Introduction

  • If you are male, aged above 40 years old and experience with: Difficulty to urinate, hesitancy, incomplete emptying then you may have Benign Prostatic Hyperplasia (BPH).

What is prostate?

  • Prostate is part of male reproduction organs, the functions is to produce semen as sperm transport.
  • Normally prostate size as walnut sized or as big as egg yolk, lies below bladder, and middle of its lay urethra, tract to pass urine through penis.
  • And if experienced with prostate enlargement, it will develop symptoms named as LUTS (Lower Urinary Tract Symptoms) or as urinate disturbance.

What is BPH?

  • Benign Prostatic Hyperplasia (BPH) is enlargement of prostate gland that never develop into cancer. To defer the two of it, the doctors must conduct advance examination, such as PSA (Prostate Specific Antigen) serum examination, which a specific laboratory test to diagnose prostate cancer. If PSA score is higher than normal, doctors may continue with biopsy.
  • The cause of prostate enlargement related with aged and testosterone which produced by Leydig cell on testis which also produces androgen as well.
  • Benign prostatic hyperplasia is the number two common disease in urologist clinic in Indonesia, so this case is very familiar found in urologist clinic.
  • When prostate size become bigger, then it will press urinary tract in the middle of prostate, named as urethra (urethra is small tract which function pass urine from bladder out of body). If that condition happened, its will obstruct lower urinary tract and caused urinate symptoms.

BPH symptoms

  • Trouble starting a urine stream or making more than a dribble
  • Passing urine often, especially at night
  • Feeling that the bladder has not fully emptied
  • A strong or sudden urge to urinate
  • A weak or slow urine stream
  • Stopping and starting again several times while passing urine
  • Pushing or straining to begin passing urine

How to diagnose Benign prostate hyperplasia?

Examination conduct by doctors will be varies to each patients:

  • Anamnesis / patient history (questioner / IPSS- International Prostate Symptom Score)
  • DRE (Digital Rectal Examination)
  • Prostate Specific Antigen
  • Transrectal Ultrasonography
  • Urine Flow Study (Uroflowmetry
  • Intravenous Pyelogram (IVP)
  • Cystoscopy

BPH treatment

  • If suffering BPH, with mild symptoms, usually only need to observe. Patients advise to reduce drinking in the night to reduce nocturia, avoid decongestant drug (parasimpatolitik), reduce drinking coffee and not drinking alcohol so patient will less to urinate.
  • This phase call watchful waiting usually for patients with mild symptoms (IPSS score ? 7). Patients advise to control the symptoms every three month and if the symptoms is increasing then need to give treatment or surgery.
  • There is many drug class indicated for benign prostatic hyperplasia, one of it is alpha blocker class, this drug work by hamper alpha receptor which found in trogonum, bladder neck, prostate and prostate capsule. This hampering caused relaxation at prostate area and caused pressure at this area decrease.
  • Alpha blocker is the first choice for BPH. Other drug that might be use is 5-alpha reduktase inhibitor and phytotherapy for another treatment
  • If this symptoms continues without improvement or develop into severe complication, the doctors will advice for surgery. Surgery aim to remove the enlargement of prostate glans so the urine will be pass normally.
  • Talk to your doctors about your symptoms and treatment choice which pick by your doctors base on degree of prostate enlargement that you experienced.

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