Living With Prostate Enlargement

Prostate is a small-sized, encapsulated walnut-shaped organ in males that encloses the prostatic part of urethra. Prostate gland in men is responsible for the release of a thin secretion that nourishes the sperms and also forms the bulk of semen. It also produces an enzyme that is required for the activation of testosterone - the primary male hormone - which in turn has a vital role in the male sexual development.

Prostate Enlargement – What Should You Know About It?

The average weight of a normal prostate gland in an adult male is 11 grams. Prostate enlargement (also referred to as Benign Prostatic Hyperplasia or BPH) is an innocuous, non-cancerous condition in which the glandular tissue increases in volume and weight due to various reasons (1). Epidemiologically, it affects more than 14 million men over the age of 50 years worldwide (2). Experts believes that the pathophysiology of prostatic enlargement revolves around age-related changes in the secretion of male hormones; however, the core mechanics are still a subject of research (1).

Men with benign prostate enlargement may experience lower urinary tract symptoms, which may be irritative or obstructive in nature. Patients often report symptoms like:

• Hesitancy in starting urination
• Straining while voiding the urine
• Weak urinary stream

Incomplete emptying of the bladder

On the other hand, some patients may suffer from urgency or nocturia - a need to get up repeatedly at night to empty out the bladder.

Living With Prostate Enlargement

With regards to management, patients are usually advised to alter their lifestyle in order to improve the quality of life. Here are some tips that patients with BPH should follow to reduce the severity of symptoms:

General Measures:

• Avoid taking too much fluid, especially after the evening meal. The last water intake should be at least 3 hours before going to bed. This would reduce the symptoms of nocturia.

• Reduce your intake of caffeinated beverages like tea or coffee at night.
• Limit alcohol and fizzy drinks, as these act as diuretics and can cause troublesome night time voiding (3).
• Try to urinate as soon as you feel the urge, because holding the urine for too long distends the bladder and increases the chances of incontinence.
• Avoid spicy food as spices can increase the bladder irritation and may worsen your BPH symptoms.
• Although drinking alcohol in moderation may help in managing erectile dysfunction as it reduces anxiety (a common complaint of male with BPH) but in elderly people it may worsen the symptoms of BPH even with occasional drinking. Therefore, make sure to completely eliminate physical, chemical and psychological stressors from your life.
• Healthcare providers strongly believes that maintenance of a healthy body weight and staying active can help cope with the symptoms (3).

What Medications To Avoid If You Have BPH

• Diuretics are a class of pharmacological agents that are generally advised to people with high blood pressure and cardiovascular ailments. Use of diuretics can increase the urinary frequency. You might want to talk to your doctor about adjusting the dosage of the drug or switching to an alternative medicine. Ask the doctor to reschedule the diuretics early in the day so that nighttime symptoms can be avoided. But make sure not to introduce changes in the dosing amount or schedule on your own.
• The medicines taken for cold and allergies called antihistamines or nasal decongestants should be avoided as they lead to decreased flow of urine and may worsen straining.

Pelvic Floor Strengthening Exercises

Contraction exercises for the pelvic floor muscles are recommended for the women who suffer from post pregnancy or post-surgical weakness of the muscles that are responsible for bladder control. They can also be advised to men with prostate enlargement to help strengthen these muscles. According to a study reported in the European Urology journal (4), it was concluded that regardless of age, more than 93% patients were able to achieve satisfactory bladder control with pelvic floor strengthening exercises within one-year time period. Also, there are no side-effects of pelvic floor training exercises (unlike most conventional treatment options for BPH).

To summarize, Prostate Enlargement can be troublesome but appropriate lifestyle changes along with medicines can alleviate the symptoms and make your life better.

References

1. Wei, J. T., Miner, M. M., Steers, W. D., Rosen, R. C., Seftel, A. D., Pasta, D. J., ... & BPH Registry Steering Committee. (2011). Benign prostatic hyperplasia evaluation and management by urologists and primary care physicians: practice patterns from the observational BPH registry. The Journal of urology, 186(3), 971-976.

2. Patel, N. D., & Parsons, J. K. (2014). Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian journal of urology: IJU: journal of the Urological Society of India, 30(2), 170-176.

3. Raheem, O. A., & Parsons, J. K. (2014). Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Current opinion in urology, 24(1), 10-14.

4. Filocamo, M. T., Marzi, V. L., Del Popolo, G., Cecconi, F., Marzocco, M., Tosto, A., & Nicita, G. (2005). Effectiveness of early pelvic floor rehabilitation treatment for post-prostatectomy incontinence. European urology, 48(5), 734-738.