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What is Benign prostatic hyperplasia or BPH ?

Benign prostatic hyperplasia, or BPH for short, is common in elderly men. It occurs when the prostate becomes enlarged and is sometimes just referred to as an enlarged prostate. It can lead to problems with urination, sex, and the kidneys. There are numerous treatment options available that can help reduce the size of the prostate and correct any problems the BPH may have caused. 

Causes of BPH

For most men, the prostate will continue to grow throughout their lives. Since the urethra passes through the prostate, if the prostate grows too large, it can cause urinary problems. Researchers do not know the reason for prostate growth, but it is linked to hormones and how they change with age. BPH affects 80% of men older than 70 years’ old. Sometimes cancer can also cause a prostate to become enlarged.

Symptoms of BPH

The symptoms of BPH are different for each person. Most of them mimic the symptoms of other illnesses or infections, so it can sometimes be hard to tell that there is a problem. Many men do not seek medical attention until they begin to experience pain or severe symptoms. The most common symptoms associated with BPH include:

  • Urgent need to urinate
  • Frequent urination at night
  • Difficulty urinating
  • Painful urination
  • Weak urine stream
  • Dribbling or leaking after urination
  • Inability to finish urinating or to empty the bladder

Diagnosis of BPH

BPH can be diagnosed several different ways. Most men should have annual prostate exams after they reach the age of 35. The most common ways BPH is diagnosed include:

  • Digital Exam – The doctor will insert a gloved finger into the rectum to feel if the prostate feels enlarged. This is actually a routine exam that many men receive even if they are not experiencing any problems.
  • Urine Test – Since there are infections and other disorder that can cause the same symptoms as BPH, doctors may ask for a urine sample, so they can rule out other things that could be causing the symptoms.
  • Blood Test – A blood test can check for certain types of infections and cancer and let the doctor know if the kidneys have been affected by the BPH.
  • PSA Test – The prostate-specific antigen test can check for elevated levels of PSA in the body. When the prostate is enlarged, it will produce high amounts of PSA. Finding excessive PSA could mean the prostate is enlarged.

Treatment of BPH

Treatment of BPH depends on its severity and cause. In most cases, doctors will try to shrink the prostate to help reduce the symptoms. The most common treatment methods of BPH include:

  • Medication – Certain medications, such as alpha blockers, 5-alpha reductase inhibitors, and even erectile dysfunction medications, can be used to shrink the prostate.
  • Surgery – If medication does not work to shrink the prostate or if cancer is suspected, surgery may be necessary. This is a noninvasive surgery with a quick recovery time. 
  • Transurethral resection of the prostate – This is a procedure that involves removing the outer part of the prostate.
  • Transurethral incision of the prostate – The doctor makes two small slits in the prostate that allow urine to pass through more easily.
  • Transurethral microwave thermotherapy – Doctors use electrodes to shrink the prostate from the inside, so urination becomes easier.
  • Prostate lift – For this procedure, doctors lift the prostate with special compressions that hold the prostate in place, so urine can pass through.

Prognosis of BPH

Most men are able to urinate normally after treatment, and the prognosis is generally good. Men who suffer from an enlarged prostate are more likely to get prostate cancer and suffer from bladder stones, kidney stones, and erectile dysfunction. Treatment does reduce the risk of these problems.

Resources:

  • Medline Plus
  • https://www.auanet.org
  • Urology Health
  • Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors.Curr Bladder Dysfunct Rep. 2010 Dec; 5(4): 212–218.

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Urology, BPH (Benign Prostate Hyperplasia)

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