Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that affects many men as they age. The prostate gland is a small, walnut-sized gland located below the bladder in men, and its main function is to produce fluids that make up semen.

Causes and Risk Factors

The exact cause of BPH is not fully understood, but it is believed to be related to hormonal changes that occur with aging. The primary risk factors for developing BPH include:

• Age: BPH is more common in men over the age of 50.
• Family history: Men with a family history of BPH are more likely to develop the condition.
• Hormonal changes: Changes in hormone levels, particularly an increase in dihydrotestosterone (DHT), may contribute to the development of BPH.

Symptoms

The symptoms of BPH can vary from man to man, but common symptoms include:

• Difficulty starting urination
• Weakened urine flow
• Frequent urination
• Urgent need to urinate
• Painful urination
• Dribbling or leaking of urine
• Nocturia (waking up multiple times at night to urinate)

Diagnosis

BPH is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests. These may include:

• Digital rectal exam (DRE): A doctor inserts a gloved finger into the rectum to feel the prostate gland.
• Urinalysis: A test to check for blood, protein, or other abnormalities in the urine.
• Prostate-specific antigen (PSA) test: A blood test to measure the level of PSA, a protein produced by the prostate gland.
• Ultrasound: A non-invasive imaging test to evaluate the size and shape of the prostate gland.

Treatment Options

Treatment for BPH depends on the severity of symptoms and may include:

• Lifestyle changes: Making dietary changes, such as reducing fluid intake before bedtime, and avoiding certain medications that can worsen symptoms.
• Medications: Alpha-blockers to relax the muscles in the prostate and bladder neck, and 5-alpha-reductase inhibitors to shrink the prostate gland.
• Minimally invasive procedures: Transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), and laser therapy to reduce the size of the prostate gland.
• Surgery: Transurethral resection of the prostate (TURP) or open prostatectomy to remove a portion of the prostate gland.

Complications

If left untreated, BPH can lead to complications such as:

• Urinary retention: The inability to empty the bladder completely.
• Bladder stones: Small, hard mineral deposits that form in the bladder.
• Bladder damage: Weakening of the bladder muscle due to prolonged obstruction.
• Kidney damage: Damage to the kidneys due to prolonged obstruction of urine flow.

It is essential for men experiencing symptoms of BPH to consult a healthcare provider for proper diagnosis and treatment to prevent complications and improve quality of life.