Definition:

Benign prostatic hypertrophy is swelling of Prostate gland. The prostate is a walnut sized gland that is only present in men. It is located just below the bladder and top of the penis. This gland surrounds the urethra ( the tube through which urine flows from the bladder and out through the penis ).

It is a very astonishing fact to know that the condition BPH has been explained in ayurveda long back. The anatomical position of prostate gland, symptoms of BPH and its remedies are explained by Acharya Sushruta.

The anatomical position of prostate gland is described in ayurvedic classics as follows

In Yogaratnakara it has been described as --
"NAABHERADHASTHAATSANJAATAHA SANCHAARI YADI VAACHALAHA |
ASHTEELAAVAD GHANO GRANTHIROODHWAR MAAYATA UNNATAHA || "

Which means "Below umbilicus (NAABHI), there is a hard gland which is little bit bulged and changes its place some times and some times stays stationary. This gland is like "Ashteela" (A small stone used to sharpen swords). This gland when affected by vitiated vata causes a disease called "vataashteela" (or benign prostate hypertrophy)

Sushruta explains the structure , anatomical position of prostate gland and symptoms of BPH as follows.

"SHACRANMAARGASYA BASTHESHCHA VAAYURANTARAMAASHRITAHAI
ASHTEELAAVADGHANAM GRANTHIMMOORDHVAMAAYATA MUNNATAM|| "

Which means - the place between rectum and bladder is occupied by vitiated vata it affects the easy flow of urine, stools and semen by enlarging the gland " Ashteela".

The prostate gland enlarges in all men as age advances. BPH is very common and affects one third of men who are over 50. A person suffering from BPH does not have the increased risk of prostate cancer.

Functions of Prostate gland

One of the main functions of the prostate is to produce a fluid, which contribute to the liquid portion of semen and this liquid allows the sperm to move freely.

The gland is divided into peripheral, transitional and central zone. The overgrowth takes place in central zone which leads to BPH.

Effects of BPH Prostate gland surrounds urethra. When prostate gland enlarges, it constricts the urethra reducing the urine flow. The emptying of bladder becomes very difficult because of this.

Causes of BPH According to present medical concepts the actual cause of prostate enlargement is unknown.

But the causes of BPH are very well explained In ayurveda which is based on tridosha theory.The causes of vataashteela or BPH are explained as follows

Causes for vataashteela according to dosha theory:
vataashteela is caused by vitiated vayu and apaana vayu ( a subcategory of Vayu)

(APAANA VAYU is located in two testicles, urinary bladder, phallus, umbilicus, thighs, groins, anus and colon.

Functions of apana vaayu are Ejaculation of semen, voiding of urine, stools, elimination of menstrual blood and expulsion of fetus. )

• The vitiation of vayu and apaana vayu is caused by

1. Controlling the urge of urination

2. Controlling the urge of defecation

3. Over indulgence in sex.

4. Consuming dry, very cold and less quantity of food

5. Old age

6. General weakness

7. Indigestion

8. Physical and mental overexertion.

Symptoms of BPH

• Difficulty in starting to pass urine ( hesitancy ),

• A weak stream of urine,

• Dribbling after urinating

• The need to strain to pass urine,

• Incomplete emptying of bladder.

• Difficulty to control the urination urge.

• Having to get up several times in the night to pass urine,

• Feeling a burning sensation when passing urine.

• Passing urine mixed with blood (indication of infection)
Symptoms of vatashteela are described as follows.

"VINMUTRAANILA SANGASCHA TANNAADMAANAMCHA JAAYATE|
VEDANAA CHA PARAA BASTOU VAATAASHTEELETI TAAM VIDUHU || "

The vitiated ashteela gland when enlarged is called as "vatashteela". This enlarged gland causes

1. Obstruction to easy flow of urine.
2. Obstruction to Easy passage of stools and gas
3. Bloating of Stomach.
4. Pain in bladder.

When the above mentioned symptoms are noticed then one should seek proper medical advice.

Diagnosis

A digital rectal examination will be performed to examine the size of prostate by inserting a finger into the rectum. A distended bladder can be felt per abdomen. Ultra sound examination will be done to determine the amount of urine left in the bladder after urination. Routine urine test will be done to rule out infections.

A prostate gland tissue may be collected using a needle to check for cancerous cells

Ayurveda tips for SELF-CARE

If symptoms are mild, the following methods can be tried for relief:

1. Vata gets vitiated when natural urges are controlled. Hence do not control the natural urge of passing urine. Urinate when you first get the urge.

2. Go to the bathroom even if you do not have urge.

3. Alcohol, tobacco, coffee increase vata and vitiate it. Hence avoid alcohol, tobacco and coffee, especially after dinner.

4. Vata gets normalized and vitiation comes down when body is warm. This can be accomplished with regular exercises and keeping the body warm.

5. Mental exertion leads to increase of vata. Avoid mental exertion at work place and at home.

6. Avoid foods which cause constipation as constipation causes vitiation of vata..

Other general tips

1. Avoid drinking fluids from two hours before going to bed.

2. Avoid cold and cough medications that contain decongestants or antihistamines. These medications can increase BPH symptoms.

3. Avoid drinking excess amount of liquids. Distribute the intake of fluids throughout day.

4. Prevention

BPH can be prevented by -
1. Consuming low fat diet

2. Including lots of fiber in diet ( fruits and vegetables which are rich in fiber).

3. Visiting your family physician as soon as you notice any symptoms while passing urine.

Apart from these many effective herbal remedies have been mentioned in Sushruta samhita and Yogaratnakara.