer from other diseases is very high in people over the age of 60 years. This worsens the chances of a complaint despite the operation and increases the risk of possible complications.

prevention

In order to prevent benign prostatic hyperplasia, due to the fact that the exact causes are not yet known, only general indications for a healthy lifestyle can be given. Healthy food, low alcohol and abstinence from tobacco products are as much a part of it as sport is.

From the age of 50, a yearly check-up of the prostate is recommended. Although benign prostatic hyperplasia can not be prevented, malignant changes of the organ can be detected early on.

You can do that yourself

If the prostate has not yet increased very much and the symptoms are only mild, the market offers natural substances to support the prostate function. However, a positive effect of pumpkin seeds and Co. on the prostate has not yet been demonstrated. The only exception are dried saw palmetto fruits, which are taken in the form of capsules. Important for the healthy functioning of the prostate is a sufficiently high testosterone level.

For a balanced diet with many amino acids (especially in tuna, quark, eggs, oatmeal and nuts) and enough sleep. Also, scientific studies have confirmed that frequent ejaculations improve prostate function. Sufficient exercise and normal body weight also contribute to a healthy prostate.

After a prostate operation, avoid spicy foods, carbon dioxide, cigarettes and alcohol as these may make the urine more "acidic" and thus delay healing as it flows through the wound. Alcohol abstinence improves the intensity of the urinary stream, so that a negative effect of a high alcohol consumption on the prostate is generally assumed.

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