BENIGN PROSTATE HYPERPLASIA & PROSTATITIS

 

Definition

 

The prostate is an exocrine gland of the male reproductive system. Its main function is to store and secrete a clear, slightly basic fluid that constitutes up to one-third of the volume of semen. A healthy human prostate is slightly larger than a walnut and surrounds the urethra just below the urinary bladder. The most common disorders of the prostate are benign prostatic hyperplasia and prostatitis. 

 

Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is associated with ageing and is estimated to affect 70% of men aged ≥70 years.

 

An enlarged prostate causes obstruction of urinary flow and can result in serious medical complications, including acute urinary retention (which can lead to renal failure), recurrent urinary tract infection, bladder calculi and haematuria.

 

Dihydro-testosterone (DHT), a metabolite of testosterone, is a critical mediator of prostatic growth. DHT is synthesised in the prostate from circulating testosterone by the action of the enzyme5α-reductase, providing a target for medical and holistic treatments.

 

Whilst total androgen levels may not be abnormal in BPH patients, the androgen-to-oestrogen ratio potentially upsets the balance of factors that regulate growth in the prostate.

 

Prostatitis is an inflammatory disorder of the prostate. Prostatitis can be idiopathic (i.e., nonbacterial prostatitis), or bacterial (i.e., caused by enteric gram-negative bacilli). It commonly causes pain in the testicles and may sometimes cause problems with ejaculation, urination, or defaecation.

 

Signs and Symptoms

 

Common signs and symptoms of BPH/prostatitis include:

 

Recurrent urinary tract infections

 

Difficulty starting urine stream

 

Decreased strength and force of the stream

 

Dribbling after urination

 

Urinary frequency, urgency and dysuria (painful urination)

 

Nocturia

 

Incomplete bladder emptying

 

Fever with chills

 

Generalised malaise

 

Bladder outlet obstruction, complete inability to urinate

 

Painful ejaculation, bloody semen, or sexual dysfunction

 

Pain localised to lower back (sacral), pelvis, or perineum

 

Blood in the urine, caused by bursting of small veins in the urethra and bladder.