Benign Prostatic Hyperplasia, Persistent Urinary Problems Even After Prostatic Urethral Lift

Hello. This is Baengnokdam Korean Medicine Clinic.

"My urination isn't clear, and I have sexual function problems…"

A man in his late 50s has been suffering from benign prostatic hyperplasia (BPH) for over a decade. He experiences a weak and unsatisfactory urine stream, along with a persistent feeling of incomplete bladder emptying. Fortunately, nocturia is not severe and only occurs occasionally, but these urinary issues cause significant daily discomfort.

Two years ago, he underwent a **Prostate Urolift Procedure**, but the treatment response was unsatisfactory, and symptoms have persisted. Furthermore, weakened pelvic floor muscles make urination even more difficult, and sexual dysfunction issues such as erectile dysfunction and premature ejaculation are also present, leading to a decline in overall quality of life.

He had previously combined Western medication treatments but did not see a clear effect. Currently, having stopped Western medication, he decided to visit us, aiming for constitutional improvement and symptom relief through Korean medicine treatment.

Why is Benign Prostatic Hyperplasia a problem?

1. Characteristics of Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) commonly occurs in men after middle age. It is a condition where the prostate gland enlarges, compressing the urethra and causing urination problems.

2. Main Symptoms

• Urinary Issues: Weak and unsatisfactory urine stream, feeling of incomplete bladder emptying, straining during urination.
• Nocturia: Frequent urination at night, disturbing sleep.
• Sexual Dysfunction: Sexual dysfunctions (e.g., erectile dysfunction, premature ejaculation) often accompany BPH.

3. Connection to Pelvic Floor Weakness

Pelvic floor muscles play a role in aiding urine expulsion. However, if these muscles weaken, it can lead to difficulties in urination and worsen the feeling of incomplete bladder emptying. This is particularly common in patients who have suffered from BPH for a long time.

Patient Analysis

He had previously used Western medication treatments, but the effect was minimal, and he has now stopped taking them.

1. BPH-Related Medications

• Alpha-Blockers

  • Key Ingredients: Tamsulosin (Brand names: Hantam, Tamsol)
  • Effect: Relaxes the smooth muscles of the prostate and bladder, facilitating smoother urination.
  • Limitations: Temporarily alleviates symptoms but does not provide a fundamental cure.

• 5-alpha Reductase Inhibitors

  • Key Ingredients: Dutasteride (Brand name: Avodart), Finasteride (Brand name: Proscar)
  • Effect: Reduces prostate size and decreases urethral compression.
  • Limitations: Takes time for effects to appear, and in some patients, it can cause sexual side effects (erectile dysfunction, decreased libido).

2. Prostate Urolift Procedure

This is a non-invasive procedure that involves placing implants to hold enlarged prostate tissue, thereby relieving urethral compression. However, despite undergoing the procedure, the symptoms had not improved satisfactorily.

Korean Medicine Approach: Constitutional Improvement Centered on Kidney Deficiency (腎虛)

In Korean medicine, benign prostatic hyperplasia and sexual dysfunction are primarily viewed as kidney deficiency (腎虛, *sinheo*). The kidneys govern reproductive function, urine expulsion, and the health of the lower back and pelvis. If kidney function weakens, problems can arise in both urination and sexual function.

1. Herbal Medicine Treatment

Herbal medicines are prescribed according to the patient's constitution and symptoms to strengthen the prostate and genitourinary system and to address kidney deficiency. Commonly used prescriptions include:

• Goshajinkigan (Niuche Shenqi Wan)

  • Effect: Strengthens kidney function and promotes smooth urine expulsion.
  • Ingredients: Prepared Rehmannia Root, Dioscorea Root, Moutan Bark, Alisma Rhizome, etc.
  • Indications: Benign prostatic hyperplasia, urinary difficulty, pelvic floor weakness.

• Hachimijiogan (Bajia Dihuang Wan)

  • Effect: Replenishes kidney essence, strengthens sexual function, and improves chronic fatigue and urinary problems.
  • Ingredients: Cinnamon Bark, Prepared Aconite Root, Prepared Rehmannia Root, etc.

• Hojuekkito (Buzhong Yiqi Tang)

  • Effect: Boosts vital energy (Qi), strengthens pelvic floor muscles, and improves urination.
  • Ingredients: Astragalus Root, Angelica Gigas Root, Ginseng, Licorice Root, etc.

2. Acupuncture and Electroacupuncture

Electroacupuncture (acupuncture with electrical stimulation) is performed on acupoints effective for benign prostatic hyperplasia and sexual dysfunction.

• Key Acupoints: Shangliao (BL31), Zhongliao (BL32), Ciliao (BL33), Guanyuan (CV4).
• Effect: Improves blood circulation, strengthens pelvic floor muscles, and activates nerve function to alleviate urination and sexual dysfunction problems.

3. Lifestyle Management

• Pelvic Floor Strengthening Exercises: Kegel exercises strengthen pelvic floor muscles, improving urination and sexual function.
• Weight Management: Obesity can worsen BPH, so maintain an appropriate body weight.
• Avoidances: Reduce consumption of bladder-irritating beverages such as caffeine and alcohol.

BPH and Sexual Dysfunction, with Korean Medicine Treatment

Even those suffering from benign prostatic hyperplasia and sexual dysfunction can improve their constitution and restore genitourinary function through Korean medicine treatment. Korean medicine helps restore the body's balance, addressing the root causes of symptoms, and contributes to long-term prevention of recurrence.

If you are seeking a new alternative to previous unsatisfactory treatments, consider Korean medicine.