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Benign Prostatic Hyperplasia
Tossing and turning all night, Mr. Chu could not hold it anymore. A while later there came a stream of flushing sound, which vexed Mrs. Chu back in the room, who was sitting on the bed and wondered what on earth was happening to Mr. Chu. Chu just hemmed and hawed, "Nothing. Probably too much soup tonight!" This failed to bring about any relief, providing Mr. Chu's recent night urinary frequency. Sour-faced, Mr. Chu admitted that his urinary frequency has recently increased; incomplete voiding has left stains on his underwear. He hoped it would get well after a while, yet the fact is otherwise. Mrs. Chu was annoyed about her husband's being clandestine, and urged him to see the doctor before it is too late.
- Elderly with Dysuria must seek diagnosis
- Changes of hormone secretion cause prostate enlargement
- Neglect of Symptoms may cause severe illness
- Smooth urination after prescription or surgery
- Some types of fruits help alleviate the BPH symptoms
- Unrelated to Sexual Dysfunction
Source: Dr Benson K.F. Yeung, Specialist in General Surgery
Elderly with Dysuria must seek diagnosis
Male elderly often think weak urinary stream, Dysuria and incomplete voiding are nothing more than signs of aging. "That's the way it is. Don't worry!" But in fact in many cases, the cause is Benign Prostatic Hyperplasia.
Benign Prostatic Hyperplasia (BPH), also known as benign enlargement of the prostate (BEP) is common to middle-aged and elderly men. An anatomical dissection research reflects that 20% of men aged between 41 and 50 have evidence of BPH; whilst 50% of men between 51 and 60; 90% of elderly aged 80 or above. Clinical observations have seen evidence of relations between aging and symptoms of BPH. 25% of men aged around 55 have Dysuria; 50% of the 75 year-old suffer from decreased urinary volume, weak urinary speed and Dysuria. Aging is not the sole reason of the occurrences of these symptoms, which are related to the internal changes of human body.
Changes of hormone secretion cause prostate enlargement
One of the causes of BEP is aging, which results in degeneration of prostate tissue. Besides this, study results prove the relationship between BEP and changes of hormone secretion.
Aging decreases the secretion of free testosterone, and also increases the secretion of estrogen. As we age, androgen acceptors, which are immune from estrogen secretion during juvenility, increase in sensitivity, along with the increased secretion of estrogen; which stimulates prostate hyperplasia.
Prostate is between bladder and urethra. Under the reactive hyperplasia, its size is enlarged, resulting in pressure on the urethra, which causes various urinary symptoms.
Neglect of Symptoms may cause severe illness
Symptoms of BPH can be mainly classified as 'storage' or 'voiding':
Storage: Intermittency, decreased urine volume and weak urinary stream, straining to void (even right after that), and repetitive voiding (void every two hours), Dysuria and dribbling.
Voiding: Urgent need to void, increased frequency of voiding, Nocturia.
As a patient feels obvious urgency to void, incontinence is less likely to occur. However, the above mentioned symptoms can cause a great inconvenience and disturbance to a patient's daily life. Do not ignore what two more times of toilet visit mean. If left untreated, the symptoms will be worsened and cause severe problems, including Anuria, cystitis, and even acute or chronic renal failure.
Smooth urination after prescription or surgery
When related symptoms are discovered, patients should immediately seek a medical consultation. The doctor will diagnose in accordance with several steps, including inquiring about symptoms. The doctor may then calculate the 'grade of symptoms' to evaluate the level of intensity; the higher the grade is, the worse the patient suffers and the earlier a treatment is needed. For high graders a surgery is required.
A clinical diagnosis includes digital rectal examination to feel the prostate. If needed, the doctor will proceed to other examinations, such as urinalysis and prostate specific antigen. A urology specialist may practice a 'Uroflowmetry'. To further measure the size of the prostate requires an ultra-sonic wave examination. If the situation proves the necessity of a surgery, the doctor will first practice a bladder endoscopy to check the situation of the urethra, bladder and prostate.
After the symptoms are identified as those of BPH, treatments will be given according to the level of severity. Those with minor illness will receive observation or medication. If medication does not yield obvious results and symptoms are worsened, a surgery is required. The surgery aims at improving the function, which doesn't require the removal of the entire organ. Instead, a device will be inserted to the prostate through the urethra to remove the proliferated cells that press the urethra bit by bit. The inside of the prostate will be thinned, whilst the outside remains intact. And the urination problem is solved.
The risk of recurrence after 15 years is high; yet the Dysuria symptoms, regardless of the level of severity, can be cured by medication.
Some types of fruits help alleviate the BPH symptoms
With Dysuria, patients should avoid any massive intake of liquid after dinner, as a prevention of sleeping quality affected by frequent nocturia. Some types of fruits, for instance tomatoes, pumpkins, and oranges, are believed to help alleviate BPH, or stop the symptoms from worsening.
Unrelated to Sexual Dysfunction
The fact that BPH leads to Dysuria arouses doubts whether it also affects sexual function. The obvious relation between the two is now a keen topic of controversy. BPH symptoms are common in aged men. One of the critical causes of erectile dysfunction is the decreased testosterone secretion, which often occurs since the middle age. Besides, prescription of antihypertensive drugs, which are common to elderly, is a possible cause of sexual dysfunction.
There are a couple of medicines that can help the symptoms of BPH; they, however, may affect the patient's sexual function, and cause erectile dysfunctions or decreased interest in sex. Such symptoms are caused by the medicine, not by BPH.
Similar to the case of prostate cancer, middle-aged men are at higher risk of the disease. Yet the two diseases, as doctors believe, are two individual, unrelated symptoms.
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Source: Dr Benson K.F. Yeung, Specialist in General Surgery
