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90 Raghuvanshi 2024 - 2025 Happy Diwali

Diagnosis and management of Benign Prostate Hypertrophy

and Prostate Cancer
The prostate is a small gland located right below the neck of the bladder and is part
of the male reproductive system. A healthy prostate gland is approximately the shape
and size of a walnut. As men age, the prostate gland often becomes enlarged (Benign
Prostatic Hyperplasia (BPH).

This causes the prostate to press against the urethra, causing Difficult urination,
Frequent need to urinate, Weak stream, Difficulty to start or stop urination, Not being
able to sleep through the night, Difficulty in voiding completely, Leakage and Sexual dysfunction.

The prevalence of BPH is 50% in men aged 51–60 years and increases to 90% in those aged 81–90
years. This non-cancerous growth of the prostate affects over 500 million men worldwide.

To diagnose BPH the urologist will perform a digital rectal examination, where the doctor inserts a gloved,
lubricated finger into your rectum to feel the back wall of the prostate gland. Urine flow tests are done to
assess if the urethra is blocked. Urinalysis tests check for important things such as blood, signs of infection,
glucose (sugar) and screen for bladder cancer. Ultrasound scans assess the size and shape of the prostate.
Magnetic resonance imaging (MRI) and computed tomography (CT) are more detailed scans.

Cystoscopy looks at the urethra or bladder with a scope. Blood Tests like Prostate-specific antigen
(PSA) will be done to screen for prostate cancer.
The main treatments for BPH are: Prescription Drugs: Alpha blockers (Alfuzosin, Doxazosin,
Tamsulosin and Terazosin) pills will relax the muscles of the prostate and bladder) to reduce BPH
symptoms. One benefit of alpha blockers is they start to work right away.

5-Alpha reductase inhibitors ( Dutasteride and Finasteride ) can increase urine flow and shrink the
prostate. You must keep taking the pills to prevent symptoms from coming back.

These prescription drugs may take many months to become fully effective. Combined therapy may
work better together than either drug does alone. A urologist may add antimuscarinics for patients
with overactive bladder symptoms which can lead to incontinence (leaking). Phytotherapies or herbal
therapies are not recommended by health care providers. One popular herb is saw palmetto. Several
important studies show they do not work.
Less Invasive Surgery can often be done as a day surgery. It can offer relief from symptoms, including
urine control problems. The most frequent procedure is Transurethral resection of prostate (TURP).

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