BPH

Background: Understanding BPH and Prostate Anatomy

The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum. It surrounds the urethra, the tube responsible for transporting urine and semen out of the body. As men age, the prostate often undergoes hyperplasia—or cellular proliferation—resulting in glandular enlargement. This enlargement compresses the urethra, leading to urinary flow obstruction and lower urinary tract symptoms (LUTS).

While BPH is distinct from prostate cancer, both can produce overlapping symptoms. Therefore, appropriate evaluation is essential to ensure accurate diagnosis and effective management.

Symptoms: Recognizing Signs of Prostatic Enlargement

Symptoms of BPH vary in severity and may progress gradually. Many patients experience bothersome urinary symptoms that disrupt daily activities and sleep quality.

Common Symptoms of BPH Include:

• Increased frequency of urination, particularly at night (nocturia)
  
• Urgency to urinate, with difficulty postponing voiding
  
• Hesitancy in initiating the urine stream
  
• Weak or interrupted urinary stream
  
• Post-void dribbling
  
• Feeling of incomplete bladder emptying
  
• Straining during urination 

These symptoms may worsen over time, particularly if the prostate continues to grow and compress the urethra. In more advanced cases, urinary retention and complications such as bladder infections or kidney dysfunction can occur.

Diagnostic Evaluation and Biomarkers

Accurate diagnosis of BPH requires a comprehensive clinical assessment, including patient-reported symptoms, physical examination, and appropriate laboratory and imaging studies.

1. Clinical History and Symptom Scoring:

• • International Prostate Symptom Score (IPSS) 

2. Physical Examination:

• • Digital Rectal Exam (DRE) 

3. Laboratory Biomarkers:

• • Prostate-Specific Antigen (PSA): May reflect prostate enlargement 
  • Urinalysis: To evaluate for infection or hematuria 
  • Serum Creatinine and BUN: Assess renal function 
  • High-Sensitivity CRP (hs-CRP): Detects systemic inflammation 

4. Functional and Imaging Studies:

• • Urinary flow rate testing 
  • Post-void residual (PVR) measurement 
  • Ultrasound or TRUS 
  • Cystoscopy or MRI (for complex cases)

Pathophysiology and Underlying Causes

Several contributing factors to BPH include:

Hormonal Imbalance:

• Declining testosterone with relative estrogen dominance
• Increased DHT stimulating prostatic cell growth

Chronic Inflammation:

• Presence of inflammatory cytokines in prostate tissue
  
• Associated with systemic inflammation

Metabolic Syndrome and Insulin Resistance:

• Insulin resistance stimulates growth factors promoting hypertrophy

Dietary Factors:

• High intake of saturated fats, red meat, and processed foods
  
• Low intake of fruits, vegetables, and antioxidants

Functional Medicine Considerations and Interfering Factors

Accurate diagnosis requires considering factors that can skew assessments, such as:

• Recent prostate manipulation
  
• Urinary tract infections
  
• Sexual activity
  
• Certain medications like 5-alpha reductase inhibitors and decongestants

Potential Complications of Untreated BPH

Without intervention, BPH can lead to:

• Acute urinary retention
  
• Urinary tract infections (UTIs)
  
• Bladder stones
  
• Hydronephrosis and kidney damage
  
• Recurrent hematuria

Functional Medicine Treatment Approach at Intercoastal Health

Our management strategy emphasizes individualized care.

Core Strategies Include:

1. Dietary Modification:
   Emphasis on anti-inflammatory, prostate-supportive foods.
   
2. Lifestyle Optimization:
   Physical activity, stress reduction, bladder-friendly habits.
   
3. Nutraceutical and Botanical Support:
   Saw palmetto, beta-sitosterol, pygeum, nettle root, pumpkin seed extract, zinc, selenium, vitamin E.
   
4. Hormonal and Metabolic Monitoring:
   Balance testosterone, estradiol, DHT; address insulin resistance.
5. Monitoring and Reassessment:
   Track IPSS scores, PSA levels, and urinary flow over time.

Conclusion

Benign Prostatic Hyperplasia is a highly prevalent condition with wide-ranging effects on urinary function and quality of life. A functional medicine approach to BPH integrates conventional diagnostic methods with advanced biomarker assessment and lifestyle-based interventions to support prostate health at its root.

In conclusion, a comprehensive evaluation by a functional medicine nurse practitioner in Florida facilitates identification of cellular-level and molecular imbalances driving prostate dysfunction. By integrating evidence-based therapies with auto accident injury management and sports injury management medical care services—where urologic health may also be impacted—we offer patients a regenerative, preventive framework to rebuild resilience and optimize wellness. Call tel:904-799-2531 or schedule online to request your personalized prostate health evaluation.

Further Reading

• American Urological Association. (2018). Benign Prostatic Hyperplasia (BPH) Guideline: Diagnosis and Treatment Recommendations. AUA. https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline

• Roehrborn, C. G. (2010). Benign prostatic hyperplasia: An overview. Reviews in Urology, 12(Suppl 1), S3–S10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950766/

• McVary, K. T., Roehrborn, C. G., Avins, A. L., et al. (2011). Update on AUA guideline on the management of benign prostatic hyperplasia. The Journal of Urology, 185(5), 1793–1803. https://pubmed.ncbi.nlm.nih.gov/21474075/

• Kaplan, S. A. (2020). Medical and surgical management of benign prostatic hyperplasia. Medscape. https://emedicine.medscape.com/article/437359-treatment