Benign Prostatic Hypertrophy

GENERAL INFORMATION:

What is benign prostatic hypertrophy?

• Benign prostatic hypertrophy is a condition where your prostate gland grows larger than normal. It is also called "BPH". The prostate is a male sex gland that helps makes semen. It is located below the bladder and wraps around the urethra like a donut. The urethra is the tube that carries urine from the bladder into the penis. The urine is then passed out of the body.
  
  
• As the prostate grows, it can squeeze the urethra making it harder to urinate (pass urine). This can block urine flow and cause urinary problems.

What causes BPH? It is not known what causes BPH. It may be just part of getting older. BPH is very common in men over 45 years of age but rarely causes problems before age 60. Some caregivers believe it is caused by a change in hormone levels as men age.

What are the signs and symptoms of BPH?

• Feeling like you have not emptied your bladder, or feeling like a lot of urine is still in your bladder after urinating.
  
  
• Waking up often at night to urinate.
  
  
• Pink or red urine.
  
  
• Trouble starting to urinate.
  
  
• Urinating more often than usual.
  
  
• Urinating little or none at all.

What problems can BPH cause? If you retain urine too long in the bladder you can get a urinary infection, or bladder stones can form. Small blood vessels in the bladder and prostate may start to bleed because you strain more when you urinate. The urethra may suddenly become blocked off, making it even harder to urinate. Over time, your kidneys can be damaged as urine backs up from the bladder and into the kidneys.

How is BPH diagnosed? You may have one or more of the following tests:

• Blood tests: Blood tests such as prostate specific antigen (PSA) measurement may be done. The amount of PSA in your blood may go up if you have BPH.
  
  
• Cystoscopy: A cystoscopy allows caregivers to look for problems inside your bladder. A cystoscope is put into your bladder through your urethra. The urethra is the tube that urine flows through when you urinate. The cystoscope is a long tube with a lens and a light on the end. The scope may be hooked to a camera or monitor, and pictures may be taken. A tissue sample may also be taken during your cystoscopy. During this test, small tumors may be removed or bleeding may be stopped.
  
  
• Digital rectal examination: This is also called "DRE". This test helps caregivers feel the size of your prostate and see if it is larger than normal. By knowing this early, you can keep from having problems caused by BPH.
  
  
• Prostate biopsy: A small piece of the prostate is removed and sent to the lab for tests.
  
  
• Transrectal ultrasound: This test is also called "TRUS". It is a test to look at the prostate gland. Sound waves are used to show pictures of your prostate on a TV-like screen.
  
  
• Urine tests:
  
  
  • Urine sample: A sample of your urine is collected and sent to a lab for tests. Your caregiver may give you a special wipe and clean cup. Use the wipe to clean the skin around the opening where you pass urine. Urinate into the clean cup. Put the lid on the cup. Do not touch the inside of the cup or the lid. Give the urine sample to your caregiver.
    
    
  • Caregivers may use a catheter to measure how much urine is left in your bladder after you finish urinating. This is called a residual urine measurement.
    
    
  • A flow rate recording may also be done. This is a test that measures the speed of your urine stream.

How is BPH treated? You may have one or more of the following treatments:

• Medicine:
  
  
  • Alpha Blockers: This medicine relaxes the muscles in your prostate and bladder (organ that holds urine). It may help you urinate more easily.
    
    
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Hormone therapy: Hormones (such as testosterone) may cause some cancer cells to grow. Medicine or surgery may be needed to block the testosterone and slow a growing tumor. Sometimes both medicine and surgery are needed. If you need surgery, your testicles may be removed to stop the testosterone.
  
  
• Stent: A stent is a short, screen-like tube that is put into the urethra to hold it open.
  
  
• Surgery: Your prostate may need to be removed by surgery called prostatectomy.
  
  
• Other procedures: The prostate may be made smaller by a procedure such as an ultrasound, transurethral needle ablation (TUNA) or microwave heat treatment. You may also have a laser procedure called interstitial laser coagulation (ILC) to remove the prostate.

What can I do to feel better if I have BPH?

• Do not drink alcohol.
  
  
• Eat at least five servings of vegetables and fruits each day.
  
  
• Decrease the amount of salt in your diet. Examples of salty foods are chips, cured meats, and canned soups. Do not use table salt.
  
  
• Do not let your bladder get too full before emptying it. Urinate when you feel the urge.
  
  
• Caregivers may tell you not to eat spicy foods such as chilli peppers. This will help you find out if spicy food causes more symptoms of BPH.
  
  
• You may have sex if you feel well. Being sexually active may help keep your urethra open. Do not get sexually aroused without ejaculating because your urethra may get blocked.

Call your caregiver if:

• Your signs and symptoms, such as trouble urinating, get worse.
  
  
• You develop a temperature over ____

Seek care immediately if:

• You cannot urinate at all and your bladder is full and painful.
  
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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