BPH (Benign Prostatic Hyperplasia) Pembesaran prostat jinak atau benign prostatic hyperplasia (BPH) adalah kondisi ketika kelenjar prostat membesar. Akibatnya, aliran urine menjadi tidak lancar dan buang air kecil terasa tidak tuntas. Kelenjar prostat hanya dimiliki oleh pria. Oleh karena itu, penyakit ini hanya dialami oleh pria.
Bph hiperplastie prostatică benignă
In Bpn cases of BPH, or when other options fail, more invasive surgery is recommended. A urologist uses medical tests to help diagnose lower urinary tract problems related to benign prostatic hyperplasia and recommend treatment. The best treatment choice for you depends on several prostatic, including: They improve symptoms and prevent BPH from getting worse. Benigăn destroying troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue destruction does not cure benign prostatic hyperplasia. Rochester, Minn. Most men Bph hiperplastie prostatică benignă symptom improvement within about two weeks. Surgery rarely causes a loss of erectile function.
Side effects include erectile dysfunction and reduced libido sex drive. Learn more about this top honor. A urologist may use cystoscopy Bph hiperplastie prostatică benignă look for blockage or stones in the urinary tract. TURP does not remove the entire prostate.
Benign Prostatic Hyperplasia (BPH): Symptoms, Diagnosis & Treatment – Urology Care Foundation
See More See Less. The doctor inserts a finger into the rectum to check your prostate for enlargement. They can offer relief from symptoms, including urine control problems. Medical tests may include urinalysis a prostate-specific antigen PSA blood test urodynamic Bph hiperplastie prostatică benignă cystoscopy transrectal ultrasound biopsy Urinalysis. This is an emergency that must be treated right away. Prescription Drugs. In: Ferri’s Clinical Advisor
Narrowing of the urethra and urinary retention — being unable to empty the bladder fully — cause many of the problems of BPH.
BPH is benign. This means it is not cancer. It does not cause or lead to cancer. However, BPH and cancer can happen at the same time. BPH is common. About half of all men between ages 51 and 60 have BPH. See More See Less. The prostate is part of the male reproductive system. It is about the size of a walnut and weighs about an ounce.
The prostate is found below the bladder and in front of the rectum. It goes all the way around a tube called the urethra , which carries urine from the bladder out through the penis. During ejaculation , sperm made in the testicles moves to the urethra.
At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mixture — semen — goes through the urethra and out through the penis. When the prostate is enlarged, it can bother or block the bladder. Needing to urinate often is a common symptom of BPH. This might be every 1 to 2 hours, mainly at night. If BPH becomes severe, you might not be able to urinate at all. This is an emergency that must be treated right away.
In most men, BPH gets worse with age. It can lead to bladder damage and infection. It can cause blood in the urine and cause kidney damage. The causes of BPH are not well-understood. Some researchers believe that factors related to aging and the testicles may cause BPH. This is because BPH does not develop in men whose testicles were removed before puberty. Throughout their lives, men produce both testosterone , a male hormone, and small amounts of estrogen , a female hormone. As men age, the amount of active testosterone in the blood lowers, leaving a higher share of estrogen.
Studies have suggested that BPH may happen because the higher share of estrogen in the prostate adds to the activity of substances that start prostate cells to grow. Another theory points to dihydrotestosterone DHT , a male hormone that plays a role in prostate development and growth. Some research has shown that, even when testosterone levels in the blood start to fall, high levels of DHT still build up in the prostate.
This may push prostate cells to continue to grow. Obesity, lack of staying active, and erectile dysfunction can also increase risk. There is no sure way to stop BPH, but losing weight and eating a healthy diet that involves fruits and vegetables may help. This may relate to having too much body fat, may increase hormone levels and other factors in the blood, and stimulate the growth of prostate cells. Staying active also helps control weight and hormone levels. See your doctor if you have symptoms that might be BPH. See your doctor right away if you have blood in your urine, pain or burning when you urinate, or if you cannot urinate.
The score rates BPH from mild to severe.
Take the test and talk with your doctor about your results. Your doctor will review your Symptom Score and take a medical history. You will also have a physical exam that involves a digital rectal exam DRE. Your doctor may also want you to have some or all of these tests: Prostate-specific antigen PSA is a protein that is made only by the prostate.
When the prostate is healthy, very little PSA is found in the blood. The test can be done in a lab, hospital, or doctor’s office.
No special preparation is needed. You should not ejaculate for 2 days before a PSA test. A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. Inflammation of the prostate, or prostatitis , is another common cause of a high PSA level. The DRE is done with the man bending over or lying curled on his side. The doctor puts a lubricated, gloved finger into the rectum to feel the shape and thickness of the prostate. The DRE can help your doctor find prostate problems. There are many options for treating BPH. You and your doctor will decide together which treatment is right for you.
Mild cases may need no treatment at all. In some cases, minimally invasive procedures surgery without anesthesia are good choices. And sometimes a combination of treatments works best. Often, BPH will only require active surveillance.
If you and your doctor choose this treatment option, your BPH will be closely watched but not actively treated. This means that BPH is monitored with regular visits to your urologist. A yearly exam is common. Your health care provider will look for worse or new issues before suggesting anything else.
Diet and exercise are often recommended as a way to prevent or manage your symptoms. Active surveillance is best for men with mild to moderate symptoms. It is also an option for men who are not bothered by the effects of BPH. If your symptoms get worse, or if new symptoms appear, your doctor may suggest that you begin active treatment. Alpha blockers relax the muscles of the prostate and bladder. They improve urine flow, reduce blockage of the urethra and reduce BPH symptoms.
They do not reduce the size of the prostate.
Men with moderate to severe BPH and men who are bothered by their symptoms are good candidates. Alpha blockers are not a good choice for men who are about to have cataract surgery. These prescription drugs are pills taken by mouth. Alpha-blocking drugs include alfuzosin, doxazosin, silodosin, tamsulosin and terazosin. Side effects may include dizziness, lightheadedness, fatigue and trouble ejaculating. One benefit of alpha blockers is they start to work right away. They shrink the prostate, increase urine flow and reduce the risk of BPH complications. They also make it less likely that you will need surgery.
These drugs may be best for men with very large prostate glands. These prescription drugs are pills taken by mouth and include dutasteride and finasteride. They may take many months to become fully effective. Side effects include erectile dysfunction and reduced libido sex drive. You must keep taking the pills to prevent symptoms from coming back. With combined therapy, an alpha blocker and a 5-alpha reductase inhibitor are used together. Men with larger prostates are good candidates for this treatment. Alpha blockers and 5-alpha reductase inhibiters may work better together than either drug does alone. They improve symptoms and prevent BPH from getting worse. A urologist may add antimuscarinics for patients with overactive bladder symptoms.
Overactive bladder is when the bladder muscles squeeze uncontrollably. It leads to the frequent and urgent need to pass urine. It can lead to incontinence leaking. Antimuscarinics relax the bladder muscles. Side effects may happen with each drug. By taking two drugs, you may have more side effects than if you were taking just one.
Some side effects in patients on combination therapy were dizziness, erectile dysfunction, weakness or lack of energy and a drop in blood pressure when moving from sitting or lying down to standing. Phytotherapies are herbal treatments. They are not prescribed by a doctor, but are sometimes a form of „self-treatment. Men buy them over the counter as dietary supplements. One popular herb is saw palmetto. Several important studies show they do not work. Also, the quality and purity of supplements vary. Doctors do not currently recommend herbal treatments for BPH. Minimally invasive or less invasive surgeries require only tiny cuts or no cuts to the body.
Good candidates include men who have taken BPH medication that did not work or men with the following symptoms:
They can often be done as an outpatient, without a stay in the hospital. Recovery time is usually quicker. They can offer relief from symptoms, including urine control problems. On the other hand, they do not reduce your risk for another surgery. Side effects for having certain types of minimally invasive surgery is the increased risk you will need to have another surgery or need to go back on medications. Other temporary side effects may include: Choosing the right type of surgery for you may depend on the size of your prostate, your overall health and your personal choice. Yet, there are many types of less invasive surgeries your doctor may suggest. PUL uses a needle to place tiny implants in the prostate.
These implants lift and compresses the enlarged prostate so that it no longer blocks the urethra. PUL may be done with either local or general anesthesia. PUL uses no cutting or heat to destroy or remove prostate tissue.
It takes less than an hour and you can usually go home the same day. Most men see symptom improvement within about two weeks. Some men may have pain or burning when passing urine, blood in the urine or a strong urge to pass urine. These side effects usually go away within two to four weeks. Men may have fewer sexual side effects after PUL than after other types of prostate surgery.
Men with many medical problems may be good candidates. Men for whom surgery is high-risk may also be good candidates.
Many men with enlarged prostates and urinary symptoms may be good candidates for PUL. If you are allergic to nickel, titanium, or stainless steel, talk to your doctor before getting PUL. Current studies have evaluated seven years of treatment with PUL and future studies may help to determine long term durability. Inside a handheld device, sterile water is heated to just above the boiling point, when it turns into steam. A precise dose of thermal energy from the steam is then injected into the prostate with a small needle.
The release of this thermal energy causes rapid cell death. You may have blood in your urine and need to use a catheter for a few days. Painful or frequent urination should go away within about two to three weeks. Sexual side effects, such as erectile dysfunction, are unlikely.
Studies currently suggest that symptom improvement lasts for at least five years. It is not currently known whether the treatment continues to work long-term beyond the five-year point or whether patients eventually need to have additional treatment. Men may be good candidates if they do not want to take medication for BPH or if they have tried medication and found it did not work. Unlike other less invasive therapies, this therapy can treat men who have a middle lobe of the prostate.
Men who prefer not to have surgery or want to avoid sexual side effects may also be good candidates. TUMT uses microwaves to destroy prostate tissue. The urologist threads a catheter through the urethra to the prostate. A device called an antenna sends microwaves through the catheter to heat selected portions of the prostate. The heat destroys excess prostate tissue.
A cooling system protects the urinary tract from heat damage during the procedure. TUMT does not require general anesthesia. The surgeon numbs the skin and gives you a pain pill. TUMT only takes an hour. It may relieve bladder obstruction. Urologists prescribe these medications mainly for erectile dysfunction. Tadalafil Cialis belongs to this class of medications and can reduce lower urinary tract symptoms by relaxing smooth muscles in the lower urinary tract.
Researchers are working to determine the role of erectile dysfunction drugs in the long-term treatment of benign prostatic hyperplasia. These medications block the production of DHT, which accumulates in the prostate and may cause prostate growth: These medications can prevent progression of prostate growth or actually shrink the prostate in some men. Finasteride and dutasteride act more slowly than alpha blockers and are useful for only moderately enlarged prostates.
Combination medications. Several studies, such as the Medical Therapy of Prostatic Symptoms MTOPS study, have shown that combining two classes of medications, instead of using just one, can more effectively improve symptoms, urinary flow, and quality of life. The combinations include. A urologist may prescribe a combination of alpha blockers and antimuscarinics for patients with overactive bladder symptoms. Overactive bladder is a condition in which the bladder muscles contract uncontrollably and cause urinary frequency, urinary urgency, and urinary incontinence. Antimuscarinics are a class of medications that relax the bladder muscles. Researchers have developed a number of minimally invasive procedures that relieve benign prostatic hyperplasia symptoms when medications prove ineffective.
These procedures include. Minimally invasive procedures can destroy enlarged prostate tissue or widen the urethra, which can help relieve blockage and urinary retention caused by benign prostatic hyperplasia.
Urologists perform minimally invasive procedures using the transurethral method, which involves inserting a catheter—a thin, flexible tube—or cystoscope through the urethra to reach the prostate.
These procedures may require local, regional, or general anesthesia. Although destroying troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue destruction does not cure benign prostatic hyperplasia. Transurethral needle ablation. This procedure uses heat generated by radiofrequency energy to destroy prostate tissue. A urologist inserts a cystoscope through the urethra to the prostate. A urologist then inserts small needles through the end of the cystoscope into the prostate. The needles send radiofrequency energy that heats and destroys selected portions of prostate tissue. Shields protect the urethra from heat damage.
Transurethral microwave thermotherapy. This procedure uses microwaves to destroy prostate tissue. A urologist inserts a catheter through the urethra to the prostate, and a device called an antenna sends microwaves through the catheter to heat selected portions of the prostate. The temperature becomes high enough inside the prostate to destroy enlarged tissue. A cooling system protects the urinary tract from heat damage during the procedure. High-intensity focused ultrasound. For this procedure, a urologist inserts a special ultrasound probe into the rectum, near the prostate.
Ultrasound waves from the probe heat and destroy enlarged prostate tissue.
Transurethral electrovaporization. For this procedure, a urologist inserts a tubelike instrument called a resectoscope through the urethra to reach the prostate. An electrode attached to the resectoscope moves across the surface of the prostate and transmits an electric current that vaporizes prostate tissue. The vaporizing effect penetrates below the surface area being treated and seals blood vessels, which reduces the risk of bleeding. Water-induced thermotherapy.
This procedure uses heated water to destroy prostate tissue. A urologist inserts a catheter into the urethra so that a treatment balloon rests in the middle of the prostate. Heated water flows through the catheter into the treatment balloon, which heats and destroys the surrounding prostate tissue.
The treatment balloon can target a specific region of the prostate, while surrounding tissues in the urethra and bladder remain protected. Prostatic stent insertion. This procedure involves a urologist inserting a small device called a prostatic stent through the urethra to the area narrowed by the enlarged prostate.
Once in place, the stent expands like a spring, and it pushes back the prostate tissue, widening the urethra. Prostatic stents may be temporary or permanent. Urologists generally use prostatic stents in men who may not tolerate or be suitable for other procedures. For long-term treatment of benign prostatic hyperplasia, a urologist may recommend removing enlarged prostate tissue or making cuts in the prostate to widen the urethra.
Urologists recommend surgery when.
Although removing troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue removal does not cure benign prostatic hyperplasia. A urologist performs these surgeries, except for open prostatectomy, using the transurethral method. Men who have these surgical procedures require local, regional, or general anesthesia and may need to stay in the hospital. The urologist may prescribe antibiotics before or soon after surgery to prevent infection. Some urologists prescribe antibiotics only when an infection occurs. Immediately after benign prostatic hyperplasia surgery, a urologist may insert a special catheter, called a Foley catheter, through the opening of the penis to drain urine from the bladder into a drainage pouch.
With TURP, a urologist inserts a resectoscope through the urethra to reach the prostate and cuts pieces of enlarged prostate tissue with a wire loop.
Special fluid carries the tissue pieces into the bladder, and the urologist flushes them out at the end of the procedure. TURP is the most common surgery for benign prostatic hyperplasia and considered the gold standard for treating blockage of the urethra due to benign prostatic hyperplasia. Laser surgery. With this surgery, a urologist uses a high-energy laser to destroy prostate tissue. The urologist uses a cystoscope to pass a laser fiber through the urethra into the prostate.
The laser destroys the enlarged tissue. However, laser surgery may not effectively treat greatly enlarged prostates. Open prostatectomy. In an open prostatectomy, a urologist makes an incision, or cut, through the skin to reach the prostate. The urologist can remove all or part of the prostate through the incision. This surgery is used most often when the prostate is greatly enlarged, complications occur, or the bladder is damaged and needs repair.
Open prostatectomy requires general anesthesia, a longer hospital stay than other surgical procedures for benign prostatic hyperplasia, and a longer rehabilitation period. The three open prostatectomy procedures are retropubic prostatectomy, suprapubic prostatectomy, and perineal prostatectomy. The recovery period for open prostatectomy is different for each man who undergoes the procedure.
A TUIP is a surgical procedure to widen the urethra. During a TUIP, the urologist inserts a cystoscope and an instrument that uses an electric current or a laser beam through the urethra to reach the prostate. The urologist widens the urethra by making a few small cuts in the prostate and in the bladder neck. After surgery, the prostate, urethra, and surrounding tissues may be irritated and swollen, causing urinary retention. To prevent urinary retention, a urologist inserts a Foley catheter so urine can drain freely out of the bladder.
A Foley catheter has a balloon on the end that the urologist inserts into the bladder. Once the balloon is inside the bladder, the urologist fills it with sterile water to keep the catheter in place. Men who undergo minimally invasive procedures may not need a Foley catheter.
The Foley catheter most often remains in place for several days. Sometimes, the Foley catheter causes recurring, painful, difficult-to-control bladder spasms the day after surgery. However, these spasms will eventually stop. A urologist may prescribe medications to relax bladder muscles and prevent bladder spasms. These medications include. Medications used to treat benign prostatic hyperplasia may have side effects that sometimes can be serious. Men who are prescribed medications to treat benign prostatic hyperplasia should discuss possible side effects with a health care provider before taking the medications.
Men who experience the following side effects should contact a health care provider right away or get emergency medical care: These side effects are mostly related to phosphodiesterase-5 inhibitors.
Side effects related to alpha blockers include. Most of the complications of minimally invasive procedures go away within a few days or weeks. Minimally invasive procedures are less likely to have complications than surgery. Problems urinating. Men may initially have painful urination or difficulty urinating. They may experience urinary frequency, urgency, or retention. These problems will gradually lessen and, after a couple of months, urination will be easier and less frequent. Urinary incontinence. As the bladder returns to normal, men may have some temporary problems controlling urination.
However, long-term urinary incontinence rarely occurs. The longer urinary problems existed before surgery, the longer it takes for the bladder to regain its full function after surgery.
Bleeding and blood clots. After benign prostatic hyperplasia surgery, the prostate or tissues around it may bleed. Blood or blood clots may appear in urine. Some bleeding is normal and should clear up within several days. However, men should contact a health care provider right away if. Blood clots from benign prostatic hyperplasia surgery can pass into the bloodstream and lodge in other parts of the body—most often the legs. Men should contact a health care provider right away if they experience swelling or discomfort in their legs.
Use of a Foley catheter after benign prostatic hyperplasia surgery may increase the risk of a UTI. Anesthesia during surgery may cause urinary retention and also increase the risk of a UTI. In addition, the incision site of an open prostatectomy may become infected. A health care provider will prescribe antibiotics to treat infections. Scar tissue. In the year after the original surgery, scar tissue sometimes forms and requires surgical treatment.
Scar tissue may form in the urethra and cause it to narrow. A urologist can solve this problem during an office visit by stretching the urethra. Rarely, the opening of the bladder becomes scarred and shrinks, causing blockage. This problem may require a surgical procedure similar to TUIP.
Sexual dysfunction. Some men may experience temporary problems with sexual function after benign prostatic hyperplasia surgery. The length of time for restored sexual function depends on the type of benign prostatic hyperplasia surgery performed and how long symptoms were present before surgery.
Many men have found that concerns about sexual function can interfere with sex as much as the benign prostatic hyperplasia surgery itself.
Understanding the surgical procedure and talking about concerns with a health care provider before surgery often help men regain sexual function earlier. Many men find it helpful to talk with a counselor during the adjustment period after surgery. Even though it can take a while for sexual function to fully return, with time, most men can enjoy sex again. Most health care providers agree that if men with benign prostatic hyperplasia were able to maintain an erection before surgery, they will probably be able to have erections afterward. Surgery rarely causes a loss of erectile function.
However, benign prostatic hyperplasia surgery most often cannot restore function that was lost before the procedure. Some men find a slight difference in the quality of orgasm after surgery. However, most report no difference.
Prostate surgery may make men sterile, or unable to father children, by causing retrograde ejaculation—the backward flow of semen into the bladder.
Men flush the semen out of the bladder when they urinate. In some cases, medications such as pseudoephedrine, found in many cold medications, or imipramine can treat retrograde ejaculation. These medications improve muscle tone at the bladder neck and keep semen from entering the bladder. Recurring problems. Men may require further treatment if prostate problems, including benign prostatic hyperplasia, return. Problems may arise when treatments for benign prostatic hyperplasia leave a good part of the prostate intact. About 2 percent of men who have an open prostatectomy require additional surgery within 5 years.
In the years after benign prostatic hyperplasia surgery or treatment, men should continue having a digital rectal exam once a year and have any symptoms checked by a health care provider.
In some cases, the health care provider may recommend a digital rectal exam and checkup more than once a year. Researchers have not found a way to prevent benign prostatic hyperplasia. Men with risk factors for benign prostatic hyperplasia should talk with a health care provider about any lower urinary tract symptoms and the need for regular prostate exams. Men can get early treatment and minimize benign prostatic hyperplasia effects by recognizing lower urinary tract symptoms and identifying an enlarged prostate.
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing benign prostatic hyperplasia. However, a health care provider can give information about how changes in eating, diet, or nutrition could help with treatment. Men should talk with a health care provider or dietitian about what diet is right for them.
Benign prostatic hyperplasia (BPH) – Symptoms and causes – Prostaffect сumpără
Benign prostatic hyperplasia—also called BPH—is a condition in men in Bph hiperplastie prostatică benignă the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when Bph hiperplastie prostatică benignă prostate doubles in size. Benign prostatic hyperplasia often occurs with the second growth phase. As the prostate enlarges, the gland presses against and pinches the urethra.
The bladder wall becomes thicker.
BPH (Benign Prostatic Hyperplasia)
Benign prostatic hyperplasia BPH — also called prostate gland enlargement — is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems. There are several effective treatments for prostate gland enlargement, Bph hiperplastie prostatică benignă medications, minimally invasive therapies and surgery. To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have and your preferences. The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time.
Common signs and Bph hiperplastie prostatică benignă of BPH include: The size of your prostate doesn’t necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.