WHAT IS BENIGN PROSTATIC HYPERPLASIA ?

Benign prostatic hyperplasia (BPH) is a condition that affects the prostate gland in men. The prostate is a gland found between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful. “Benign” means the enlargement isn’t caused by cancer or infection. “Hyperplasia” means enlargement.

WHAT ARE THE SYMPTOMS OF BPH?

Most symptoms of BPH start gradually. One symptom is the need to get up more often at night to urinate. Another symptom is the need to empty the bladder often during the day. Other symptoms include difficulty in starting the urine flow and dribbling after urination ends. The size and strength of the urine stream may decrease.

These symptoms can be caused by other things besides BPH. They may be signs of more serious diseases, such as a bladder infection or bladder cancer. Tell your doctor if you have any of these symptoms, so he or she can decide which tests to use to find the possible cause.

HOW WILL MY DOCTOR KNOW IF I HAVE BPH?

After your doctor takes a complete history of your symptoms, a rectal exam is the next step. This exam allows your doctor to actually feel the size of the prostate gland.

It might not be possible for your doctor to be sure that your prostate problem is benign just by taking a history and performing a physical exam. Your doctor might need to look at a sample of your urine for signs of infection. Your doctor may also do a blood test. An ultrasound exam or a biopsy of the prostate may help your doctor make the diagnosis.

HOW WILL MY DOCTOR TREAT MY BPH?

Once your doctor is sure that your symptoms are caused by benign growth of the prostate gland, treatment can be recommended. However, your doctor may suggest that you wait to see if your symptoms get better because sometimes mild symptoms get better on their own. If your symptoms get worse, your doctor may suggest another treatment option.

Surgery is considered the most effective treatment and is used in men with strong symptoms. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done through the urethra, leaving no scars. Surgery does have risks, such as bleeding, infection or impotence. These risks are generally small.

ARE THERE ANY DRUG I CAN TAKE?

Drug treatments are available. Finasteride (brand name: Proscar) makes the prostate shrink, but it does not help all patients. The side effects of finasteride are rare and mild, but they usually have to do with sexual function. They go away when the medicine is stopped. The prostate will enlarge again when the medicine is stopped, so another treatment may have to be tried.

Another kind of medicine, called alpha blockers, also can help the symptoms of BPH. Some of these drugs are terazosin (brand name: Hytrin), doxazosin (brand name: Cardura) and tamsulosin (brand name: Flomax). Alpha blockers have been used for a long time to treat high blood pressure, but they can also help the symptoms of BPH, even in men with normal blood pressure. These medicines may not work in all men. The side effects of alpha blockers are mild and go away if you stop taking the medicine. The side effects include dizziness, fatigue and lightheadedness.

IMPOTENCE:

HOW IS ERECTILE DYSFUNCTION TREATED?

How erectile dysfunction is treated depends on what things are causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.

WHAT OTHER OPTIONS DO I HAVE ?

If the medicines aren’t right for you, you could also try using vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options.

HOW DO I KNOW WHICH TREATMENT FOR IMPOTENCY IS BEST SUITED FOR ME?

The decision about treatment option should be discussed with your physician. Your choice of treatment will depend on personal preference and economic factors. Both you and your partner should be comfortable with your choice.

IS IT NECESSARY FOR MY SEXUAL PARTNER TO BE INCLUDED IN DISCUSSIONS ON MY IMPOTENCE?

She helps the doctor understand the problem and must agree with the treatment choice.

CAN ANY OF THESE TREATMENT OPTIONS REVERSE IMPOTENCE?

Most impotence is irreversible. While none of the three treatment options reverse a man’s impotence, they do offer a solution to the problem.

HOPE THROUGH RESEARCH

Advances in suppositories, inject able medications, implants, and vacuum devices have expanded the options for men seeking treatment for ED. These advances have also helped increase the number of men seeking treatment. Gene therapy for ED is now being tested in several centers and may offer a long-lasting therapeutic approach for ED.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsors programs aimed at understanding the causes of erectile dysfunction and finding treatments to reverse its effects. NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases supported the researchers who developed Viagra and continue to support basic research into the mechanisms of erection and the diseases that impair normal function at the cellular and molecular levels, includingdiabetes and high blood pressure.

POINTS TO REMEMBER

  • Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse.
  • ED affects 15 to 30 million American men.
  • ED usually has a physical cause.
  • ED is treatable at all ages.
  • Treatments include psychotherapy, drug therapy, vacuum devices, and surgery.