As the name suggests, BPH is a benign hypertrophy of the prostate gland.
Benign prostatic hyperplasia (BPH) also known as benign prostatic hypertrophy (technically a misnomer), benign enlargement of the prostate (BEP), and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate in middle-aged and elderly men. It is characterized by hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the periurethral region of the prostate. When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, obstruction of the urethra, which interferes the normal flow of urine. It leads to symptoms of urinary hesitancy, frequent urination, dysuria (painful urination), increased risk of urinary tract infections, and urinary retention. Although prostate specific antigen levels may be elevated in these patients because of increased organ volume and inflammation due to urinary tract infections, BPH is not considered to be a premalignant lesion.
Adenomatous prostatic growth is believed to begin at approximately age 30 years. An estimated 50% of men have histologic evidence of BPH by age 50 years and 75% by age 80 years. In 40-50% of these patients, BPH becomes clinically significant.
BPH – Homeopathy Treatment & Homeopathic Remedies
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat prostate gland enlargement but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat prostate gland’s diseases that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of prostate gland enlargement:
Homeopathy offers very good treatment for BPH or benign prostate hypertrophy. Some of the medicines commonly used for this condition are thuja, ferrum-pic, conium, baryta-carb, copaiva, populus-t, calc-carb, sabal-ser, selenium etc.
Oxydendron arboreum [Oxyd]
In cases of urinary troubles accompanying ills of the prostate the Oxydendron arboreum 0, in doses of 5 drops, will often give relief; also in cystitis.
Polytrichum juniperinum [Polytr]
According to the late Dr. A.M. Cushing, this remedy haircap moss or Robin’s eye will, in the tincture, or an infusion i.e. the moss steeped in water, have a powerfully good effect in the ills of old men suffering from a bad bladder or enlarged prostate- prostatitis. This he got from the old herbalists.
Hydrangea arborescens [Hydrang]
In a case of enlarged prostate, where a surgical operation was declared imperative, Hydrangea arb. 0, 6 drops, 10 night and morning, effected a remarkable cure, and the patient was able to void his urine comfortably, and completely.-J. Compton Burnett, M.D., Lond. Dr. Burnett got the hint from Dr. Henry Thomas, who had elderly gentlemen coming to him from far and near for prostatic troubles and they mostly received Hyd. arb.
Calcarea fluorica [Calc-f]
It is said that for the ills of old men in the matter of the prostate, ills that baffle the best physicians, there is nothing that will equal Calcarea fluor. 6x, 5 grain doses, twice a day. This, it has been said, will do about all that can be expected in such cases Biochemic.
Picric acid [Pic-ac]
This drug, in the 30th potency, is said to have given relief in enlarged prostate and its accompanying ills. The drug is known to have a strong action on the sexual organs from the proving.
This medicine 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.
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.
is one of the best medicines for prostatic enlargements in the aged. The 3X is advised.
gives occasional good results in relieving the tenesmus, frequent urination and general discomfort due to prostatic hypertrophy. Spongia is also is also a remedy for this condition.
SENILE HYPERTROPHY OF PROSTATE, CARDIAC SYMPTOMS MARKED; dribbling discharge of urine and continued fulness after micturition or fruitless effort to urinate; throbbing pain in region of neck of bladder during the straining efforts to pass water; increased desire to urinate after a few drops have passed, causing the old man to walk about in distress though motion increases desire to urinate; frequent desire to defaecate at the same time; very small, soft stool passed without relief, urine pale, slightly cloudy, looking smoky.
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. Lycopodium, pressure in the perinaeum near anus while urinating.
RETENTION OF URINE IN VERY OLD PEOPLE FROM ENLARGED PROSTATA, when there is a great deal of trouble in urinating.
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.
BPH – CAUSE
Evidence suggests a link between benign prostate hyperplasia and hormonal activity. As men age, production of androgenic hormones decreases, causing an imbalance in androgen and estrogen levels, and high levels of dihydrotestesterone, the main prostatic intracellular androgen.
Other causes include neoplasm, arteriosclerosis, diabetes, inflammation, and metabolic or nutritional disturbances.
Whatever the cause, BPH begins with changes in periurethral glandular tissue. As the prostate enlarges, it may extend into the bladder and obstruct urinary outflow by compressing or distorting the prostatic urethra. BPH may also cause a pouch to form in the bladder that retains urine when the rest of bladder empties, this retained urine may lead to calculus formation or cystitis.
BPH – MECHANISM
Histologically, the inner zone of the gland undergoes hyperplasia and hypertrophy, and there is an increase in fibro muscular stroma. the enlarged prostate obstructs the outflow of urine by compressing, displacing and elongating that part of urethra which passes through the prostate gland.
What is Prostate gland?
The prostate is a glandular organ lying between the pubic bone and the rectum and between two lines going from the pointed end of the coccyx bone at the back to the upper and to the lower margin of the pubic bone in front. The longer line, a line joining the two, roughly defines the prostate. The base of it lying above, the apex below. The urethra passes through the prostate in such a way that the grater part of the prostate lies under the urethra, the smaller part above. The prostate embraces the urethra rather like a signet ring.
In the adult the prostate has the size and shape of a walnut, being about 12 inches broad, I inch long and 3/4 inch thick. Its average weight is about 42 drachms. This, however, represents the average weight of the prostate when removed from the dead body, covered by its “sheath,” which, as we shall state later on, is not really a part of the prostate, but only the envelope in which it lies. The real weight is less-probably about 3 drachms. The base is directed backwards and upwards towards the bladder, the neck of which it embraces, while the apex looks forwards and downwards. The posterior surface, which is smooth and slightly grooved in the middle line, rests on the rectum, from which it is separated by dense fibrous tissue, which forms part of the “sheath” of the prostate.
The prostate consists of two lateral lobes, between which the ejaculatory ducts enter from behind, before opening into the prostatic part of the urethra. A third, or “median” lobe was described by Sir Everard Home in the early part of the last century as existing in the normal prostate, and Sir Henry Thompson refused to agree. His contention has been almost universally accepted. Practical experience derived from numerous dissections of the healthy prostate and 1,625 operations for removal of the enlarged organ in its capsule, convinced Sir Peter Freyer that Sir Henry Thompson was correct in his view and that the so-called “middle” lobe is merely a pathological product, derived from one or both lobes, and that it is non-existent in the normal prostate. There is, it is true, a median portion or bridge of tissue, sometimes forming a rounded prominence above the ejaculatory ducts in the normal prostate, but this is derived from both lateral lobes, which are in this position more intimately blended than in the rest of their course on either side of the prostatic urethra.
Structurally the prostate is composed of glandular substance and stroma made up of muscular and fibrous tissues. The glandular substance consists of follicular pouches with ducts lined with columnar epithelium. The excretory ducts, from twelve to twenty in number, open into the urethra beside the veru montanum. The muscular tissue forms the bulk of the prostate, its supposed function being to eject the glandular secretion or prostatic fluid to mix with that form the ejaculatory ducts of the testicles.
The function of the prostatic fluid consists in mobilizing the spermatozoids. It the semen does not contain the prostatic fluid, the spermatozoids are devoid of motion, consequently such an individual is sterile.
The prostate has a general tendency to increase in size after the age of fifty, but not all these men suffer form any subjective symptom through it. From statistics, collected by the late Sir Henry Thompson and others, about 33 per cent. of men beyond 55 years of age are subject to enlargement of the prostate, but no more than 5 per cent. ever suffer from symptoms. This percentage is rather too low. Anyway, as already mentioned in my first statement, the number suffering from troubles due to the enlargement of the prostate is very large. Every practitioner has to deal with them and is aware of the serious symptoms frequently met with in these cases.
BPH SIGNS AND SYMPTOMS
- The stream of urine is poor
- Benign prostatic hypertrophy symptoms are classified as storage or voiding.
- Storage symptoms include urinary frequency, urgency (compelling need to void that cannot be deferred), urgency incontinence, and voiding at night (nocturia).
- Voiding symptoms include weak urinary stream, hesitancy (needing to wait for the stream to begin), intermittency (when the stream starts and stops intermittently),straining to void, and dribbling. Pain and dysuria are usually not present.
- There is difficulty in initiating micturation (hesitancy)
- There is difficulty in stopping it (terminal dribbling)
- Recurrent haematuria (blood in urine) may occur
- There may be aching pain in loins, sometimes aggravated by drinking
- Recurrent urinary tract infections may occur
BPH – HOW DIAGNOSIS IS MADE?
- History – a detailed history should be taken assessing prior surgery, infections, stones, tumors, bleeding in the urinary tract.
- Physical examination – general physical examination – for general nutritional status and signs of chronic renal failure.
- Abdominal examination – for any palpable mass, or bladder.
- Examination of male genitalia and digital rectal examination to assess prostate size, and anal tone.
- Laboratory tests – mainly include urinalysis, urine culture, complete blood count, and determination of serum creatinine, blood sugar, blood urea nitrogen, and serum electrolytes for mostly patients.
- Prostate specific antigen is highly recommended (PSA) for patients more than 50 years of age.
- Ultrasound – to evaluate the upper tracts, assess the size and consistency of prostate and measure the volume of post-void residual urine.
- Uroflometry – it should always be performed in conjunction with estimation of post-void residual urine volume.
Anuria (complete stoppage of urine flow)
Uraemia (consequence of anuria)
Benign Prostate Hypertrophy – WHAT TO DIFFERENTIATE FROM?
All other causes of urinary tract obstruction esp. vesical (urinary bladder) calculus; fibrosis following trauma, stone, instrumentation; urethral valves etc.
Benign Prostate Hypertrophy – CONVENTIONAL TREATMENT
Transurethral resection of the prostate tissue is the treatment of choice to relieve the outflow obstruction
WHAT ELSE CAN I DO? – ACCESSORY MANAGEMENT
Regular exercise increases the level of androgens, so it may slow down the progression of this condition.
WHERE ELSE TO FIND MORE INFO? – INTERNET RESOURCES
- Harrison’s Principles of Internal Medicine, 14th ed, McGraw-Hill
- Davidson’s Principles and Practise of Medicine, 17th ed, 1996, Churchill Livingstone
- New Manual of Homeopathic Materia Medica & Repertory, William Boericke, 2nd revised ed., 2001, B. Jain
- A Concise Repertory of Homeopathic Medicines, S.R.Phatak, 3rd ed, B. Jain
- A Clinical Repertory to the Dictionary of Materia Medica, J.H.Clarke, reprint ed, 1989, B. Jain