Alternate Names: (Benign Prostatic Hypertrophy) BPH

Definition   

The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body. An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems. An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.

Causes   

The actual cause of prostate enlargement is unknown. It is believed that factors linked to aging and the testicles themselves may play a role in the growth of the gland. Men who have had their testicles removed at a young age (for example, and as a result of testicular cancer) do not develop BPH.

Similarly, if the testicles are removed after a man develops BPH; the prostate begins to shrink in size.

Some facts about prostate enlargement: The likelihood of developing enlarged prostate increases with age. BPH is so common that it has been said, that all men will have an enlarged prostate if they live long enough. A small amount of prostate enlargement is present in many men over age 40 and more than 90% of men over age 80. And No risk factors have been identified other than having normally functioning testicles.

Symptoms 

Benign prostatic hyperplasia symptoms are classified as obstructive or irritative. Obstructive symptoms include hesitancy, intermittency, incomplete voiding, weak urinary stream, and straining. Irritative symptoms include frequency of urination, which is called nocturnal when occurring at night time, and urgency (compelling need to void that can not be deferred). These obstructive and irritative symptoms are evaluated using the International Prostate Symptom Score (IPSS) questionnaire, designed to assess the severity of BPH.

BPH can be a progressive disease, especially if left untreated. Incomplete voiding results in stasis of bacteria in the bladder residue and an increased risk of urinary tract infections. Urinary bladder stones, are formed from the crystallization of salts in the residual urine. Urinary retention, termed acute or chronic, is another form of progression. Acute urinary retention is the inability to void, while in chronic urinary retention the residual urinary volume gradually increases, and the bladder distends. Some patients who suffer from chronic urinary retention may eventually progress to renal failure, a condition termed obstructive uropathy

Exams and Tests   

After taking a complete medical history, your doctor will perform a digital rectal exam to feel the prostate gland. The following tests may also be performed:
Urine flow rate ; Post-void residual urine test to see how much urine is left in your bladder after urination ; Pressure flow studies to measure the pressure in the bladder as you urinate ; An IVP (an x-ray study) to confirm BPH or look for blockage ; Urinalysis to check for blood or infection ; Urine culture to check for infection ;A prostate-specific antigen (PSA) blood test to screen for prostate cancer ; and Cystoscopy.

In addition, you may be asked to complete a form to evaluate the severity of your symptoms and their impact on your daily life. Your score may be compared to past records to determine if the condition is getting worse.

Treatment   

The choice of a treatment is based on the severity of your symptoms, the extent to which they affect your daily life, and the presence of any other medical conditions. Treatment options include "watchful waiting," lifestyle changes, medication, or surgery.

If you are over 60, you are more likely to have symptoms. But many men with an enlarged prostate have only minor symptoms. Self-care steps are often enough to make you feel better.

If you have BPH, you should have a yearly exam to monitor the progression of your symptoms and determine if any changes in treatment are necessary.

Possible Complications   

Men who have had long-standing BPH with a gradual increase in symptoms may develop: Sudden inability to urinate; Urinary tract infections; Urinary stones; Damage to the kidneys; Blood in the urine

Even after surgical treatment, a recurrence of BPH may develop over time.

Lifestyle modifications
SELF-CARE IS VERY IMPORTANT AND ALL MEN SHOULD OBSERVE IT ESPECIALLY WHO ARE SUFFERING:

For mild symptoms:

Patients should decrease fluid intake before bedtime, moderate the consumption of alcohol and caffeine-containing products, and follow timed voiding schedules. Urinate when you first get the urge. Also, go to the bathroom when you have the chance, even if you don't feel a need to urinate. Avoid alcohol and caffeine, especially after dinner. Don't drink a lot of fluid all at once. Spread out fluids throughout the day. Avoid drinking fluids within 2 hours of bedtime.

CAUTION: TRY NOT TO TAKE OVER-THE-COUNTER COLD AND SINUS MEDICATIONS THAT CONTAIN DECONGESTANTS OR ANTIHISTAMINES. THESE MEDICATIONS CAN CERTAINLY INCREASE BPH SYMPTOMS.

Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms. Reduce stress. Nervousness and tension can lead to more frequent urination.

Pumpkin seed oil

Uses: Pumpkin seed oil is most commonly used to treat irritable bowel syndrome. Small studies have also shown that pumpkin seeds, which contain amino acids, steroidal compounds, and omega-3 and omega-6 fatty acids, may lower the risk of certain types of kidney stones and improve symptoms associated with enlarged prostates. Additionally, pumpkin seeds reportedly contain significant amounts of L-tryptophan. Some studies have also found pumpkin seeds to prevent arteriosclerosis and regulate cholesterol levels. Pumpkin seed oil, commonly prescribed in German folk medicine, remedies parasitic infestations of the intestinal tract such as tapeworms. Pumpkin seed oil serves as a salad dressing when combined with honey or olive oil. The typical Styrian dressing consists of pumpkin seed oil and cider vinegar. But the oil is also used for desserts, giving ordinary vanilla ice-cream an exquisite nutty taste. Using it as cooking oil, however, destroys its essential fatty acids.

Saw palmetto (Sabal serrulata in homeopathy)

Saw palmetto has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to medication. Experts suggest a fat-soluble saw palmetto extract with 85 - 95% fatty acids and sterols. However, a well-conducted study published in the February 9, 2006 edition of the New England Journal of Medicine found that the popular herb was no better than a dummy pill in relieving the signs and symptoms of BPH. Further studies are needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.

Contraindications and side effects (Saw palmetto)

Though men taking saw palmetto may develop mild nausea, reduced libido, or erectile dysfunction, the rate of such problems is clinically and statistically far less common than in men taking drugs to treat BPH symptoms, based on the JAMA meta-analysis cited above. There are no known drug interactions. It has not been proven that Saw palmetto causes a reduction of libido or erectile dysfunction. In fact saw Palmetto is used also as a light aphrodisiac; Saw palmetto reduces the DHT in the blood in a different way than Finasteride which could cause reduced libido. It is common to find in herbal drugs as a cure for sexual problems, such as reduced libido or erectile dysfunction, a small dose of saw palmetto extract associated with ginseng or other plants that contain L-arginine (Emanuel Gargiulo). While saw palmetto is generally considered safe, one of its primary active ingredients, beta-sito-sterol, is chemically similar to cholesterol. High levels of sito-sterol concentrations in blood have been correlated with increased severity of heart disease in men who have previously suffered from heart attacks.

As with other nutrients and herbs, various people may have different responses based on their chemical and biological make up.

ROLE OF HOMEOPATHY IN THE TREATMENT OF BPH

The role of homeopathic treatment is very successful in relieving men suffering from this most troublesome malady. The treatment is both curative in curable cases and certainly palliative in most advances cases.

Miasm:  Sycosis

Prognosis: Favorable. (Homeopathy cures the patient by strict individualization. It cures the man as a whole single unit and not by parts).

Homeopathic therapeutics

Apis mellifica: Stinging pain during urination that is worse when the final drops are passing is a strong indication for this remedy. Discomfort may also involve the bladder. The prostate area is swollen and very sensitive to touch. The person may feel worse from heat and from being in warm rooms, with improvement from being out in open air or from cool bathing.

Causticum: Urine loss when the person coughs or sneezes often indicates a need for this remedy. Once urine has started passing, the person may feel pressure or pulsation extending from the prostate to the bladder. Causticum is also indicated when sexual pleasure during orgasm is absent or diminished.

Chimaphilla umbellata: This remedy is often helpful when the prostate is enlarged, with urine retention and frequent urging. The person may have the feeling that a ball is lodged in the pelvic floor, or experience pressure, swelling, and soreness that are worse when sitting down. Chimaphilla gives occasional good results in relieving the tenesmus, frequent urination and general discomfort due to prostatic hypertrophy. Spongia is also a remedy for this condition.

Clematis: This remedy is often indicated when swelling of the prostate seems to have narrowed or tightened the urinary passage. Urine usually emerges slowly, in drops instead of a stream, with dribbling afterward.

Lycopodium: This remedy may be helpful if urine is slow to emerge, with pressure felt in the prostate both during and after urination. The prostate is enlarged, and impotence may also be a problem. People who need this remedy often suffer from digestive problems with gas and bloating, and have an energy slump in the late afternoon. Lycopodium, pressure in the perineum near anus while urinating.

Pulsatilla: Prostate problems with discomfort after urination and pains that extend to the pelvis or into the bladder (often worse when the man is lying on his back) suggest a need for this remedy. There may also be a bland, thick, yellow discharge from the penis. Pulsatilla is usually suited to emotional individuals who want a lot of affection and feel best in open air.

Sabal serrulata: A frequent urge to urinate at night, with difficulty passing urine, and a feeling of coldness in the sexual organs, suggest a need for this remedy. It is sometimes also used in lower potencies for urinary incontinence in older men. This remedy is made from saw palmetto which is also used as an herbal extract for similar prostate problems. Sabal serrulata has been recommended for various prostatic troubles, but its homoeopathic use seems confined to acute cases of enlarged and inflamed prostate. The gland is hot, swollen and painful. Here also come in our regular inflammation polychrests such as Aconite and Belladonna and it will not be necessary to go outside of them. Sabal is not altogether useless in senile hypertrophy. The writer has seen a marked palliative action in several cases and avoidance of surgical interference.

Staphysagria: This remedy may be indicated if a man feels burning pain in his urinary passage even when urine is not flowing, and urine retention is troublesome. Men who are likely to respond to Staphysagria are often sentimental and romantic, and may also have problems with impotence (most often caused by shyness). Frequent and copious urination; burning the whole length of urethra; frequent urging with scanty discharge of a thin stream of red-looking urine; urging as if bladder were not emptied; discharge of dark urine by drops; pain extending from anus along urethra, coming on after walking or riding.

Thuja: When the prostate is enlarged, and the person has a frequent urge to urinate, with cutting or burning pain felt near the bladder neck, this remedy may bring relief. After urine passes, a dribbling sensation may be felt. A forked or divided urine stream is sometimes seen when this remedy is needed. Frequent pressing to urinate with small discharge, patient strains much. Stitches from rectum into the bladder. Discharge of prostatic juice in the morning on awaking.

Conium maculatum:  This remedy is useful in chronic hypertrophy of the prostate with difficulty in voiding urine, it stops and starts, and there is an accompanying catarrh of the bladder. The suitability of Conium to the complaints of the aged should be considered. Dr. Bessey, of Toronto, speaks highly of Cimicifuga in prostatic hypertrophy.

 Ferrum picratum is one of the best medicines for prostatic enlargements in the aged. The 3x is advised.

 Selenium metallicum Prostatic juice oozes while sitting, during sleep, when walking and at stool; involuntary urination while walking, drips after stool or micturition; stool hard and impacted that it requires mechanical aid; aggravation in hot weather, after sleep, from anything which causes relaxation.

Sepia: Feeling in neck of bladder of urgent desire to pass water; must wait a long time before urine comes; any attempt to retain urine causes anxiety and pressure on bladder; urine thick, offensive, slimy, with yellow pasty sediment.

 Sulphur: Offensive sweat around genitals; stools hard, knotty, insufficient; urine fetid, with greasy-looking pellicle on it; painful desire, with discharge of bloody urine, requiring great effort; mucous discharge from urethra.

Sulphur iodatum: Pain in prostata; sensation of torpor in bladder; insufficient urination; incontinence of urine; mucous deposits in urine.

Triticum repens

 Retention of urine in very old people from enlarged prostata, when there is a great deal of trouble in urinating.

"The sick are entitle to exact knowledge, not guess work." – J T Kent.

Repertorial analysis

GENERALS - SYCOSIS

Apis ARG-MET. ARG-N. Calc. Caust.. Dulc.. Ferr. Fl-ac. Graph.. Iod. KALI-S.. Lach. Lyc. Mang. MED.. Merc-c.. Merc-sul. Mez. Nat-m. Nat-p. NAT-S. NIT-AC. Phyt. Sars. Sec. Sel. SEP. Sil.. STAPH. Sulph. THUJ.

PROSTATE GLAND - SWELLING

Apis. Arg-n. Aur-m. BAR-C. Benz-ac. Berb. CALC. CHIM.. Cimic.. CON. DIG. Dulc.. Ferr-m. ferr-pic. Gels.. hydrang. Hyos. Iod.. Kali-i. Lyc.. Med. Merc. Nat-c. Nat-s. Nit-ac. Pareir.. Phos.. Pop. Psor. PULS. sabal. Sec. Sel.. Sil. solid. Spong. Staph.. sul-i. Sulph. Thiosin. Thuj. Zinc.

PROSTATE GLAND - INDURATION

Cadm-p. Con. Cop. Iod. Phos.. Psor. Sel. Sil. Sulph. THUJ.

PROSTATE GLAND - INFLAMMATION

Aur. bar-c. Caps. Colch. Con. Dig. Dulc. Fab. Gels. Hep.. Kali-bi. Lyc.. Merc.. Nit-ac. Nux-v.. Ph-ac.. PULS. Sel. Sep. Sil. solid. Staph. Sulph. Thuj. Trib. Verat-v..

PROSTATE GLAND - INFLAMMATION - chronic

Aur. bar-c. Con. Ferr-pic.. Kali-bi. Lyc. Merc. Merc-c. Nit-ac. Nux-v. Puls.. Sabal Sel. Sep.. Staph.. Thuj. Trib.

PROSTATE GLAND - HARDNESS

Cadm-p. CON. Cop.. med. Phos. Sil. Thuj.

PROSTATE GLAND - MASTURBATION, complaints after

tarent.

PROSTATE GLAND - COMPLAINTS of prostate

Hydrang. med. Mela. solid.. thuj.

PROSTATE GLAND - COMPLAINTS of prostate - accompanied by - urination; frequent

apis ferr-pic. sabal staph.

BLADDER - URINATION - frequent

Aesc.. All-c.. Alum. Alumn. AM-C.. APIS ARG-MET. ARG-N.. BAR-C. Bar-m. Bell. benz-ac. CALC. CALC-ARCamph. Cann-i. Cann-s. CANTH.. Carb-v.. CASTM. CAUST.. Chim.. Cic. cimic. Cina . Clem.. Coff. Colch. Coloc. conCupr. Dig. dulc. Ery-a. Eup-pur. euph. EUPHR. Ferr-p. Fl-ac.. GELS.. GRAPH.. Kali-c.. LAC-AC. LACH.. LYC. MERC. MERC-C. Mez. Mur-ac. Murx. Nat-c. Nat-m.. Nat-s.. NUX-V.. Olnd. Op.. Petr.. Ph-ac. Plan.. Podo. Psor. PULS. RHUS-R. Rhus-t. Sabin. Sars. Sel. Seneg. Sep.. STAPH. SULPH. Ter. Thuj.

BLADDER - URINATION - interrupted

Caust.. CLEM. CON. Dulc. Iod. Kali-c. kali-p. Lyc med. meph. nux-v. Ph-ac.. Puls.. Sulph. Thuj

BLADDER - URINATION - dribbling - enlarged prostate, with

Aloe arn. bar-c. bell. cop. Dig.. Nux-v. Puls. Staph.