Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) refers to an enlarged prostate. While the prostate in adult men is typically the size of a walnut or golf ball, it can grow larger, even exceeding the size of an orange. This enlargement may exert pressure on the urethra, the tube responsible for urine passage. Immediate medical attention is required if there is a complete inability to urinate or if kidney failure is a concern. However, symptoms like a weak urine stream or the need to strain during urination can often be monitored.

The causes of BPH are not entirely clear, but hormonal changes, as well as heredity, are believed to play a role.

Risk Factors for BPH: 

• Men over 50, as the risk increases with age.
• Men with a family history of benign prostatic hyperplasia.
• Overweight or obese men.
• Some men with erectile dysfunction (ED).

Symptoms of BPH:

• Experiencing the sensation of a full bladder, even after urination.
• Urinating frequently, typically every 1 to 2 hours.
• Feeling an urgent need to urinate.
• Having an interrupted or inconsistent urine flow.
• Struggling to initiate urination or needing to strain.
• Waking up more than twice at night to urinate.

Diagnosis of BPH:

• Symptom Score Index, which evaluates urinary symptoms from mild to severe.
• Digital rectal exam, in which the prostate is assessed for enlargement, tenderness, lumps, or hard spots.
• Urine tests, which measure urine flow to detect possible blockages.
• Imaging scans, including ultrasound, MRI, CT, or cystoscopy, which reveal the prostate’s size and shape.
• Blood test, which measures prostate-specific antigen (PSA) levels, a protein produced exclusively by the prostate.

Treatment options for BPH:

• Active surveillance involves monitoring the condition without active treatment, requiring regular visits to a urologist.
• Prescription drugs may be used to manage symptoms and reduce prostate enlargement.
• Less invasive or minimally invasive surgical treatments are available and are often performed on an outpatient basis.
• More invasive surgery may be recommended in severe cases or when other treatment options fail.
• The gold standard for management of BPH is the newer bipolar transurethral resection of the prostate, which offers improved outcomes.

Preventing Reoccurance of BPH:

After surgical treatment, medication may be necessary to manage residual or new symptoms. Some men may require repeated treatment. In older men, symptom control may be possible until the end of life.

Preventative Measures of BPH:

There is no guaranteed prevention for BPH. However, maintaining a healthy weight and adopting a balanced diet rich in fruits and vegetables may be beneficial. Excessive body fat could elevate hormone levels, stimulating prostate cell growth. Staying physically active also aids in weight management and hormone regulation, which may reduce the risk of prostate enlargement.