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BPH

 What is Benign Prostatic Hyperplasia (BPH)?

 Who is at risk for BPH?

 What are the symptoms?

 When should I seek treatment for BPH?

 How is BPH diagnosed?

 Is there a BPH-cancer link?

 What are the treatments for BPH?


What is Benign Prostatic Hyperplasia (BPH)?
BPH is a non-cancerous condition in which prostate cells grow, enlarge the gland and cause
it to squeeze the urethra. A variety of symptoms may result, including difficult, frequent or urgent urination.


Who is at risk for BPH?
Generally, men over the age of 60. It is estimated that one in every four men in the United States will be treated for relief of symptomatic BPH.

What are the symptoms?
Many of the symptoms of BPH stem from obstruction of the urethra and gradual loss of
bladder function, which results in incomplete emptying of the bladder. The symptoms of
BPH vary, but the most common ones involve changes or problems with urination,
such as:

 A hesitant, interrupted, weak stream
 Urgency and leaking or dribbling
 More frequent urination, especially at night

The American Urological Association's symptom index (below) assists physicians in
diagnosing BPH by assigning a "score" to a patient's severity and frequency of symptoms.
By answering the questions in this test, patients can help their doctor get a better indication
of whether or not they have BPH.
It's important to remember that urinary symptoms can be caused by a variety of causes
other than BPH. To evaluate any symptoms you may have, you should see a physician.



Question Not at all Less than 1
time in 5
Less than
half
the time
About half
the time
More than
half
the time
Almost
always
Over the past month, how often have you
had a sensation of not emptying your
bladder completely after you finished
urinating?

1 2 3 4 5 6
Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?

1 2 3 4 5 6
Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?

1 2 3 4 5 6
Over the past month, how often have you found you stopped and started again several times when you urinate?

           
Over the past month, how often have you found it difficult to postpone urination?

           
Over the past month, how often have you had a weak urinary stream?

           
Over the past month, how often have you had to push or strain to begin urination?

           
Over the past month, how often have you had a weak urinary stream?

           
Over the past month, how any times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?
0 = No Times,
1 = One Time,
2 = Two Times,
3 = Three Times,
4 = Four Times,
5 = Five Times

           


Add the total points together to determine your individual symptom score:

Score Interpretation
0 - 7 Mild obstruction
8 - 19 Moderate obstruction
20 - 35 Severe obstruction


When should I seek treatment for BPH?
If the symptoms of BPH are affecting the quality of your life, it is time to seek treatment.
One example is if you are losing sleep because you need to urinate during the night.



How is BPH diagnosed?
If you're a man at least 60 years of age, you may first notice symptoms of BPH yourself, or
your doctor may find that your prostate is enlarged during a routine checkup. When BPH is suspected, you may be referred to a urologist, a doctor who specializes in problems of the urinary tract and the male reproductive system.

Several diagnostic tests help the doctor identify the problem and decide which treatment is
best. The tests vary from patient to patient, but the following are the most common:


 RECTAL EXAM
  This exam, called the digital rectal exam (DRE) is usually the first test done. The doctor
   inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum.   This exam gives the doctor a general idea of the size and condition of the gland.


 ULTRASOUND
  In this procedure, a probe inserted into the rectum directs sound waves at the prostate.
  The sound waves form an image of the prostate gland on a display screen. This image
  helps doctors evaluate the prostate and any obstruction.


 URINE FLOW STUDY
  Sometime the doctor will ask a patient to urinate into a special device that measures how   quickly the urine is flowing. A reduced flow often suggests BPH.

 INTRAVENOUS PYELOGRAM (IVP)
  IVP is an X-ray of the urinary tract. In this test, a dye is injected into a vein. The dye makes   the urine visible on the X-ray and can show if an enlarged prostate is blocking the urethra.

 CYSTOSCOPY
  In this exam, the doctor first numbs the inside of the penis with an anesthetic gel, then inserts
  acystoscope through the opening of the urethra in the penis. The cystoscope contains a lens   and a light system which help the doctor see the inside of the urethra and the bladder. This   procedure allows the doctor to determine the size of the prostate gland and identify the
  location and degree of the obstruction.

Is there a BPH-cancer link?
BPH is not cancer and there is no reported link between BPH and cancer.

What are the treatments for BPH?
The doctor and the patient will evaluate the severity of the condition
and the treatment options available. These options include:

 "Watchful Waiting"

Medications
Alpha Blockers
Hormone-Suppressing Drugs

Minimally Invasive Procedures
 Interstitial Laser Coagulation of the Prostate (ILC)
 TransUrethral Microwave Thermotherapy (TUMT)
 TransUrethral Needle Ablation (TUNA)

Surgery
 TransUrethral Resection of the Prostate (TURP)
 TransUrethral Incision of the Prostate (TUIP)

Long-term catheterization

 

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