Help for men with BPH on falling and staying asleep

Just when you’re about to fall asleep, it happens.  This frustrating situation is called nocturia or having frequent sensations of needing to urinate during the night prompting sufferers to wake up from sleep.  Nocturia is common in both women and men, but for older men, this disorder is more likely to appear.  And one of the main reasons is due to the condition of benign prostatic hyperplasia or BPH.

As men get older, many changes can occur one of which is their risk for developing an enlarged prostate gland. This condition is known as BPH which affects about half of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80. 

The prostate is a walnut-sized gland located between the bladder and the penis. It surrounds part of the urethra which is the tube that carries urine and semen out of the body.  But if the prostate enlarges, it can begin to squeeze the urethra causing a man to wake up during the night to go to the bathroom.  For some men that can occur as frequently as every hour or two throughout the night.  The one thing men should know is that BPH is not linked to cancer of the prostate and does not increase a man’s risk of developing prostate cancer even though the symptoms of BPH and prostate cancer are similar. 

Development and causes of BPH

The causes of BPH are not completely understood.  Appearing to play a role in the enlargement of the prostate gland could be changes occurring with male sex hormones as part of the aging process.  Androgens (male hormones) affect prostate growth.  The most important androgen is testosterone which is produced in the testes throughout a man’s life. 

The prostate coverts testosterone to another powerful androgen called dihydrotestosterone (DHT).  DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. DHT is a prime suspect in prostate enlargement in later adulthood. 

Symptoms of BPH

Generally, BPH is considered a harmless condition unless a man is bothered by the symptoms.  Symptoms can include an urgent or frequent need to urinate, slow flow, difficulty starting a urine stream, dribbling or not being able to completely empty the bladder or having to get up frequently during the night to urinate.  All men are unique and therefore not all men with BPH will experience these symptoms.   It depends on which area of the prostate enlarges that will determine if there is any urinary obstruction or not.

Simple steps a man can do at home to manage symptoms

 There are some things a man can do that may help reduce how much BPH affects his quality of life:

·       Men should take their time and relax when urinating. 

·       Practice “double voiding” by urinating as much as possible, relaxing for a few moments, and then urinating again.

·       Spread fluid intake throughout the day. Limit fluid intake in the evening if night time urination is a problem. 

·       If possible, avoid medications that can make symptoms worse.  These might include antihistamines, decongestants, allergy pills, antidepressants and pain medicines.  Also testosterone including gels, implants or injections.  A man should discuss with his doctor regarding these medications and their effect on BPH. 

Other treatments options are available 

Fortunately, there are a range of treatment options available for BPH.  A man’s doctor can help him develop a treatment plan to meet a man’s specific needs.  If a man has no symptoms or if they are very mild, treatment may not be required.  Treatment for BPH will depend if the prostate is continuing to enlarge and what symptoms are present.  Options for treating BPH include:

·      Active surveillance or watchful waiting.  This is done of a man has few if any symptoms and the prostate enlargement is stable.

·      Medications used for controlling symptoms such as Avodart, Cardura, Uroxatral, Proscar, Cialis, and Flomax.

·      Transurethral resection of the prostate (TURP).  This surgery is considered to be the optimum treatment for BPH.  It reduces symptoms in 80-90% of patients.

·      Transurethral needle ablation (TUNA).  This procedure involves passing a scope into the urethra placing needles into the prostate gland.  Radio waves pass through the needles heating and destroying excess prostate tissue blocking urine flow. 

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