Benign Prostatic Hyperplasia

Description

Alternative Names

Lifestyle Changes

Certain lifestyle changes can help relieve symptoms and are particularly important for men who choose to avoid surgery or drug therapy. Men should take the time to urinate when it is convenient even if there is no urge. They should take aisle seats in theaters and when traveling. Cold weather and immobility may increase the risk for urine retention. Keeping warm and exercising may be useful. Stress reduction techniques may also help.

Dietary Factors

Some small studies have suggested the following:

• Avoiding fluids after the evening meal is helpful.
• Coffee has been associated with a higher risk for BPH. There is some indication that drinking green tea, however, may benefit the prostate.
• Moderate alcohol consumption may be protective. (Heavy alcohol consumption, however, may increase the risk for lower urinary tract symptoms, and, in any case, is harmful.)
• Genistein, a chemical found in soy, reduced the growth of BPH tissue in the laboratory. Although Asians have a low incidence of BPH and prostate cancer and also have diets rich in soy, it is not yet known if eating soy products will reduce the risk of BPH or improve any symptoms.
• One recent well-publicized study found an association between a lower risk for BPH and high intake of fruits and a higher risk for BPH with a high intake of butter and margarine.
• Zinc is of interest because it accumulates to the highest levels in a mans body in either a normal prostate or one enlarged from benign prostate hyperplasia. Some laboratory studies suggest that zinc might inhibit activation of prostate cancer cells. A 2003 study, however, reported that men taking zinc supplements in high doses (100 mg) had a higher risk for advanced prostate cancer. Of note, such men also took higher levels of calcium, iron, and other supplements that might have biased these results. More research is needed to determine the role of zinc on prostate health.

Avoiding Medications that Aggravate Symptoms

Decongestants and Antihistamines. Men with BPH should avoid, if possible, the many medications for colds and allergy that contain decongestants, such as pseudoephedrine (Sudafed). Such drugs, known as adrenergics, can exacerbate urinary symptoms by preventing muscles in the prostate and bladder neck from relaxing to allow urine to flow freely. Antihistamines, such as diphenhydramine (Benadryl), can also slow urine flow in some men with BPH.

Diuretics. Men who are taking diuretics, which increase urination, may discuss reducing the dosage or switching to another drug. These are important drugs for many people with high blood pressure, with a proven track record for saving lives; no one should go off these medications without medical supervision.

Other Drugs. Other drugs that may exacerbate symptoms are certain antidepressants and drugs used to treat spasticity.

Exercise

A recent study reported that even moderate exercise can reduce urinary tract problems associated with BPH. According to a 2001 study, however, physical activity does not seem to protect against developing BPH.

Kegel Exercises

Kegel (pelvic floor muscle) exercises, which were first developed to assist women with childbirth, are also useful for men in helping to prevent urine leakage. They strengthen the muscles of the pelvic floor that both support the bladder and close the sphincter.

Performing the Exercises. Since the muscle is internal and is sometimes difficult to isolate, doctors often recommend practicing while urinating:

• The patient is asked to contract the muscle until the flow of urine is slowed or stopped. He attempts to hold each contraction for ten seconds.
• He then releases it.
• In general, patients should perform five to 15 contractions, three to five times daily.
• Kegel exercises should not be regularly performed while urinating; this practice may eventually weaken the muscles.