BENIGN HYPERTROPHY OF PROSTRATE

By Dr. Anjali Miglani
Chief medical officer ( H )
Dte. Of ayush

1. BENIGN HYPERTROPHY OF PROSTRATE Dr . Anjali Miglani Chief medical officer ( H ) Dte . Of ayush

2. What is benign hypertrophy of prostrate Benign prostatic hyperplasia is non malignant growth of prostate. age-related phenomenon in nearly all men, starting after 40 years of age. H istologically 50-60% men in 60s and 80-90 % in their 70s and 80s suffer from bhp . P rostate gland size increases up to 45gms. (The normal weight is approx. 10 gms )

3. etiopathology Etiology is poorly understood despite decades of intense research. It is thought to be stimulated by dihydrotestosterone (DHT ) Risk factors are: changes to bladder anatomy and function, Urinary Tract Infection, formation of bladder stones and renal failure Additional risk factors: positive family history of bhp

4. Symptoms/ signs H esitancy , frequency, urgency, straining, weak flow, prolonged voiding, partial or complete urinary retention, small voided volumes, nocturia , painful urination.   If peak urinary flow rate <10 mL/s, then sub vesical obstruction is seen in 90% patients of bhp Sometimes other diseases e.g. prostate cancer, bladder outlet obstruction like urethral stricture and stones also have similar Lower urinary tract symptoms and should be ruled out

5. diagnosis Careful history and physical examination including Rectal examination (DRE) DRE is however unreliable in assessing size and may underestimate size of prostate. Urine Analysis, serum Cr. Prostrate Specific Antigen. Uroflowmetry -Urinary flow rate <10 mL/s highly suggestive of outlet obstruction transabdominal ultrasound - for Postvoid residual urine measurement

6. managment Avoid fluids prior to bedtime or going out Reduce caffeine and alcohol especially towards evening Scheduled urination at least once every 3 hours In case of urgency of urine, pass urine as soon as possible. If the urge is neglected for a considerable time , it may lead to acute urinary retention. Lead a healthy life style

7. Allopathic treatment Alpha-1-adrenergic antagonists It Relaxs smooth muscle in the bladder neck, prostate capsule, and prostatic urethra 5-alpha-reductase inhibitors  It Reduces the size of the prostate gland Anticholinergics for patients with predominately irritated symptoms related to overactive bladder

8. Surgical options In case oral medications do not help, Surgery can be thought of. It can be Open Prostatectomy, or Endoscopically when Transurethral Incision of the Prostate (TURP ) is done other surgical interventions are: Transurethral needle ablation (TUNA ) transurethral microwave therapy (TUMT ) Transurethral Electro evaporation of The Prostate (TUVP)

9. Homoeopathic medicines Benzoic Acid - Dribbling of urine in old men. Urine in clothes scents the whole room. Urine dark brown in color and very offensive. Staphisagria - old men with frequent urination and dribbling of urine after wards. backache worse at night in bed and in the morning before rising. Conium maculatum - urine flows, stops and flows again intermittently, esp in old bachelors. Dribbling of urine in old men. Sweating day or night, as soon as one sleeps or even when closing the eyes. Thuja - anti sycotic remedy. Proliferations, prostratic affections and pathological vegetations esp after suppressed gonorrhoea . Pain and burning felt near neck of bladder with frequent , urgent desire to urinate

10. Homoeopathic medicines Carbolicum acidum - irritable bladder in old men with frequent urination at night. Urine almost black. Bhp with diabetes Sabal serrulata - cystitis with bhp . Discharge of prostatic fluid with wasting of testis and Loss of sexual power. iritis with prostatic troubles. Ferrum picricum - frequent urination at night, feeling of fullness and pressure in rectum. Smarting at neck of bladder and penis. Retention of urine.