BPH

Benign Prostatic Hyperplasia (BPH), also known as benign prostatic hypertrophy or prostate enlargement, is a common condition affecting older men. It involves noncancerous increase in size of the prostate gland. The prostate is a small gland located below the bladder and in front of the rectum. It surrounds the urethra, which carries urine from the bladder out of the body. As the prostate enlarges, it can impede the flow of urine, leading to bothersome urinary symptoms.

Causes

The exact cause of BPH is not well understood. It is believed to be related to changes in hormone levels as men age, including an increase in estrogen relative to testosterone. Additionally, some genetic factors may predispose individuals to develop the condition.

Symptoms

Common symptoms of BPH include:

• Increased urinary frequency and urgency
• Difficulty in starting urination
• Weak urine stream or a stream that stops and starts
• Dribbling at the end of urination
• Inability to completely empty the bladder
• Nocturia (increased frequency of urination at night)

In severe cases, BPH can lead to urinary retention, bladder stones, or kidney damage.

Diagnosis

Diagnosis of BPH typically involves:

• Medical history assessment
• Physical examination, including a digital rectal exam (DRE)
• Urine tests
• Blood tests to check kidney function and to measure Prostate-specific antigen (PSA) levels, which can help rule out prostate cancer
• Uroflowmetry, a test to measure the speed and volume of urine flow
• Postvoid residual volume test, to determine the amount of urine left in the bladder after urination

Treatment

Treatment options for BPH vary depending on the severity of symptoms and can include:

• Lifestyle changes such as reducing fluid intake before bedtime
• Medications, including alpha blockers such as tamsulosin and 5-alpha-reductase inhibitors such as finasteride, which can help shrink the prostate or relax muscles near the prostate to ease symptoms
• Minimally invasive therapies such as transurethral microwave thermotherapy (TUMT)
• Surgical procedures, including Transurethral resection of the prostate (TURP), which is considered the most effective treatment for severe BPH

Prevention

There are no definitive ways to prevent BPH, but maintaining a healthy lifestyle with regular exercise and a balanced diet may help reduce the risk.

Epidemiology

BPH is a very common condition that affects about 50% of men in their 50s and as many as 90% of men over the age of 80.

See Also

• Prostate cancer
• Urinary tract infection
• Kidney stones