Understanding Benign Prostatic Hyperplasia (BPH) or Vatashteela

Benign prostatic hyperplasia (BPH), also known as an enlarged prostate gland, is common in older men. An enlarged prostate gland may lead to uncomfortable urine symptoms like the bladder being unable to empty in one stretch. It may cause problems in the kidneys, bladder, and urinary system.

Prostate gland enlargement can give rise to a variety of symptoms, all of which tend to get progressively worse with time.

The typical warning signs and symptoms of BPH include:

• Frequent urges to urinate or a feeling of urgency to urinate
• Trouble beginning urination
• Intermittent or weak urine flow
• Leaking or dribbling urine after urination has finished
• Frequent urination during nighttime (nocturia)
• Inability to fully empty the bladder

Less commonly seen signs and symptoms include::

• Urinary tract infection (UTI)
• Inability to urinate (Urinary Retention)
• Blood in the urine (Haematuria)

The seriousness of symptoms is not always connected to prostate size. Some men with significantly enlarged prostates may have only mild urinary symptoms, while others with only a mildly enlarged prostate may experience significant difficulties. For some men, symptoms may stabilise or improve over time,and may even get better.

The following conditions can cause symptoms similar to those caused by an enlarged prostate:

• Urinary Tract Infection (UTI)
• Prostate inflammation (prostatitis)
• Narrowing of the urethra (Urethral Stricture)
• Scarring in the bladder neck due to previous surgery
• Kidney or bladder stones (renal calculi)
• Problems with the nerves responsible for controlling the bladder (neurogenic bladder)
• Prostate or bladder cancer

Understanding the causes of BPH

The prostate gland is situated beneath the urinary bladder. The tube that takes urine from the bladder out of the penis (urethra) goes through the centre of the prostate. As the prostate gland grows to a large size, it can obstruct the flow of urine.

Throughout a man’s life, the prostate gland will continue to grow in size. Many men’s prostates continue to grow and can eventually obstruct the flow of urine or cause urinary system symptoms. The exact cause of prostate enlargement is not fully understood.. The changing ratio of sex hormones that occurs with age may be a contributing factor to prostate enlargement.

Risk factors for benign prostatic hypertrophy (BPH)

Factors that may increase the risk of prostate gland enlargement:

• Ageing: Enlarged prostate glands rarely cause symptoms in men under the age of 40. By age 60, about one-third of men have moderate to severe symptoms, and by age 80, nearly half have symptoms.
• Family history: Men are more likely to experience prostate issues if a blood relative, such as a father or brother, has had prostate problems.
• Heart disease and diabetes: Studies have shown that beta-blocker use, heart disease, and diabetes may be risk factors for BPH.
• Lifestyle: Exercise may reduce the risk of BPH, but obesity may increase the risk.

Complications of BPH (Benign Prostatic Hypertrophy)

Complications of an enlarged prostate may include:

• Sudden inability to urinate (urinary retention): A catheter may be needed to drain the bladder and surgery may be required to treat urinary retention in some men with an enlarged prostate.
• Urinary tract infections (UTIs): The inability to fully empty the bladder can increase the risk of developing a UTI. Surgery to remove part of the prostate may be necessary if UTIs occur frequently.
• Bladder stones: The inability to fully empty the bladder is often the cause of bladder stones. They can also be caused by infections, irritations of the bladder, blood in the urine, and obstructions in urine flow.

• Bladder damage: A partially empty bladder can expand and weaken over time. The muscular bladder wall may not contract properly, making it more difficult to fully empty the bladder.
• Kidney damage: Urinary retention can cause pressure in the bladder that can directly harm the kidneys or allow bladder infections to spread to the kidneys.

Although these complications are rare in men with enlarged prostates, kidney damage and acute urine retention can pose serious health risks. There is no evidence to suggest that an enlarged prostate increases the risk of prostate cancer.

Effective treatments for BPH 

Prostate gland enlargement can be effectively treated with medication, surgery, or less invasive procedures. The best treatment option should be based on the symptoms, size of the prostate, and other health conditions, and should consider both current concerns and potential future risks.

Ayurvedic Treatment and BPH    

In Ayurveda, BPH may be correlated with Vatashteela or Purushagrandhi Sopham.

The causes of this disease condition may include:

• Ativyavayam (excessive sexual activity)
• Ativyaayamam (too much exercise)
• Avyaayamam (Sedentary Lifestyle)
• Sthaulyam (Obesity)
• Moothra Vega Udharanam (Forcefully expelling urine)
• Moothravega Dharanam (Frequent practice of holding urine)
• Vrudhhavastha (Increased dryness (rooksha) leads to overactivity of the prostate gland (grandhi) in an attempt to maintain proper bodily function.)

Treating BPH with Ayurveda: A Holistic Approach

In Ayurveda, this condition is referred to as grandhi sopham. As with any disease, the first principle of Ayurvedic treatment is to remove the causative factors (Nidana Parivarjanam) and adopt a healthy lifestyle. This involves eliminating any factors that may be contributing to the condition and adopting healthy habits. Medical management is the primary method used to shrink the prostate gland (grandhi) and improve its function. One effective form of treatment is Vasthi Chikitsa, or enema therapy, which can both alleviate symptoms and reduce the size of the grandhi.