Benign Prostatic Hyperplasia or BPH refers to a non malignant enlargement of the prostate gland. The cells inside the prostate gland increases in number leading to an enlarged prostate. As the prostate gland enlarges, it extends upwards towards the bladder hence obstructing the outflow of the urine. Eventually, it may lead to other medical conditions. BHP is more common in men aged 50 years and above, about 50% of them develop BPH. It is more evidenced in older men aged 80 years and above, affecting 80% of the population.
Though the cause of BPH is unknown but there are studies that suggest the level of estradiol hormone may be directly related to the size of the prostate gland among men with high testosterone levels.
BPH Risk Factors
- Race - Benign Prostatic Hyperplasia is more common in African American men and it develop at a younger age than in other races.
- Less likely in men of Asian origin.
- Men with smoking history.
- Heavy alcohol consumption
- Hypertension and heart diseases.
- Diabetes
- Diet
Benign Prostatic Hyperplasia Symptoms
- Increase in urinary frequency and urgency.
- Nocturia (excessive urination at night).
- The urine flow force is decreased.
- A feeling of abdominal straining while urinating.
- A decrease in the amount of urine.
- A delay in initiating urination (hesitancy).
- Decrease in urine volume.
- Urine dribbling (urine still drib out after urinating).
- A feeling that the bladder has not been completely emptied.
Other medical conditions that product similar symptoms like the one listed above are; prostate cancer, neurogenic bladder, urethral stricture and urinary bladder stones.
Benign Prostatic Hyperplasia Possible Complications
- May lead to Acute Urinary Retention if more than 60 ml of urine remains in the bladder.
- Urinary statis result to frequent urinary infections.
- The accumulation of the nitrogenous (waste products that are usually removed by urine) may lead to azotemia.
- Possible renal failure with chronic urine retention.
- Other generalized symptoms like fatigue, nausea and vomiting.
- Hemorrhage (major complication).
Benign Prostatic Hyperplasia Diagnostic
Diagnosis of BPH includes;
- Looking at patient's past medical history and current medical conditions.
- Current symptoms experienced by the patient.
- Family history of the any other medical conditons.
- A thorough physical examination to check whether the prostate is enlarged.
Other test that are performed to diagnose BPH includes;
- Digital Rectal Exam (DRE) - reveals large, rubbery and non tender prostate gland.
- Prostate specific antigen test (PSA test) - Used for measuring the amount of prostate-specific antigen in the blood. The amount of PSA is increased as the prostate enlarges. Men with normal sized prostate gland usually have low amounts of PSA in the blood.
- Urinalysis and urodynamic studies to assess the flow of urine.
- Renal functions test (creatinine test).
- Cytoscopy (visualization of the urinary bladder via the urethra).
- Complete Blood Count to access hemorrhage.
Benign Prostatic Hyperplasia Treatment
The kind of the treatment given depends on;
- The severity of the obstruction by the time the patient seek medical help.
- The cause of Benign Prostatic Hyperplasia (BPH).
- Patient overall health conditions (current and previous medical history).
For example, a patient who is admitted because he cannot void is immediately catheterized. A thin wire called stylet may be inserted by the an urologist to prevent the catheter from collapsing when it gets into contact with resistance.
Pharmocological interventions include use of medications to relax the smooth muscle to improve the urine flow.
Antiandrogen agents may be given to prevent the conversion of testosterone to dihydrotestosterone when hormone is suspected as supporting the growth.
Other treatment options include the TULP (a laser beam is used to make an incision in the prostate to decrease the resistance of urine flow into the bladder and improve the symptoms.
Microwave therapy which involves the application of heat to the prostatic tissue.
Transurethral Neeedle Ablation - Use of low radiation to produce localized heat that destroy the prostate tissue, leaving other parts like urethra intact.
Resection of the prostate gland can also be performed, guided by an ultrasound.
Though BPH is non cancerous, in some cases patients suffering from BPH may also have Prostate cancer or BPH may change to Prostate Cancer later on. High risk men above 40 years should under go regular Prostate examinations tests and recommended for all men above 50 years.
Patients who may have enlarged prostate gland without obstruction problems are periodically monitored to make sure the disease is not progressing and to prevent development of other complications.
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