Father's Day is in Three Days...What You Need to Know About BPH

Father's Day is just around the corner! Did you know that June is also Men's Health Month? Giving the older fathers in our lives the tools to manage their health issues that arise with age is important! One health issue we focus on is called BPH (benign prostatic hyperplasia) which is the medical term for prostate enlargement. Although the topic of prostates may not sound fun or comfortable, it is still important nonetheless for men to know their body and know how to care for it. In just the United States, there are an estimated 42 million cases of BPH.

In case you’ve ever wondered just what exactly a prostate is, it’s a small gland about the size of a walnut that is situated below the bladder (which holds urine). The urethra (a tube that carries urine out of the body) runs through the center of the prostate and the penis. The prostate is part of the male reproductive system and its function is to help make seminal fluid that mixes in with the sperm to produce semen.

There are different prostate conditions out there, but one thing we want you to rest assured of is that BPH doesn't increase risk of prostate cancer because as the B in BPH implies (benign), BPH is not cancerous. BPH commonly affects men 50 and older. 

The hormone known as testosterone helps the prostate grow throughout a man's life. Did you know that about 60-70% of men may have BPH in their 60s and that by the time the male population hits the 90s age range, about 90% of men may have developed BPH? This condition can bear a significance on quality of life as we'll later explain.    

Prostate symptoms may be tested with a PSA (prostate specific antigen) blood test but this PSA test alone cannot determine whether the symptoms men experience are BPH or prostate cancer. It is also important to discuss whether this test is necessary on an individual basis. 

Now, onto the BPH symptoms. As the prostate grows, the urethra is squeezed, blocking the flow of urine from the bladder to out of the body. As a result symptoms include the following:
- frequent urination at day and at night
- sudden urges to urinate
- urinary stream is weak or slow
- difficulty when starting to urinate
- stopping and starting while voiding

The interesting thing is that BPH is the number one reason men go to the urologist even though they may not know it's even called BPH. The impacts that BPH can have on men's lives include the following: 

- A disruption of normal sleeping patterns
- Have to plan life and activities around where the nearest bathroom is (such as needing an aisle seat on the plane and being unable to go on long road trips)
- Changing to use of bathroom stalls instead of urinals due to embarrassment over slow urinary flow or difficulty urinating 

As men age, it is likely that BPH is an inevitable prostate issue, so our advice to the men and dads around the world is not to wait so long to get evaluated, and don't leave it untreated!

Not treating BPH could lead to these problems:

- Permanent bladder damage or compromised bladder condition
- UTIs (urinary tract infections)
- Bladder and/or kidney stones
- Kidney damage
- Bladder retention
- Complete inability to urinate

So what can men do? You can make an appointment with a urologist by telehealth or at their office. You may talk about your medical history and take an IPSS (international prostate symptoms score) survey, and you and your doctor can determine how much your BPH is bothering you.

BPH can be diagnosed or detected with a bladder scan, uroflowmety (to test the speed of urinary flow), a digital rectal exam, a transrectal ultrasound, or a cytoscopy (camera placed through the urethra to check the prostate and bladder)

The IPSS survey scores symptoms based on the patient's feedback and can determine how  mild or severe the BPH is based on a numerical score. 

The sooner you go on treatment and/or manage symptoms the sooner your quality of life can be restored. Treatment options for BPH will depend on a number of factors:

- The size of the prostate
- The age of the BPH patient
- The desire of the BPH patient to preserve his sexual function
- The overall health of the BPH patient
- The severity of BPH symptoms

In mild cases, doctors may recommend monitoring symptoms with watchful waiting.  

One thing to consider is that medication is not the only way to treat BPH. Some concerns about medication are that it may be inadequate and only provide temporary relief, and it may carry unpleasant side effects (dizziness, headaches, sexual dysfunction). This is why about 27% of men stop taking medication after being on it for one year.  

When making a decision about treatment options, men need to evaluate the key differences in long and short term effects and the convenience of the treatment. Will he need a catheter? How long is the recovery period?  Are the side effects permanent or temporary? 

Alternatives to medication in order of risk include plant based therapies, minimally invasive surgeries, or major surgical procedures.

The goal of BPH treatment is to manage and alleviate symptoms so that men can resume a normal daily life. Treatments that have been reviewed by the FDA or have undergone clinical studies could be promising based on the results of success rates. 

And for some men who are still sexually active with their partners, preserving sexual function can be a consideration for their preferred treatment. Men who are sexually active want no problems with ejaculations or erections.

Treating BPH rather than ignoring it could be a gradual change or a night and day difference, but the importance is to start. Some men may not want to use a catheter, they may want little to no down time, and they may also want little to no side effects. They may not want to experience occasional bleeding after urination or pain in bladder or pelvis. 

Treating BPH could be a game changer not only in men's lives but in their partner's lives as well. Husbands and wives want men to see the urologist- don't keep living with bothersome BPH symptoms! Talk to your doctor, get medical opinions, and responsibly seek and share information. 

Granted, medical procedures may be big or scary decisions. If you are considering complementary therapy (taking natural therapy while taking medication) with the goal of reducing or getting off your current prescription dosage, talk to medical professionals before reducing or going off medications to avoid complications. 

Imagine men experiencing urinary frequency at the worst possible times, such as during a long flight (getting up every hour or half hour. Imagine getting up 3-4 times a night (interrupting ability to get good night's sleep). Imagine urinary urges that take place during  demanding schedules with work or life. Imagine being fatigued in the afternoon due to lack of a good night's sleep. This is the reality some men with BPH face day to day when they don't address their BPH.  

Partners of men who may have BPH, ask him to take the IPSS survey. Don't let your partner suffer for years with BPH. Arrange to meet with a urologist.

What does relief look like?
- Feeling more rested
- Getting up less
- Having more energy
- Being less tired
- Doing better in daily life in your career and personal life
- A return to normalcy
- Happiness with yourself and partner

This Father's Day and Men's Health Month, spread BPH awareness!