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BENIGN PROSTATIC HYPERPLASIA (BPH)

What is Benign Prostatic Hyperplasia (BPH)?

Benign Prostatic Hyperplasia or BPH is a well-known benign enlargement of the prostate faced by men of advancing age.

BPH causes the prostate gland to become enlarged and causes difficulty during urination.

Who Does Benign Prostatic Hyperplasia Affect?

BPH occurrence increases with increasing age. Around 30% at age 60 experience it and it rises to over 50% of men aged 80 or higher. Other risk factors for BPH include:

  • A positive family history,
  • obesity,
  • cardiovascular conditions and
  • pre-existing diabetes

How Does Benign Prostatic Hyperplasia Occur?

BPH occurs as a result of proliferation and increased growth (hyperplasia) of the epithelial and stromal layers of the prostate gland. This is typically in response to hormonal changes which results in enlargement of the gland.

Causes Of Benign Prostatic Hyperplasia?

BPH is a benign enlargement of the prostate gland. The exact causes are not fully understood, however, it may be due to the natural growth process or due to hormonal changes that occur with age, specifically testosterone and dihydrotestosterone (DHT).

Symptoms of Benign Prostatic Hyperplasia

The symptoms caused by BPH are a result of the constriction of the urethra which results in:

  • Increased urgency (going to the bathroom frequently)
  • Increased need to go to the bathroom at night-time (nocturia)
  • Increased frequency of urination
  • Dissatisfaction due to incomplete bladder emptying, giving the sensation that you haven't emptied your bladder fully
  • Need to strain during urination
  • Weak stream of urine and dribbling after urination

Stages Of Benign Prostatic Hyperplasia

The growth of a benign tumour can be determined by your surgeon and its size can determine the severity of the symptoms. However, prostate size is not always an indicator of symptoms severity.

How is Benign Prostatic Hyperplasia Diagnosed?

The diagnosis of BPH is made by the doctor by performing the following tests:

  • History of symptoms and family history, as well as other pre-existing disorders
  • Digital Rectal Examination (DRE)
  • Blood Tests,
  • PSA (Prostate-specific antigen) test
  • Urinary Flow Test
  • Prostate Biopsy may be done to rule out prostate malignancy
  • Cystoscopy
  • Ultrasound

How is Benign Prostatic Hyperplasia Treated?

Treatment options for BPH include both medications as well as surgical options, and the best course of therapy is determined by the doctor based on:

  • overall health,
  • lab results,
  • progression of the enlargement, and
  • presence of complications due to the hyperplasia.

Medicine works best in cases with mild to moderate symptoms and includes

  • Alpha blockers,
  • 5 - Alpha Reductase Inhibitors, or
  • A combination of both.

These work by relaxing bladder muscles and shrinking the prostate gland, respectively.

In more advanced cases,

The prostate gland is treated with surgery with a wide variety of procedures, ranging from:

Embolization is another therapeutic approach that is undergoing experimental phase right now, requiring more long-term data before it can be recommended.

What If Benign Prostatic Hyperplasia Is Untreated

If left untreated, the symptoms caused by BPH may continue to cause the patient mild or severe distress, depending upon the growth of the prostate gland.

Further distress can result from the frequently worrying about having to urinate and constant visits to the bathroom when at work or attending events and at night.

Sometimes, complications such as frequent urine infections, an inability to pass urine at all (retention), bladder stone formation, and kidney damage can occur.

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