Wednesday, December 07, 2016

Physical Abdominal/Rectal Exam

BPH: Enlarged Prostate

By Jennifer G, Health Guide Friday, August 20, 2010

Benign prostatic  hyperplasia, or BPH, is a common phenomenon among older men.  It basically is the non-cancerous enlargement of the prostate gland. It's believed that more than half of all men in their 60's experience some sort of enlargement of this gland. The initial growth of the prostate happens in puberty, and a second growth spurt happens at around age 25. Continual growth after this is very common, and problems with growth don't  usually surface until later in life.

 

Although there is no definite cause for prostate enlargement, a couple of theories include hormone imbalances and biological factors.

 

BPH Symptoms

Prostate growth most often triggers obstruction of the urethra, since the gland encompasses it.  This results in such symptoms as the following:

 

  • Incomplete emptying of the bladder
  • Weak urine stream
  • Interrupted urine stream
  • Urinary hesitancy
  • Leaking or dribbling
  • Frequent urination
  • Inability to urinate (acute urinary retention)
  • Incontinence
  • Urinary tract infections
  • Urinary tract stones

 

BPH Tests/Diagnosis

Although certain above-mentioned symptoms may occur, many men learn that they have enlarged prostates during routine physical checkups. There are several tests a doctor may utilize to diagnose BPH, including a digital rectal exam (DRE), a Prostate-Specific Antigen (PSA) blood test, a rectal ultrasound (with or without a prostate biopsy), a urine flow study that checks the rate of urination, and/or a cystoscopy exam which can detect an obstruction(s.) The DRE can detect an enlarged prostate by feeling the size and shape of the gland. The bloodwork may indicate abnormal prostate levels which the ultrasound and biopsy then determine are from benign or malignant prostate growth.

 

BPH Treatments

Often an enlarged prostate isn't initially treated, merely because it is not causing a patient problems--- yet.  If and when treatment is considered, the least invasive BPH treatment is drug therapy.  Such medications either reduce  prostate-enlarging hormones in the blood stream, and may actually shrink the prostate, or drugs may relax the muscles in the gland to improve urine flow and prevent bladder obstruction.

 

Minor prostate procedures:

Several minor procedures can help patients with BPH.  The first, a type of microwave therapy, can help with urinary frequency, straining, urgency, and hesitancy.  An ablation therapy uses twin needles to burn away excess prostate tissue and a heated balloon inserted into the urethra can also be used to obliterate extra prostate gland. Finally, ultrasound used at high intensities is being tested in the United States as another way to remove tissue.

*All of these procedures are minimally invasive and hence minimally painful.

 

Prostate surgery

Several prostate surgeries, which are a little more invasive, exist.  The first, named transurethral resection of the prostate (TURP), is utilized for about 90% of all surgeries due to BPH.  This procedure is performed by using a resectoscope that is inserted into the urethra.  Another surgery is called transurethral incision of the prostate (TUIP), and it widens the urethra by making several small cuts in the bladder neck.  Open surgery, the most invasive type, is performed if the situation is more complicated or if bladder repair also needs to be made.

By Jennifer G, Health Guide— Last Modified: 09/08/12, First Published: 08/20/10