Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia
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Synonyms	BPH, Prostate Enlargement
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Benign Prostatic Hyperplasia (BPH), also known as prostate enlargement, is a common condition as men age. It involves enlargement of the prostate gland, which can lead to urinary symptoms such as difficulty in starting urination, a weak urine stream, frequent urination, and inability to completely empty the bladder.

Causes

The exact cause of BPH is not well understood, but it is believed to be related to changes in hormone levels, including testosterone and estrogen, as men grow older. Additionally, factors such as genetics and lifestyle may play a role in the development of BPH.

Symptoms

Common symptoms of BPH include:

• Frequent urination, especially at night (nocturia)
• Urgency to urinate
• Difficulty starting urination
• Weak urine stream or a stream that stops and starts
• Dribbling at the end of urination
• Inability to completely empty the bladder

Diagnosis

Diagnosis of BPH typically involves a combination of medical history, physical examination including a digital rectal exam (DRE), and various tests. These tests may include:

• Urinalysis to rule out infections or other conditions
• Prostate-specific antigen (PSA) test to screen for prostate cancer, which can present with similar symptoms
• Uroflowmetry, measuring 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 such as alpha blockers (e.g., tamsulosin) and 5-alpha reductase inhibitors (e.g., finasteride)
• Minimally invasive therapies such as transurethral microwave thermotherapy (TUMT)
• Surgical options like Transurethral resection of the prostate (TURP) for more severe cases

Prognosis

While BPH can cause significant discomfort and impact on quality of life, it is not a life-threatening condition. With appropriate management, most men can achieve good symptom control and maintain a normal lifestyle.

Epidemiology

BPH is a very common condition affecting older men. It is estimated that up to 50% of men show signs of BPH by the age of 50, and this number increases with age.

See also

• Prostatitis
• Urinary retention