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By Dr Ajit Saxena
Benign prostatic hyperplasia (BPH) — also known as prostate gland enlargement — is a common condition among men as they get older. The condition may lead to uncomfortable urinary symptoms, including blocking the flow of urine out of the bladder. It can also cause kidney, bladder or urinary tract problems (LUTS)
As the prostrate gets bigger, it presses on the urethra obstructing the flow of urine out of the bladder.
Common Symptoms
While the severity of symptoms varies from person to person, Some of the commonly reported symptoms and complaints are increased frequency at night, poor flow of urine, hesitancy, urgency or painful or difficult urination..
Management of BPH
There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have and your preferences.
Today surgery is advised only in extreme cases, as in patients with severe symptoms or complications like hydronephrosis (swelling of kidney due to a build-up of urine). The medications that are commonly used to relax muscle tissue and blood vessels in the prostrate gland to improve the flow of urine and blood include doxazosin, tamsulosin, terazosin, alfuzosin, silodosin. Some of the combination drugs suggested are:alfuzosin/finasteride; doxazosin/finasteride; terazosin/finasteride.
Other Methods
Some of the other techniques used to address prostate gland enlargement include: balloon dilation, a non surgical procedure; use of stents and lasers.
Advantages and Disadvantages
While interventional therapies can prevent the progression of the condition, doubt remains over the long-term effectiveness of some procedures. It can also lead to significant morbidity. Similarly, while medications can provide quick relief, data is limited for its long term effects and preventing the progression of the disease.
Dr Saxena is senior consultant, uro-andrologist at Indraprastha Apollo Hospitals, New Delhi. He specialises in treating prostate disease and impotence using a bloodless technique called vapour resection. He is also the founder president of Andrology India.