INTRODUCTION;--BPH Refers to The Increase in size of the Prostate in elderly men. Few other name of this condition are: senile enlargement of prostate, adenoma, Adenomyoma, nodular Hyperplasia. The Prostate is small walnut shaped gland that forms part of the male reproductive system and is situated at the base of the urinary bladder. The gland is made of two lobes, enclosed by an outer layer of tissue. The Prostate is located in front of the Rectum and just below the bladder, where urine is stored. The Prostate also surrounds the urethra, the canal through which urine passes out of the body. One of its main roles is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps in making up semen, energizes the sperm and makes the vaginal canal less acidic.

When Prostate becomes enlarged, the nodules compress the urethral canal to cause partial or complete obstruction of the urethra. It leads to symptoms of urinary retention and increased risk of UTI. Benign Prostatic Hypertrophy can be a Progressive disease, especially if left untreated. Prostate is rudimentary in children. It grows throughout the childhood up to the age of puberty. As a man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. It starts increasing and gradually attains the normal adult size which weighs about 20gms. Second growth occurs at 50 to 60 years of age, which weighs 2 to 4 times more from its normal weight, this change is termed as BENIGN PROSTATIC HYPERTROPHY (BPH).

After the age of 50, 40 -50% of men show the prevalence of BPH. 

By the age of 85, 90% of the men suffer from symptoms arising from BPH. As the Prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so some of the urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. In an acute crisis, where there is retention of urine, most of the surgeons suggests prostatectomy rather more correctly the removal of adenomatous hyperplasia. 

The surgical procedure at an old age is usually troublesome and create various post operative complication such as, recurrent infection of the Prostatic bed, Epididymitis, incontinence of urine, acute Pyelonephritis and renal failure.

For improving the quality of life, Homoeopathic miasmatic approach is to be followed. The miasmatic approach is to evaluate the disease in its whole extent, where by a lot of emphasis is given to the patient as whole besides minutely studying various aspect of the BPH, there by treating the patient with a holistic approach.

Signs and Symptoms;- 

Frequency of urine; it is one of the earliest symptoms. At first it’s nocturnal. 

-Urgency-Dribbling 

– Residual urine increases, frequency becomes more and more evident and there is terminal dribbling.

-Difficulty in Micturition

-Weak stream

-Pain occurs on cystitis and acute retention of urine. 

Hydronephrosis  occurs there may be a dull pain in loins.

-Acute Retention

-Retention with overflow 

-Haematuria due to rupture of prostatic vein.

-Renal insufficiency means renal failure, UTI, bladder or kidney damage, bladder stones, and incontinence, the inability to control urination.

INVESTIGATIONS -CBC, S.creatinine, S. PSA, ESR-URINE R-M-DRE for check hardness of prostate and enlargement of prostate.--X-ray, Ultrasound, Uroflowmetry-Cystoscopy-If patient diabetic than go for HbA1C and urodynamic study.

Homoeopathic Medicines

1) Apis mellifica- Stinging pain during urination that are worse when the final drops are passing is a strong indication for this remedy.

2) Cantharis-Burning Urination - Burning Pain and an intolerable, constant urge to urinate while only losing a few drops of urine. Only a few bloody drops will pass at a time and the pain in the urethra and bladder are coupled with intense burning, cutting and itching. 

3) Causticum-Urine loss when the person coughs or sneezes often indicates a need for this remedy. 

4) Chimaphila umbellata-Useful in frequency and urgency of urine.

5) Clematis-Often indicated when swelling of the prostate seems to have narrowed or tightened the urinary passage.

6) Ferrum Picricum (picrate of iron)-For senile prostatic hypertrophy.-Frequent micturation at night.

7) Hydrangea (seven barks)-Enlargement of prostate with great thirst.-Remedy for stones, profuse deposits of white amorphous salts in urine.-Urine hard to start.-Sharp pains in loins.

8) Lycopodium-The prostate is enlarged, and impotence may also be a problem.

9)Petroselinum (Parsley)-Sudden urging to urinate.-Milky discharge.-Associated with piles.

10)-Prunus Spinosa (Black thorn)-BPH with retention symptoms. Hurriedly impelled to urinate.-Tenesmus of bladder. Useful in retention symptoms where patient has to press a long time before urine passes.Slide -Neuralgic dysuria-Ineffectual urge to urinate-

10) Pulsatilla-There may also be a bland, thick, yellow discharge from the penis.

11) Sabal serrulata-A frequent urge to urinate at night, with difficulty passing, and a feeling of coldness in the sexual organs.-It is sometimes also used in lower potencies for urinary incontinence in older men.

 12) Solidago virga (goldenrod)-Pain in region of kidneys, with dysuria.-Difficulty and scanty urine.-Used when cystitis and kidney affections are present with BPH

13) Staphysagria-Burning pain in his urinary passage even when urine is not flowing, and urine retention is troublesome.

14) Thuja - Enlarged prostate and the person has a frequent urge to urinate, with cutting or burning pain felt near the bladder neck, this remedy may bring relief. Dribbling sensation.

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