Benign Prostatic Hyperplasia (BPH) In Ayurveda – Symptoms, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Benign Prostatic Hyperplasia (prostate adenoma) refers to the non-malignant growth of prostatic tissue in men from middle age onwards. In a young man, the prostate gland is at an almost undetectable rudimentary stage, and spreads across the coating of the urinary tract like a cluster of seeds. During puberty due to the increased production of the testosterone and dihydrotestosterone hormones, its form begins to change.
Read more about Benign Prostatic Hyperplasia – Modern view

The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow

Causes

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

It isn’t entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.
Read more about – Causes, Symptoms of BPH

Symptoms

Obstructive symptoms
Weak or intermittent flow of urine.
Decrease in the force and calibre of the urine.
Feeling of incomplete emptying of the bladder.
Double voiding (urinating for a second time within a period of 2 hours).
Post-void dribbling.
Difficulty or delay when initiating urination.
Urinary retention.
Read – Dysuria: Causes, Remedies, Tips, Diet, Ayurvedic Treatment

Irritative symptoms
Polyuria, or increased frequency of urination.
Nocturia, or the need to urinate frequently during the night.
Sudden urge to urinate.
Urge urinary incontinence.

Less common signs and symptoms include:
Urinary tract infection
Inability to urinate
Blood in the urine

The size of your prostate doesn’t necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

Read – Urinary Obstruction: Causes, Types, Symptoms, Ayurvedic Treatment

Treatment

Medication
Minimally invasive therapies
Surgery

Medication
Alpha blockers. These medications relax bladder neck muscles and muscle fibers in the prostate, making urination easier.
5-alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth.
Combination drug therapy
Tadalafil (Cialis) -Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement.
Minimally invasive or surgical therapy
Transurethral resection of the prostate (TURP)
Transurethral incision of the prostate (TUIP)
Transurethral microwave thermotherapy (TUMT)
Transurethral needle ablation (TUNA)

Laser therapy
The options for laser therapy include:
Ablative procedures.
Enucleative procedures.

Prostatic urethral lift (PUL)
Embolization
Open or robot-assisted prostatectomy
Read – Urinary calculi – Home Remedies, Ayurvedic Treatment, Diet, Recipes

Prostate Adenoma In Ayurveda

Probable Ayurvedic correlation

Mutraghata – obstruction to easy passage of urine as explained in Ayurveda can be compared with prostate adenoma. To be specific, the below mentioned types of mutraghata shall be strictly considered –

Ashtila / Mutrashtila – is a condition which has often been compared to enlargement of prostate gland. A stony swelling which obstructs the passages of urine and feces is said to be formed. This happens when the vata vitiated in the region of bladder causes distension of bladder and rectum. The swelling is movable and elevated.

Mutra Granthi – A small, rounded, unmovable cystic swelling which gives pain similar to urinary stones is suddenly formed at the opening of the urinary bladder (at the place where the prostate gland is located) and causes obstruction to the passage of urine.
Mutrakrichra – difficulty in passing urine
Read – Mutra sharkara – gravel in urine – Ayurvedic understanding and treatment

Samprapti – pathogenesis

Dosha – Vata, Kapha
Dushya – rakta (blood), mamsa (muscular fibers of the gland), mutra (urine), shukra (semen, male hormones
Srotas – mutravaha, shukravaha
Sroto dushti lakshana – sanga (obstruction to free flow of urine and semen)
Roga Marga – abhyantara (viscera), madhyama (prostate is related to urinary bladder which is a vital organ)
Krichra Sadhya Asadhyata (prognosis) – curable with difficulty

Treatment principles

Treatment principles will be same as in prostatitis. Ashtila and Mutra granthi may be considered as different presentations of the same condition. While ashtila might be movable due to predominant involvement of vata, mutragranthi may be taken as a condition wherein kapha and blood get involved in the pathogenesis making the enlarged prostate immobile. Treatment should be in accordance with the predominance of dosha(s) involved in the pathology.
Read – Prameha: Ayurvedic Approach To Urinary Disorders

Ashtila is a large enlargement while mutragranthi is small swelling. Both are painful. Ashtila might also cause constipation since the big swelling might put pressure on the rectum. Effective laxatives and vata relieving remedies, including enemas will be beneficial to combat obstruction to urine and feces. If there is predominance of kapha in mutragranthi, therapeutic emesis shall be planned. Local or total body massage and sudation shall be done liberally to relieve the pressure symptoms, to ease these organs and to combat vata. If inflammatory signs are seen in mutra granthi, mild sudation shall be given and purgation shall be preferred.

Ashmari Chikitsa – Since there is ‘calculi like pain’ in mutragranthi, this condition shall be treated with medicines effective for curing urinary stones.

Use of Vanga and Shilajitu – Use of Vanga Bhasma and Shilajit combination is ‘spot on’ prescription for prostate adenoma, especially when kapha is involved. They are not only disease modifying, but also act like Rasayana. Trivanga Bhasma is another good option along with Chandraprabha Vati. A famous prescription of combination of Bangsil (Vanga and Shilajit are main ingredients) and Fortege, proprietary medicines from Alarsin Pharma will not disappoint the doctors in treating this condition.
Read – Shilajit Uses, Tests For Quality, Purification, Side Effects, Medicines, Research

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