Benign prostatic hyperplasia (BPH) is one of the most common diseases in ageing men which can lead to lower urinary tract symptoms (LUTS)(1) Autopsy studies have observed a histological prevalence of 8%, 50%, and 80% in the 4th, 6th, and 9th decades of life, respectively Incremental increase is greater in Africa, Asia, Latin America and the Caribbean regions there is decreased risk among the Asians compared to the western white population. Genetics, diet and life style may play a role here.  Globally, the estimated incidence case of BPH in 2019 was 11.26 million (95%UI: 8.79, 14.46), increasing from 5.48 million (95%UI: 4.20, 7.12) in 1990. Proliferation of both stromal and epithelial cells of the prostate in the transitional zone around the urethra characterises BPH, which frequently results in lower urinary tract symptoms such as incontinence  ● Voiding symptoms - hesitancy (worsened if the bladder is very full) , poor flow (unimproved by straining) , intermittent stream – stops and starts , dribbling (including after micturition) , sensation of poor bladder emptying , episodes of near retention. ● Storage symptoms - frequency , nocturia , urgency , urge incontinence , nocturnal incontinence (enuresis) . Risk factors of BPH include age, family history, obesity, Type 2 Diabetes, sedentary life and erectile dysfunction. BPH is diagnosed based on symptoms and examination after ruling out other possible causes.  BPH is diagnosed with the digital rectal examination(DRE), cystoscopy, trans abdominal & trans rectal prostate ultrasound and urodynamic, prostate-specific antigen(PSA), urinalysis and culture and bladder ultrasound. Transabdominal pelvic ultrasonography is a tremendously versatile tool and it is a non invasive method for evaluating the lower urinary tract and prostate in men and the bladder in women. Severity of symptoms can be ascertained by using International Prostate Symptom Score questionnaire [IPSS] Non-medicinal management were advised: To urinate when they first got the urge ; To discontinue tobacco, alcohol and caffeine, especially after dinner ; Not to drink a lot of fluid at once and to avoid drinking fluids within two hours of bed time; Not to take overthe-counter cold and sinus medications that contain decongestants and antihistamines, As these can increase BPH symptoms; to keep themselves warm by exercising regularly and to reduce stress , nervousness and tension which lead to more frequent urination; to perform Kegel exercises for strengthening pelvic muscles. BPH is associated with quality of life issues, it is not life-threatening, and it does not lead to prostate carcinoma.

 RATIONALE OF THE STUDY

 Homoeopathy is the second-most widely used Complementary and alternative medicine (CAM) in healthcare systems according to the World Health Organization. The Central Council for Research in Homoeopathy (CCRH) had carried out preliminary study on symptomatic BPH with positive effects. The Council then took up a multi-centre study to evaluate the usefulness of a group of pre-defined homoeopathic medicines in BPH patients as a primary objective. The secondary objective was to check the progression of disease by evaluating changes in prostate volume (PV), post-void residual urine (PVRU) and peak urine flow rates (Qmaximum and Qaverage in mL/sec).But In this study, it is observed that homeopathic medicines were able to change significantly the PV, maintain serum PSA till 12 months of treatment but no change was observed in post-void residual urine, Qmax and Qavg. Medical Management in modern medicine is with alpha adrenoreceptor blockers, but it causes reflex tachycardia, cardiac arrhythmia and retrograde ejaculation and there is a marked increase in incidence of Benign Prostatic Hyperplasia in India due to rapid urbanization and lifestyle changes. α1 adrenergic receptor blockers are not able to significantly alter PSA, and PV. There are only a few studies conducted in homoeopathy in this topic. As homoeopathy is a system on wholistic approach, we can effectively manage Benign Prostatic Hyperplasia. Most of the researches in homoeopathy reduced the lower urinary tract symptoms , but no change was observed in post residual urine. Therefore this study is a humble effort to check the progress of BPH by evaluating ultrasonographic findings & International prostate symptom score with homoeopathic medicines.