Overview:

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which commonly affects men as they age, particularly after the age of 50. The prostate is a small gland located below the bladder and in front of the rectum, surrounding the urethra (the tube that carries urine out of the body). As the prostate enlarges, it can press on the urethra and cause urinary symptoms.

Causes:

The exact cause of BPH is not fully understood, but it is believed to be linked to hormonal changes in men as they age, particularly changes in testosterone and estrogen levels. Family history and lifestyle factors can also contribute to the risk of developing BPH.

Symptoms:

BPH can cause a variety of urinary symptoms, which may range from mild to severe. Common symptoms include frequent need to urinate, especially at night (nocturia), difficulty starting urination, weak or interrupted urine stream, dribbling at the end of urination, inability to completely empty the bladder, and sudden, strong urges to urinate (urinary urgency).

Complications:

Although BPH is not cancerous, it can lead to complications if left untreated. These may include urinary retention (inability to urinate), bladder stones, urinary tract infections (UTIs), and in severe cases, bladder or kidney damage.

Diagnosis:

BPH is typically diagnosed based on medical history, symptoms, and physical examination, including a digital rectal exam (DRE) to assess the size of the prostate. Other diagnostic tests may include urine tests to check for infection or other causes of symptoms, prostate-specific antigen (PSA) blood tests to rule out prostate cancer, ultrasound of the prostate, uroflowmetry to measure the strength of urine flow, and cystoscopy to examine the inside of the urethra and bladder.

Treatment:

Treatment for BPH depends on the severity of symptoms. Options include lifestyle changes such as reducing fluid intake before bedtime, limiting caffeine and alcohol consumption, and performing bladder training exercises.

Medications such as alpha blockers (e.g., tamsulosin) can help relax the muscles of the prostate and bladder neck, while 5-alpha-reductase inhibitors (e.g., finasteride) can shrink the prostate by reducing hormone levels. Combination therapy of both medications may also be used.

For more severe cases, minimally invasive procedures such as transurethral microwave therapy (TUMT) or transurethral needle ablation (TUNA) may be recommended. Surgical options include transurethral resection of the prostate (TURP), laser surgery to remove prostate tissue, or prostatectomy (removal of part or all of the prostate).

Prognosis:

With appropriate treatment, most men with BPH can manage their symptoms and maintain a good quality of life. Early diagnosis and treatment can help prevent complications.

Prevention:

There is no sure way to prevent BPH, but maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding excessive alcohol or caffeine, can help reduce the risk of developing severe symptoms.