AlzU Blog

Urinary Health for Seniors with Alzheimer's Disease: Treatment of Benign Prostate Hyperplasia

If you are a caregiver for a male with Alzheimer’s disease, chances are, you know about prostate problems.  After around age 25, the prostate begins a natural process of enlarging.  Approximately half (and up to 60%) of all males with benign prostate hyperplasia (BPH) never develop symptoms and the remaining 40 to 50% develop symptoms such as:

  • urinary hesitancy
  • weak non-continuous urine stream
  • urgency, leaking, or dribbling
  • feeling incomplete emptying of the bladder
  • frequent need to urinate (particularly at night)

This condition does not lead to prostate cancer, but it’s possible the two disorders (BPH and prostate cancer) could coexist. Prostate cancer can block the urethra which results in a condition called “overflow incontinence.”  This can cause symptoms listed above. Surgery can weaken or damage pelvic floor muscles causing significant leakage (in approximately half the men who receive the surgery). A year or more after the surgical procedure, approximately 1 in 5 men continue to have problems. This is one reason that in case of slow-growing prostate cancers, doctors may suggest what is called “watchful waiting.”

Treatment for BPH

Over time, successful medical intervention for BPH has continued to improve. There is also a wider variety of medications for BPH available today than ever before. This means if one type of medication doesn’t work, there are alternatives.  Surgical intervention continues to improve as well.  Surgical procedures for BPH are increasingly effective, with fewer side effects than in the past.

If you or a loved one with AD have BPH, and the symptoms are not particularly troubling, perhaps the best course of action is to simply watch the progression of the condition to ensure complications don’t occur.  For problematic symptoms, here are some simple lifestyle changes recommended by Harvard Health that may help:

       
  • Exercise to reduce stress, some men experience increased urination when they are nervous; practicing stress reduction (such as meditation) and implementing a regular workout regime has been known to help.
  •    
  • Take plenty of time when going to the bathroom, to ensure complete emptying of the bladder
  •    
  • Consult with the primary physician about any medications you may be taking, some could contribute to or even cause urinary symptoms. Your physician can discuss lowering the dose or perhaps changing medications when indicated.
  •    
  • Don’t drink caffeinated beverages and alcohol (particularly at night), reduce the intake of fluids before bedtime.  Caffeine and alcohol can contribute to decreased muscle tone in the bladder while stimulating the kidneys, causing extreme nighttime urination.


Treatment for more severe symptoms may include a combination of lifestyle changes (such as exercise), medication and/or surgical intervention.  Oftentimes, medication and lifestyle changes are enough to improve symptoms and surgery isn’t required.

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