Benign prostatic hyperplasia, or BPH, is more commonly known as an enlarged prostate. A non-cancerous condition, BPH occurs in half of all men after age 49, and continues to affect an increasing number of men the older they get.
Normally the size of a walnut, the prostate gland produces fluid carrying sperm. Located directly beneath the bladder, the prostate encircles the urethra, which is the conduit carrying urine from the bladder to the body’s exit point. As men age, the prostate begins to enlarge to the size of a lime or a small orange. That marked increase in size puts pressure on the bladder and compresses the urethra. As the prostate enlarges, the increased pressure on the bladder intensifies the urgency and frequency of urination.
There are several risk factors associated with an enlarged prostate.
Family history – A male with a brother or father who experienced prostate difficulties has a greater likelihood he will have prostate problems.
Heart Disease and diabetes – BPH is associated with diabetes, as well as heart disease and the associated use of beta-blockers.
Aging – By age 50, at least half of all men will experience symptoms associated with an enlarged prostate. The percentage increases with age. Few men under the age of 40 have any signs or symptoms of an enlarged prostate.
Diet and lifestyle – obesity increases a man’s risk for prostate enlargement, conversely, exercise lowers the risk.
The primary symptoms of an enlarged prostate include:
Frequently (more than eight times) needing to urinate during the day as well as at night
Increase in occasions when the sudden urgency to urinate happens
Inability to completely empty the bladder
Weak stream while urinating
Stream that stops and starts during urination
Difficulty beginning urination
Dribbling that occurs at end of urination
Complications directly related to primary symptoms include:
Urinary retention – Sudden and unexpected inability to urinate. A catheter may be inserted into the bladder to allow urine to drain. Occasionally, surgery is necessary to relieve the retention of urine.
Bladder stones – Usually caused by an inability to empty the bladder thoroughly, these stones can be a further obstruction to the flow of urine. Additionally, bladder stones are a cause of irritation and infection to the bladder.
Urinary tract infections (UTI) – The inability to empty the bladder completely increases the risk of urinary tract infection.
Kidney damage – Pressure on the bladder from retention of urine can allow bladder infections to reach the kidneys, causing direct damage to the kidneys.
Bladder damage – A bladder not emptied completely can weaken and stretch over time. This results in the bladder’s muscular wall being unable to contract properly, adding to difficulties trying to empty the bladder completely.
A digital rectal exam to check the prostate for enlargement typically takes place. Ordering a urinalysis will check for infections while ruling out other causes for symptoms relating to BPH.
Additional tests often used for diagnosis of BPH include obtaining a transrectal ultrasound. This gives a view of the prostate size and checks for cancer. The prostate-specific antigen (PSA) blood test measures the levels of PSA in the blood. Increased PSA levels can help diagnose an enlarged prostate.
A wide array of treatments are available depending upon the size of the prostate, the level of discomfort, and the age and the health of the man seeking treatment.
Normal treatment protocol begins with the least invasive treatment likely to relieve symptoms associated with BPH. Diet and lifestyle changes carry the potential to reverse and reduce the enlarged prostate and symptoms. Medications allowing the prostate to relax and reduce in size are common forms of treatment.
Surgical intervention through minimally invasive methods allow excess trimming of prostate tissue. Finally, surgical removal of the prostrate may be necessary to avoid further complications to other parts of the body.