Benign prostate enlargement (BPH, BPH) is often a benign expansion of the prostate related, that causes enlarged prostate.
Enlarged prostate is usual in males 50 yoa.
CAUSE
The source is unknown, but may be due to modifications to change that occur because of the maturing.
Prostate gland surrounding the urethra (the tube that carries urine out of your body), so increase in glands will gradually narrow the urethra. Ultimately blockage of the flow of urine.
As a result, the muscles in the bladder come to be a greater and stronger to push urine out.
If a patient with BPH voiding, the bladder seriously isn't completely empty.
Retained urine from the bladder, making the individual prone to infections and form stones.
Blockage might cause long term harm to the kidneys.
In patients with BPH, the use of drugs that obstruct the flow of urine (eg OTC antihistamines) might cause blockages.
SYMPTOMS
Initial symptoms arise if the prostate is enlarged begin to clog the flow of urine.
At first, the individual has difficulty to begin urinating. Patients also felt how the process isn't yet complete berkemihnya.
Patients are more frequent urination during the night time (nocturia) and if straining to urinate ought to be stronger.
Volume and power radiating urination be also reduced at the final of voiding urine still dripping.
Consequently, full bladder, causing incontinence uri (beser).
If the patient straining to urinate, small veins in the urethra and bladder can rupture so that the urine contained blood.
Total blockage causes sufferers to urinate so that the patient can't feel her bladder is full and incurred severe pain inside the lower abdomen.
If there is an infection from the bladder, there'll be a burning sensation while urinating, fever also.
Retained urine in the bladder also cause increased pressure on the kidney, but rarely produce permanent kidney damage.
Diagnosis
Diagnosis will depend on symptoms and physical examination.
Digital rectal examination to feel / felt the prostate gland.
This examination can be known with the enlarged prostate, hard lumps (indicating cancer) and tenderness (indicating infection).
Usually do blood tests to find out kidney function and then for prostate cancer screening (measuring numbers of PSA or PSA).
In patients with BPH, PSA levels increased by about 30-50%. Automobile surge in PSA levels, it's important to perform further tests to discover regardless of if the patient also endured prostate type of cancer.
To measure the number of urine remaining within the bladder after voiding patient, or the patient catheter was asked to urinate right uroflometer (a device used to measure the rate of flow of urine).
By utilizing ultrasound, could the size of the gland and determined the reason BPH.
Sometimes finished with endoscopic examination is inserted throughout the urethra to view other causes of blockage of urine flow.
To search for the blockage of urine flow can IVP X-ray examination.
Urine analysis completed to search for blood or infection.
TREATMENT
Drugs
1. Alpha 1-blockers
By way of example doxazosin, prazosin, tamsulosin and terazosin.
These drugs cause relaxation (relaxation) the muscles with the bladder, so people much better to urinate.
2. Finasterid
Finasterid prostate contributes to reduced degrees of hormones that slow up the sized the prostate.
Prescription drugs also causes increased urine flow rate and lower symptoms. However it takes about 3-six months towards the occurrence of significant improvement.
Side effects of Finasterid is reduced eros and impotence.
3. Other drugs
To help remedy chronic prostatitis, which will accompanies BPH, given antibiotics.
Surgery
Surgery is frequently performed on patients who may have:
- Incontinence uri
- Hematuria (blood in urine)
- Retained placenta (retained urine from the bladder)
- Recurrent urinary tract infections.
Variety of surgery usually depends upon the seriousness of symptoms as well as the size and shape in the prostate.
1. TURP (trans-urethral resection in the prostate)
BPH TURP surgery is often times performed.
Endoscope is inserted over the penis (urethra). Good thing about TURP is just not done incisions, thereby reducing the risk.
88% of patients who undergo TURP experience improvement that can last for 10-fifteen years. Impotence happened in 13.6% of patients and 1% of patients experienced incontinence uri.
2. TUIP (trans-urethral incision from the prostate)
TUIP like TURP, but is normally performed on patients that have a somewhat small prostate.
On prostate tissue made a small incision to widen the opening for the opening from the urethra and bladder, resulting in improved the flow of urine rates and symptoms reduced.
Possible complications are bleeding, infection, urethral stricture and impotence.
3. Open prostatectomy.
An incision can be made within the abdomen (over the structure behind the pubic bone / retropubic and above the pubis / suprapubic) or perhaps in the perineum (pelvic flooring areas scrotum towards anus). Through a perineal approach currently used jarangn again as the incidence of impotence after surgery reached 50%.
This surgery may take some time to patients really should be treated for five-10 days.
Complications which could occur are impotence (16-32%, with regards to the surgical approach) and incontinence uri (a lot less than 1%).
Other treatment effectiveness remains to be under study is hyperthermia, laser therapy and prostatic stents.
Should the level of blockage is minimal, are capable of doing the next actions:
# Hot bath
# Immediately upon urination urge to urinate appear
# Perform sexual activity (ejaculation) as usual
# Avoid alcohol
# Avoiding excessive fluid intake (especially in the evening)
# To reduce nocturia, should slow up the intake of fluids several hours before going to bed
# Patients with BPH should prevent the using flu and sinus medications that are sold freely, which boasts a decongestant because it can increase the the signs of BPH.
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