‎Benign Prostate Hyperplasia Is NOT Prostate Cancer: Debunking the Myths and Understanding the Real Link.

BPH is a non-cancerous condition in which the inner part of the prostate (around the urethra) often keeps growing as men get older.In BPH, the prostate tissue can press on the urethra, leading to problems passing urine. Is not cancer and does not develop into cancer. But it can be a serious problem for some men.

‎CAUSES

‎1-Theories

‎•Hormonal levels related to age throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen within the prostate increasing the activity of substances that promote prostate cell growth.

‎•Another theory focuses on Dihydrotestosterone (DHT), a male hormone that plays a role in prostate development and growth, Indicates that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.

‎2- Other causes

‎•Radiation

‎•Age

‎•Drugs (carcinogenic drugs)

‎•Smoking increases the risks.

‎•Infections.

‎

SIGNS AND SYMPTOMS

‎°Urinary frequency—urinating eight or more times a day

‎°Urinary urgency—the inability to delay urination

‎°Trouble starting a urine stream

‎°A weak or an interrupted urine stream

‎°Dribbling at the end of urination

‎°Nocturia frequent urination during periods of sleep

‎°Urinary retention

‎°Urinary incontinence—the accidental loss of urine

‎°Pain after ejaculation or during urination

‎°Urine that has an unusual color or smell

‎

‎INVESTIGATIONS

‎•Digital rectal examination: The Digital Rectal Examination (DRE) is an integral part of the evaluation in men with presumed BPH. During this portion of the examination, prostate size and contour can be assessed, nodules can be evaluated, and areas suggestive of malignancy can be detected.

‎•Urinalysis - Examine the urine using dipstick methods and/or via centrifuged sediment evaluation to assess for the presence of blood, leukocytes, protein, or glucose

‎•Urine culture - This may be useful to exclude infectious causes of irritative voiding and is usually performed if the initial urinalysis findings indicate an abnormality

‎•Prostate-specific antigen - Although BPH does not cause prostate cancer, men at risk for BPH are also at risk for this disease and should be screened accordingly

‎•Ultrasonography (abdominal, renal, transrectal) and intravenous urography are useful for helping to determine bladder and prostate size and the degree of hydronephrosis (if any) in patients with urinary retention or signs of renal insufficiency. Cystoscopy may be indicated in patients scheduled for invasive treatment or in whom a foreign body or malignancy is suspected.

‎

‎TREATMENT

‎Alpha-1–receptor blockers - by relaxing smooth muscle tissue found in the prostate and the bladder neck, this allows urine to flow out of the bladder more easily e.g. Terazosin 1-5mg OD.

‎Terazosin and doxazosin are usually taken at bedtime (to reduce light-headedness). The dose can be increased over time if needed.

‎

‎SURGERY

‎Prostatectomy  surgical removal of the portion or the whole prostate gland.

‎TYPES OF SURGERIES

‎°Radical Retropubic Prostatectomy. The entire gland, and nearby lymph nodes, is removed through an incision in the abdomen.

‎°Radical Perineal Prostatectomy. The entire gland is removed through an incision between the scrotum and the anus. Nearby lymph nodes can also be removed at the same time through a separate incision in the abdomen.

‎°Laparoscopic prostatectomy. The entire gland, and nearby lymph nodes, is removed through a number of small incisions, rather than a single long cut in the abdomen. A thin, lighted tube known as a laparoscope is used to remove the prostate.

‎°Transurethral resection of the prostate (TURP).  Part of the gland is removed using a long, thin device which is inserted through the urethra. TURP may not remove all of the cancer, but it can remove tissue that is blocking the flow of urine.

‎

COMPLICATIONS

‎•Haemorrhage following surgery

‎•Urinary bladder clot formation due to inadequate irrigation.

‎•Infertility if damage to the spermatic cords

‎•Urethra scarring

‎•urinary tract infections due to longer periods of catheterization.

‎

‎About the Author

‎Clinician. Rodgers Choolwe- dip. Clinical medical sciences, Cert. HIV/AIDS Counseling and Management for Paediatrics and Adults, BSc. (Understudy).

‎

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