The condition benign prostatic hypertrophy, BPH, in which the prostate is enlarged, often results in urinary retention— the inability to empty the bladder. Using the medical terminology, write a paragraph explaining the causes, symptoms, signs, and treatment of BPH. Sandra has been unable to get pregnant for two years despite fertility treatments, and so she is undergoing an exploratory surgical procedure to look for possible anatomical causes of her infertility. What do you think the common three causes? Explain your answers in medical terms.
Benign prostatic hypertrophy (BPH) is a medical condition characterized by the enlargement of the prostate gland. The causes of BPH are multifactorial and can be attributed to both hormonal and age-related factors. It is commonly associated with an increase in the production of dihydrotestosterone (DHT), a potent androgen hormone derived from testosterone. DHT stimulates the proliferation of prostate cells, leading to the enlargement of the gland. Additionally, an imbalance in the levels of estrogen and androgen hormones may contribute to the development of BPH.
Symptoms of BPH primarily arise from the mechanical obstruction of the urethra, which is caused by the enlarged prostate. These symptoms include urinary retention, which is the inability to completely empty the bladder, leading to frequent urination, nocturia (increased urination during the night), and difficulty starting and stopping urine flow. Other symptoms include weak urinary stream, dribbling after urination, and a sensation of incomplete bladder emptying. In severe cases, BPH can lead to urinary tract infections, hematuria (blood in the urine), bladder stones, and even renal damage.
The diagnosis of BPH involves a combination of medical history evaluation, physical examination, and diagnostic tests. During the physical examination, the healthcare provider may perform a digital rectal examination (DRE), in which the size and consistency of the prostate gland are assessed. This is typically done by inserting a gloved, lubricated finger into the rectum to palpate the prostate. The healthcare provider may also conduct other tests, such as a urine flow study to assess the rate and force of urine flow, as well as blood tests to evaluate kidney function.
The treatment options for BPH range from conservative management to surgical interventions, depending on the severity of symptoms and the impact on the patient’s quality of life. Conservative management includes lifestyle modifications, such as avoiding excessive fluid intake, reducing caffeine and alcohol consumption, and practicing timed voiding. Medications such as alpha-adrenergic blockers and 5-alpha reductase inhibitors may be prescribed to improve urinary symptoms and minimize the progression of BPH. These medications can relax the smooth muscles of the prostate, thereby reducing the obstruction and improving urine flow. However, it is important to note that medication alone cannot shrink the size of the prostate gland.
Surgical interventions may be considered if conservative management and medication fail to provide adequate relief or if the symptoms are significantly impacting the patient’s quality of life. Transurethral resection of the prostate (TURP) is a commonly performed surgical procedure where excess prostate tissue is removed using a thin tube inserted through the urethra. It is considered the gold standard treatment for BPH. Other surgical procedures, such as laser ablation, transurethral incision of the prostate (TUIP), or open prostatectomy, may be considered depending on the size of the prostate gland and the patient’s overall health.
In conclusion, BPH is a common condition that primarily affects aging males due to the enlargement of the prostate gland. It is caused by hormonal imbalances and age-related changes. The symptoms of BPH arise from the mechanical obstruction of the urethra and can have a significant impact on the patient’s quality of life. The diagnosis involves a combination of medical history evaluation, physical examination, and diagnostic tests. Treatment options include conservative measures, medication, and surgical interventions, depending on the severity of symptoms and their impact on the patient’s well-being.