Urology

Benign Prostatic Hyperplasia

What is a benign prostatic hyperplasia, what are the causes of this phenomena, how to diagnose and treat it? All the answers to these questions - in the following article.

Did you know? About 50% of the men may suffer from benign prostatic hyperplasia after the age of 50, and this situation becomes more common with age.

What are the causes and symptoms of benign prostatic hyperplasia?

Benign prostatic hyperplasia derives from a growth of the inner part of the gland, from an unknown reason. The symptoms for the growth are disruption in urinating. The common symptoms include Weak urine stream or a stream that stops and starts, Inability to completely empty the bladder, making an effort to urinate, Frequent or urgent need to urinate and increased frequency of urination at night.

How to diagnose benign prostatic hyperplasia?

The diagnosis is clinical, which means it is based on the presence of typical disruptions in urinating and negation of other factors. Also, within the medical questioning we perform a manual examination of the prostate to evaluate its size and to negate findings that may rise a suspicion for prostate cancer.

Other tests that can be performed in the urology clinic in the Kaplan Medical Center are:

  • Uroflow - a test designated to evaluate the strength of the urine stream objectively. During the test the patient is required to urinate into a device measuring the urine quantity and the stream intensity.
  • Urodynamic test - this test is designated to examine the function and capacity of the bladder, and the sense and contraction ability of the bladder. During the examination, a thin catheter is inserted through the urethra into the bladder and fluids are inserted until the bladder is full. This exam measures the patient’s feeling in response to the bladder filling and the pressures in the bladder.
  • Kidney and urinal tract sonar - a test enabling general evaluation of the kidneys, bladder and prostate.

How to treat benign prostatic hyperplasia?
There are two lines of treatment: medicinal and surgical.

The first line of treatment is medicinal and it includes two types of medicines:

  1. Medicines to relax the exit muscle of the bladder and prostate - these act within a few days and usually create an improvement in the intensity of the urine flow and the ability to fully empty the bladder.
  2. Medicines to decrease the hormonal influence of the prostate and cause a decrease in the prostate size. These medications influence for the long-term.

Today, it is known that an integrated treatment of drugs from both groups creates the most significant improvement - more than each of the drugs separately.

The decision upon a surgical procedure to treat the problem is received, usually, when there are complications such as holding urine, repetitive significant infections of the urinary tracts, repetitive events of bleeding from the urinal tracts, etc.

There are a few options for surgical treatment, all designated to remove the inner part of the prostate:

  1. TURP - an endoscopic surgery which inserts an optic device through the urethra and performs a direction of the inner part of the prostate. After the surgery the patient has a catheter, usually for two days.
  2. SPP - removal of the inner part of the prostate using an open surgery. The surgery is done when the prostate is enlarged.
  3. PVP - vaporizing the prostate using a green laser, endoscopically, through the urethra. The Kaplan Medical Center urology unit is leading this innovative treatment. The surgery allows treating patients who use blood thinning medications and usually entails a day of admittance, after which the catheter is removed.