Posted on 5th March, 2024 at 11:02:01 PM
Education about prostate symptoms and reassurance-patient must understand prostate and urinary symptoms relation, BPH progression, and consequences. They must be assured that an enlarged prostate does not mean prostate cancer. And not all prostate patients will need surgery. Your doctor will guide and explain to you.
Advice of fluid– Some patients had false belief that increasing fluid intake will be helpful for prostate related urinary problem, most of the time it is not true. On the other hand, fluid intake of 1.5-2L/day, may (increase half liter in summertime) decrease frequent urination. Or if someone talks 4-5 lit water daily, decrease that amount to 3-3.5 L/day. Increase fluid intake only help when there are urinary tract infection related symptoms. Body will require 1.5-2.5 lit water daily for good health, more than this may not needed. Specially kidney disease and heart disease patients will require less amount of daily fluid intake(1-1.5L/d).
Also restrict fluid intake during outdoor journey, travel etc. that will help decrease urinary frequency and urgency episodes.
For nocturnal urination, restrict fluid intake at night or after evening, specially 2-3 hrs. before bedtime. In that case, most of the fluid may be taken during daytime.
Avoid bladder irritant food-Decrease or avoid taking tea, alcohol, spicy food specially after evening time. Tea better to take at morning or before evening time will help decrease urinary problems like urgency or frequency.
Adjusting medications- This is very important. Adjustment of medication will simply prevent some urinary problems like frequency, urgency, nocturia etc. No of medicine at night should be decrease, if possible, this will help decrease taking water at night and nocturnal urinary frequency. Some anti-hypertensive like diuretics may be adjusted or replaced with non-diuretic medicine to prevent frequent urination. This needs coordination with physician. Many patients refuse to adjust medication because of their false belief that physician has prescribed their medications despite having urinary problem. This is not good practice and this can be solved after discussion with physician.
Also avoid constipation by increasing fresh vegetables, fruit etc.
Regular daily exercise, at least 30 min daily for 4- 5 days decrease tension and will help good bowel and toilet habit. Control of diabetes and hypertension will help decrease urinary problems. Also, optimization of neurogenic problems will have good effects on urinary control. Weight reduction for obese patient will help decrease some urinary problems specially stress incontinence.
Toilet and bladder training-Double voiding (twice voiding in single attempt) decreases post void dribbling of urine. Milking of urethra with hand will also decrease post void dribbling.
Regular pelvic floor training and perineal exercise will help reduce many urinary tracts problems like urgency, stress urinary incontinence, increase holding power of urine.
Urge suppression techniques may be well suited for some patients where every time patient must hold and suppress voiding urge for few seconds and gradually increase this time interval.
All these measures will eliminate need of prostate medication in most of the mild symptomatic patients and few of moderate symptomatic patients if followed optimally. These principles should be exercise in good spirit and may be monitored by health specialist best outcomes.
