Benign Prostatic Hyperplasia (BPH)

Your Prostate   The normal prostate gland is about the size of a golf ball. It is situated at the bottom of the bladder and extends about 2.5cm down the urethra (the tube that extends from the bladder through the penis through which urine and semen travels and exists). The prostate’s function is to produce fluid that make up part of the semen.   As men grow older their prostate starts to enlarge. In the majority of cases this enlargement is not dangerous but can cause problems by squeezing the urethra and obstructing the flow of urine. This type of benign (non-cancerous) prostate enlargement is called benign prostatic hyperplasia or BPH for short.

How common is the problem in PNG?

Our health system does not have the appropriate monitoring systems for us to work out how common BPH, however in Australia BPH is very common in men over 45 but the problems with the waterworks usually starts to be seen in the mid to late 50 years age group and beyond. It is likely that the case is very similar in PNG

What are the symptoms of BPH

?

T

he symptoms of BPH are:

* It becomes difficult to start urination and when started the flow of urine is slow. This is especially experienced in the morning upon waking up.

* A tendency to dribble after urinating. It can lead to the wetting of the underwear.

* Some men experience the need to urinate a second time about 15 minutes after the first because they weren’t able to empty their bladder completely during the first.

* Increased frequency of urination, more than usual.

* Waking up at night more frequently with an urge to urinate

.

What your doctor should do if suspecting pro

state enlargement.

When your doctor suspects prostate enlargement they should do a rectal examination with a gloved finger.  By doing this examination the doctor can feel the size, consistency, whether it is smooth or lumpy and whether it is tender. While this procedure is slightly uncomfortable, it is very simple and will take only a minute or two and provides very useful information to guide the next steps.

Having BPH does do increase the chances of developing prostate cancer however with someone with an enlarged prostate the doctor may order special tests to check whether the enlargement is caused by prostate cancer.  These tests include a special blood test called Prostate Specific Antigen (PSA) and sometimes they may request an ultrasound scan.

The further management of BPH should

involve a urologist – a surgeon who specialises with the kidney, bladder and the prostate

.

T

reatment of BPH

Many cases of BPH will eventually require an operation but not all.

In some cases men can learn to live with their BPH.

 It helps if the following are done:

1) Avoid or cut down on alcohol.  Alcohol causes large amounts of urine to be formed and this exacerbates the symptoms of BPH.

2) Avoid taking in fluids about 3 hours and empty the bladder completely before bed time.

3

) Visit the toilet to urinate when you feel the first urge instead of “holding on” and wait a little longer after urinating to ensure that the bladder is completely empty

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Drugs treatment

Your doctor may sometimes prescribe drugs to treat your BPH.  For some men these drugs work very well for some not so well.  Some drugs work by relaxing and or shrinking the prostate while others relax the bladder.   For any drugs there are side effects and also situations where they should not be used or used with caution.  Your doctor must explain all these to you.

Surgery

For some cases that do not respond to drugs surgery is the next step.  This is done by a urologist.  The first choice of surgery is call transurethral resection of the prostate or TURP for short.  In this procedure the patient will be put to sleep and sections of the inner part of the prostate causing the blockage is remove using a special instrument that is inserted through the urethra.

About Dr. Poyap J Rooney

Dr. Rooney is a medical doctor who has gained both his undergraduate medical degree and more recently his post graduate masters degree in clinical biochemistry at the University of Papua New Guinea.
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2 Responses to Benign Prostatic Hyperplasia (BPH)

  1. marie says:

    Very useful, information thank you doctor. My questions is what would be your recommendation for best urologist in the country?

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