The prostate is a walnut-size exocrine gland
of the male reproductive system. It is located just below the urinary bladder where it wraps
around the first part of the male urethra. Prostate gland produces a milky fluid that
is expelled into the urethra to mix with spermatozoa during ejaculation. The fluid serves as a
lubricant and nutrition for the sperms. Benign prostatic hyperplasia, or BPH, also
called benign prostatic hypertrophy or enlarged prostate, is a condition in which the size
of the prostate gland is increased. It is considered “benign” because it’s not a cancer,
and it does not increase the risk of cancer. However, when it becomes sufficiently large,
the prostate tissue may compress the urethra and block the urine flow causing a number
of urination problems and urinary tract infection. BPH is very common in aging men: about 50%
of men have some degree of BPH by the age of 60, with half of them demonstrating clinically
significant symptoms. BPH is a result of hormonal changes and is considered a normal part of
male aging. In aging prostate tissue, the rate of cell proliferation induced by male
hormones somehow exceeds the rate of programmed cell death or apoptosis. This results in increased
number of cells and enlargement of the prostate. There are two main classes of medication for
BPH treatment: – alpha-blockers: these drugs relax smooth
muscle in the prostate and the bladder neck, thus relieving the blockage of urine flow.
– 5-alpha reductase inhibitors: these inhibit local production of Dihydrotestosterone or
DHT- the hormone that is responsible for prostate enlargement.
For those who do not respond to medication, minimally invasive treatments are available.
These non-surgical therapies use heat to cause cell death or necrosis in prostate tissue.
The heat is delivered in small amount and to a specific location to minimize unwanted
damage. Different procedures differ mainly in the type of energy used. Transurethral resection of the prostate is a surgical procedure for removal of prostate
tissue through the urethra. This procedure has been around for a long time and is still
considered gold standard for treatment of severe BPH. Nowadays, it is usually performed
when medications and less invasive methods fail.