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Benign prostatic hyperplasia

Category: Illness or disabilities

Type

Involuntary

Introduction and description

 

Benign prostatic hyperplasia (BPH), also called benign enlargement of the prostate (BEP), is a Reproductive system disease.

It is such a common problem however that it was thought it deserved its own entry on the site.

BPH is also called adenofibromyomatous hyperplasia and is an increase in size of the prostate.

When sufficiently large, the nodules compress the urethral canal to cause partial, or sometimes virtually complete, urinary tract obstruction by the urethra, which interferes with the normal flow of urine. 

Globally, benign prostatic hyperplasia affected about 210 million males as of 2010 (6% of the population). The prostate gets larger in most men as they get older. For a symptom-free man of 46 years, the risk of developing BPH over the next 30 years is 45%.   An estimated 50% of men have histologic evidence of BPH by age 50 years and 75% by age 80 years; in 40–50% of these men, BPH becomes clinically significant.

Disability-adjusted life year for benign prostatic hyperplasia per 100,000 inhabitants in 2004 - dark colours indicate greater incidence

BPH, as far as can be ascertained, has caused no hallucinations or out of body experiences, but many of the drugs prescribed for it have, as such this entry has been provided to show the problems.  There are also a number of fairly gentle natural healing foods and approaches that can be used for prostate problems, as such this section enables them to be described.

Symptoms

BPH leads to symptoms of urinary hesitancy, frequent urination, increased risk of urinary tract infections, urinary retention, all of which can contribute to or cause insomnia. Prostate specific antigen levels may be elevated because of increased organ volume and inflammation due to urinary tract infections.

BPH involves hyperplasia of prostatic stromal and epithelial cells, resulting in the formation of large, fairly discrete nodules in the transition zone of the prostate. When sufficiently large, the nodules impinge on the urethra and increase resistance to flow of urine from the bladder. This is commonly referred to as "obstruction," although the urethral lumen is no less patent, only compressed. Resistance to urine flow requires the bladder to work harder during voiding, possibly leading to progressive hypertrophy, instability, or weakness (atony) of the bladder muscle. BPH involves hyperplasia (an increase in the number of cells) rather than hypertrophy (a growth in the size of individual cells), but the two terms are often used interchangeably, even amongst urologists.

spermatic veins

The following paper is interesting in that it adds extra information on what is happening when BPH occurs.  Note that this does not give the cause, but it adds extra vital detail.

We found that in all BPH patients, the one-way valves in the vertically oriented internal spermatic veins are destroyed (clinically manifested as varicocele), causing elevated hydrostatic pressure, some 6-fold greater than normal, in the venous drainage of the male reproductive system.
The elevated pressure propagates to all interconnected vessels leading to a unique biological phenomenon: venous blood flows retrograde from the higher pressure in the testicular venous drainage system to the low pressure in the prostatic drainage system directly to the prostate (law of communicating vessels).
We have found that free testosterone levels in this blood are markedly elevated, with a concentration of some 130-fold above serum level. Consequently, the prostate is exposed to:
(i) increased venous pressure that causes hypertrophy;
(ii) elevated concentration of free testosterone causing hyperplasia.
We have treated 28 BPH patients using a technique that restores normal pressure in the venous drainage in the male reproductive system. The back-pressure and the back-flow of blood from the testicular to the prostate drainage system were eliminated and, consequently, a rapid reduction in prostate volume and a regression of prostate symptoms took place.  PMID:  18811916

Causes

Not many celebrities are willing to admit to BPH, more's the pity,
Gérard Depardieu is one of the honest few

As we can see from the paper above, it is damage to the spermatic veins that may be one of the causes in the cause effect chain.  But what caused this damage?  One reason may simply be wear and tear on the valves, a sort of varicose veins of the testes, but if we exclude this there may be other causes - shared with the pathogens that attack the blood circulatory system in general.

There is clear evidence that these attackers are not endogenous.  This disease has nothing to do with high levels of endogenous testosterone, this is just another side effect in the chain, the paper above gives reasons and the paper below helps to prove this.

… The aim of this post hoc analysis was to determine the association between LUTS  [Lower urinary tract symptoms]and endogenous Testosterone levels in a subset of men participating in the 2013 Prostate Cancer Awareness Week………Endogenous TT levels did not correlate with LUTS or prostate size. PMID:  26077271

In the end it appears we can return to the main pathogens that consistently appear in all illnesses:
  • direct attack by a pathogen [toxin, bacteria, fungi, parasite, virus, heavy metals,] causing inflammation and cell proliferation;  this may include a genetic disorder which may itself be caused by a pathogen [like nanoparticles or certain viruses];
  • indirect attack by a pathogen [toxin, bacteria, fungi, parasite, virus, heavy metals, radiation] on another organ – the testicles for example or the endocrine glands, causing hormonal imbalance and thus prostate malfunction

The attack is via the lymph system or the blood circulatory system

Viruses

a rectal exam to test for enlargement

There have been a number of sponsored studies appearing in PubMed, principally from the USA, that appear to indicate that viruses have no role in BPH.  These go against the evidence that has been accumulated from independent research worldwide, where a role for viruses has been found, for example

We report on 4 cases of transient neurogenic dysfunction of the urinary bladder caused by herpes zoster. All patients noticed a slow urinary stream leading to complete urinary retention and loss of sensation following the vesicular stage of herpes zoster, necessitating the insertion of a suprapubic tube. …  PMID:  2431531

Although it is clear that viruses are not the only cause, the viruses implicated are those with latency, which may be why they were not found in many of the USA studies where only antibodies were checked.  Since the virus is latent, antibodies may well not be present, even though recurring infections may cause gradual damage over time, for example:

Men with BPH were more often seropositive for HPV 18 and ….. had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305).  ……. Serostatus was not a predictor of disease stage in the studied population.  PMID:  21291519

Examples of viruses exhibiting latency include the Herpes Virus family, Herpesviridae, all of which establish latent infection; the Chicken-pox virus [VZV], Herpes simplex viruses (HSV-1, HSV-2), Epstein-Barr Virus, the HPV human papilloma virus, Vaccinia virus, Cytomegalovirus [CMV], the BK virus, Hepatitus viruses, measles virus, mumps virus and the Rubella virus.   Immunity to a virus which has become latent is only achieved for a short space of time. 

Prostate cancer has been projected to cause almost 10% of all male cancer deaths in the United States in 2007. The incidence of mutations in the tumor suppressor genes .... has led to the hypothesis that a human virus such as BK virus (BKV), which establishes a persistent subclinical infection in the urinary tract and encodes oncoproteins that interfere with these tumor suppressor pathways, is involved. Previously, we detected BKV DNA in the epithelial cells of benign and proliferative inflammatory atrophy ducts of cancerous prostate specimens. In the present report, we demonstrate that BKV is present at a much lower frequency in noncancerous prostates. PMID: 18160432

Over time loss of the antibodies occurs and thus the virus can simply reappear in its new virulent form.  Whenever times of high stress occur, the immune system is compromised and the virus can emerge in its new guise and migrate to other parts of the body or attack where it is resident.

The viruses implicated for prostate cancer appear to be different from those for BPH, but the difference may simply be which viruses are latent and which not:

The serum antibody titers of cytomegalovirus (CMV), Herpes Simplex Type I (HSV-L) and Adenovirus (ADV) were detected by complement fixation technique in 40 patients with benign hyperplasia of prostate (BPH), and prostatic carcinoma. The control group consisted of 20 healthy military personnel. While, antibody levels of CMV and HSV-I was found to be elevated in BPH, the titers of ADV was elevated in protatic cancer patients. PMID: 2436029

Bacterial infection

Bacterial infection also appears to play a role in development of BHP direct infection, for example

PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for ……. Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) ……...  Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. …...  PMID:  21291519

Ureaplasma urealyticum is a bacterium belonging to the family Mycoplasmataceae. Its type strain is T960.  Chlamydia trachomatis, an obligate intracellular human pathogen, is one of four bacterial species in the genus Chlamydia.

Again, these studies simply indicate that a host of pathogens may be responsible and that looking for  a single cause is not helpful.  Given the pattern that is very evident on this site, there are always multiple pathogens that can do the damage, and where they go in the body is often a function of emotional not physical criteria.

Vaccines

The same pathogen can cause more than one illness if allowed to spread,
in September 2013 Billy Connolly underwent minor surgery for early-stage
prostate cancer. The announcement also stated that he is being treated for the
initial symptoms of Parkinson's disease

The name for a vaccine that has a live virus in it is an attenuated vaccine.   Although most attenuated vaccines are viral, some are bacterial in nature. As we can see from the description above, BPH can be caused by viruses and bacteria.  There appears to be a belief by those promoting vaccines that the immune system defeats the virus as it builds up an immunological record.  But there is now enough research to show that this is not the case.  A virulent strain of attenuated virus may replicate very fast before the immune system has had time to muster its defences - particularly if the virus is injected or administered by nasal spray. A virus is capable of then secreting itself and 'laying low'.  And this is exacerbated if the virus shows virus latency.

As such BPH may be caused by viruses, obtained from vaccines, emerging at times of stress, or high emotion and thus low immunological function.

Parasites

A significant and often grossly underestimated role is often played by parasites in all disease, and it is clear that parasites have a role to play in BPH:

Cells of the innate immune system, antimicrobial peptides, cytokines, chemokines and adaptive immunity in the reproductive tract are evolved during infection, and a pro-inflammatory response is generated to fight against the invading pathogen.
Trichomonas vaginalis, a primary urogenital protozoa, the etiological agent of human trichomoniasis, is a curable sexually transmitted infection. The involvement of the urogenital tract by other protozoal infections such as P. falciparum, Trypanosoma, Leishmania, Toxoplasma, Entamoeba histolytica and Acanthamoeba infection has also been reported.
Trichomonas induce pro-inflammatory and immunosuppressive responses in infected subjects. Multifactorial pathogenic mechanisms including parasite adherence, cysteine proteases, lipophosphoglycan, free radical, cytokine generation and Toll-like receptors appear to interplay with the induction of local and systemic immune responses that ultimately determine the outcome of the infection. However, the involvement of urogenital pathogen-specific immune mechanisms and effect of normal local resident flora on the outcome (symptomatic vs. asymptomatic) of infection are poorly understood. Moreover, immune interactions in trichomoniasis subjects co-infected with bacterial and viral pathogens need to be elucidated.  PMID: 25201404

 

Toxins

 

Some studies have appeared to indicate that dietary patterns may affect development of BPH. Studies from China, for example, suggest that greater protein intake may be a factor. Men older than 60 years in rural areas had very low rates of clinical BPH, while men living in cities and consuming more animal protein had a higher incidence of BPH.  But this is too simple a conclusion.  For a start, those in rural communities may be less stressed, furthermore they may have access tto 'healthier food.  In effect, the real problem is toxins.

The question is then what toxins? And the principle answer appears to be endocrine disruptors – of which there are many:

The declining level of androgen during aging, associated with an inclining level of estrogen, has been hypothesized to be important in the development of benign prostatic hyperplasia (BPH). Within physiologic range, increasing estrogen levels can stimulate prostate to develop and permanently increase prostate size. As an estrogenic endocrine disruptor, bisphenol A (BPA) might be stimulatory to prostate development. ... We found that weight and volume in rats treated with low dose BPA (10 μg/kg) was higher than that of model control, and BPA significantly increased the relative weight of prostate (p < 0.01). …. BPA could also decrease testosterone level and increase prostate-specific antigen level. ….. We concluded that environment exposure to low dose of BPA may induce prostate to proliferate and aggravate testosterone-induced benign hyperplasia prostate in rats.  PMID:  21415097

And quite probably in humans too, however, you can’t do these sorts of experiments on humans to find out.  Many herbicides and defoliants are also endocrine disruptors and we have an observation that shows that the defoliants used on potatoes also has an effect.

Pharmaceuticals

The eHealthme site collects the Adverse Drug reports submitted by doctors to the FDA and SEDA in the USA.  It then summarises them for ease of use.  We originally provided a direct link to the BPH entry listed on this site and the pharmaceuticals that can cause it, but the eHealthme website developers frequently reorganise the site and thus break the links.  Thus in order to find out which pharmaceuticals are implicated in BPH.

  • Follow the LINK to the eHealthme website
  • Using the ‘All conditions’ index find the appropriate entry
  • Now scroll down until you get to the section marked ‘Drugs that could cause

The list shows you all the drugs implicated in CAUSING BPH as well as the number of people who have made a complaint to their doctor and had their case reported by him.  Note that it is up to the doctor whether he reports or not.

As of October 2016, about 950 pharmaceuticals were in this list

Source: eHealthme Number of reports submitted per year:

It appears that the pharmaceutical is either a toxin to the body, or destroys the body's natural immunlogical response to pathogens, thus allowing the ones above to gain a hold.  If we look at just a few in the list by class we find:

  • Pain killers and NSAIDs - both aspirin and paracetemol appear to be implicated, as well as a COX-2 selective nonsteroidal anti-inflammatory drugs (NSAID).  Rofecoxib for example, also known as Vioxx and now [theoretically] withdrawn from the market over its safety record caused many cases of BPH

EHealthme
On Jun, 29, 2015: 107,335 people reported to have side effects when taking Vioxx. Among them, 615 people (0.57%) have Benign Prostatic Hyperplasia.

 

 

  • The immunosuppressants - The corticosteroids, specifically glucocorticoids, are also causative agents along with others like the TNF inhibitors.  Since the disease is caused by pathogens, in general using immunosuppressants - drugs that suppress the immune system - are bound to have a negative effect. 
  • Gout treatments - Another drug which may be a surprise to some is Allopurinol, sold under the brand name Zyloprim/Lypurin and generics, and used "to treat excess uric acid in the blood and its complications, including chronic gout". Since uric acid is not the cause, but a cure, one assumes that by lowering uric acid one effectively removes all chance of the person defending themselves from pathogens
  • Anti-histamines - also appear to figure strongly, which is to be expected.  The histamine reaction by the body is to enable the immune system fight pathogens.  If you suppress the immune system, the pathogens will of course multiply unchecked.
  • Anti-biotics - whose action may serve to reduce the gut flora and thus allow pathogens and toxins to enter the system
  • Statins - are present in large numbers as causative agents.  Statins are used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, in the liver.  Cholesterol is an essential structural component of animal cell membranes.  It is required to establish proper membrane permeability and fluidity.  It is thus a repair material.  Statins take away the repair material and furthermore as cells are attacked by pathogens ensure that there is nothing to do any more repairs with. They are a form of slow death.  High cholesterol is a symptom not a cause - a symptom of attack by pathogens.   Statins are treated as a toxin by the body.
  • Osteoporosis treatments - also occur frequently in the list.  This class of drugs results in numerous side effects, one of which is death, so it is not surprising to see it in this list.
  • Benign prostate hyperplasia drugs - according to the eHealthme lists, the very class of drugs designed to treat the symptoms of BPH causes the illness.  For example

    Duloxetine failed to receive US approval for stress urinary incontinence amid concerns over liver toxicity and suicidal events; however, it was approved for this indication in the UK, where it is recommended as an add-on medication in stress urinary incontinence instead of surgery

  • Blood thinners - like Clopidogrel and Warfarin.  Here the mechanisms by which BPH is produced are difficult to work out.  It might be that simply altering the blood's composition results in lower uric acid concentrations and thus more chance for pathogens to act.
  • Anti-depressants - here the use of the drug may simply indicate a stressed and depressed state and thus a compromised immune system
  • Vitamin and mineral supplements - including the B vitamin groups.  Supplements create overdosing and thus act as poisons.  Any figures on this are likely to be the tip of the iceberg as most people regard vitamins as 'good'.  To realise they are only good when in a food in a balanced amount requires wisdom - 87 doctors were wise enough to make the connection

eHealthme:   On Jun, 29, 2015: 38,376 people reported to have side effects when taking Vitamins. Among them, 87 people (0.23%) have Benign Prostatic Hyperplasia.  For example, using Vitamin E

  • Diuretics - particularly, but not exclusively, loop diuretics.  Yet again indicating the body regards this class of drug as toxic.  Diuretics appear to destroy vital gut flora, allowing pathogens to enter the system
  • Anti-diabetic drugs - interfere with sugar levels and sugar levels seem to be key in determiing uric acid levels.  See fructose and sucrose digestion.  Biguanides, for example, reduce hepatic glucose output and increase uptake of glucose by the periphery, including skeletal muscle.  So in general they are interfering with the uric acid levels.  Uric acid is key to our protection in the blood
  • ACE inhibitors - these drugs act on the kidney and appear to have side-effects related directly to uric acid levels.  Uric acid balance is key to our defences
  • Benzodiazepines - which appear simply to be treated as toxins by the body
  • Proton pump inhibitors - reduce stomach acid.   Hydrochloric acid is required for the digestion of proteins and for the absorption of nutrients, particularly of vitamin B12 and of calcium, thus PPIs send undigested and unusable food through to the intestine.  This may 'leak' into the blood stream, acting as a toxin.  Furthermore a lack of stomach acid allows pathogens to proceed through to the intestines
  • Calcium channel blockers - which appears to indicate the body regards this class of drug as toxic
  • Erectile dysfunction drugs - some interesting hypotheses can be made here.  If  the body is preventing an erection in order to stop the pathogen from spreading via the dilated arteries and veins, then the use of this drug would allow the pathogen to spread.
 

Nanoparticles

 

A particle is defined as a small object that behaves as a whole unit with respect to its transport and properties. 

The term Nanopowders then describes agglomerates of ultrafine particles or nanoparticles.  

 

Nanometer-sized single crystals, or single-domain ultrafine particles, are often referred to as nanocrystals.

 

They are one of the most dangerous new inventions by science to have been released into the environment without adequate analysis and understanding of their damage.  And they are being implicated as seed crystals in numerous diseases.

Stress and extreme negative emotion

High levels of negative emotions do not directly cause BPH, but all forms of stress affect the immune system.  Stress compromises our immune responses and as a consequence the pathogens that may be in our bodies can proliferate and start to attack us.

Surgery

One of the very confusing things about this illness is its worldwide prevalence.  If we look at the map below, the question remains - what factor links those countries?  At the moment we could find no firm studies to back the hypotheses being suggested.  One hypothesis which can be refuted simply using a map is that HIV/AIDs infection is the linking factor.  But this map proves this hypothesis to be untenable

But another hypothesis is based on circumcision.

All the countries were at one time or now, countries that used circumcision.

The research now being undertaken is being based on whether it is circumcision of itself that leads to BPH or whether it is the unsafe surgical practices leading to infection.  At the moment both hypotheses seem to be being proved valid - circumcision leads to BPH, as do the poor surgical practises with which it is performed.

Interestingly the research is both on female circumcision and male.  The theory here is that where high levels of 'female genital mutilation' occur, the procedure results in undetected infection, which is then subsequently the cause of both male and female illness.  Eritrea and Djibouti, for example, have very very high rates of BPH.  In Somalia, the prevalence of female circumcision is 98%, in Guinea 96%, in Djibouti 93% and in Egypt, 91%. In Eritrea and Mali the figure is 89% and a prevalence of 88% was reported in both Sierra Leone and Sudan.

Controlling for age in proportional hazards models, statistically significant predictors of surgery were prior clinical diagnosis, lower socioeconomic status, Jewish religion, and not currently smoking cigarettes; …. this diagnosis is neither sensitive nor specific in its association with surgery.  PMID:3964994

Treatment

Find the cause.

Once the cause is known then you can base all healing on attacking the pathogen.  In this eating for health, which helps to boost the immune system, and healing yourself are two vital strategies.  If the pathogen is a virus, heat may help [sauna and warmth for example].

This has particular importance as one of the suggested natural remedies for BPH will only work on cases caused by hormone imbalance.  The hormone imbalance may be toxin related or it might be related to attack by a pathogen of the endocrine system, at the moment it is unclear which of the two the plant helps with, all that is clear is that it is the hormone related problems it helps

Serenoa repens has been widely used to treat benign prostatic hyperplasia and lower urinary tract symptoms; however, most of the studies have been conducted in individuals with normal weight and not obese. In this study, the effects of a lipidic extract of S. repens, in markers of oxidative stress, inflammation, and growth factors, in obese rats with testosterone-induced prostatic hyperplasia, were investigated. ….. The obese rats had a higher prostate weight compared with controls. …… S. repens showed high antioxidant and anti-inflammatory activity in obese rats, suggesting that their use could be beneficial in the treatment of benign prostatic hyperplasia. PMID:  26104840

 The ‘voiding position’

The following paper may be helpful

Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis - Ype de Jong et al

It is suggested that the body posture during urination can influence urodynamic parameters in patients with Lower Urinary Tract Symptoms (LUTS) to an extent approaching pharmacological interventions. In this article, the influence of body position during micturition on maximum urinary flow rate (Qmax), voiding time (TQ) and post-void residual volume (PVR) in healthy males and patients with LUTS is analyzed by means of a systematic review and meta-analysis.

A systematic search was conducted in 14 medical databases. Studies comparing urodynamic parameters in standing versus sitting position were eligible for inclusion. Studies were stratified according to health status of included male participants: healthy individuals and patients with LUTS. ….Eleven articles were included. …..For healthy men, no difference is found in any of the urodynamic parameters. In patients with LUTS, the sitting position is linked with an improved urodynamic profile.   PMID 25051345

Radiation

 All radiation whether 'cosmic' or electromagnetic impacts our bodies and depending on its frequency, it resonates different parts of us. The reason that nuclear radiation is so dangerous is that it impacts cells, but what we appear to have overlooked is that all radiation impacts some part of us. 

Every aggregate in our bodies - organs, cells, the body itself, has natural ‘resonance’.  Resonance is a substance’s natural tendency to oscillate – vibrate – at maximum amplitude at certain frequencies, known as the thing’s resonant frequency.  And some radiation affects the reproductive system organs.  High intensity radiation affects the reproductive system organs in the short term, but even low exposure radiation of the 'right' frequency can have an effect in the long term.

At this point you may think that the conclusion is here that BPH is also caused by radiation, but there is no evidence that this is so.  Prostate cancer can be, but not BPH and there is even a paper that we have included that shows that some frequencies may even heal. 

In effect, there is a possibility here that the frequencies are those that destroy the pathogen rather than us and this offers considerable scope for a whole new range of therapies against pathogens.

Related observations