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BPH (Benign Prostatic Hyperplasia)

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Dr. Lawrence Jenkins

Benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, is a prevalent condition in aging men. Approximately half of men aged 51 to 60 and up to 90 percent of men over 80 experience BPH. While BPH itself may not necessitate treatment, addressing symptoms can be beneficial. It is essential to note that BPH is non-cancerous and does not lead to cancer, although they can coexist. If you are experiencing symptoms, consulting with your doctor can provide insights into relief options.

Understanding BPH:

While the normal size of the prostate in adult men is akin to 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.

While the normal size of the prostate in adult men is akin to 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 men age 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 BPH
  • Overweight or obese men
  • Inactive individuals
  • Some men with erectile dysfunction (ED)

Symptoms of BPH:

When the prostate enlarges, it can affect or obstruct the bladder, leading to symptoms such as:

  • Feeling a full bladder, even after urination
  • Frequent urination, occurring every one to two hours
  • Starting and stopping during urination
  • Urgent need to urinate
  • Weak urine flow
  • Difficulty initiating urination or the need to strain
  • Waking up more than twice at night to urinate

Diagnosis of BPH:

Various tests are employed for BPH diagnosis, including:

  • Symptom Score Index: Assessing urinary symptoms from mild to severe.
  • Digital Rectal Exam: Examination of the prostate for enlargement, tenderness, lumps, or hard spots.
  • Urine tests: Measuring urine release to detect possible blockages.
  • Scans: Imaging tests (ultrasound, MRI, CT, or cystoscopy) revealing the size and shape of the prostate.
  • Blood test: Prostate-specific antigen (PSA) test gauging PSA levels, a protein produced exclusively by the prostate.

Treatment Options for BPH:

  • Active Surveillance: Monitoring without active treatment with regular visits to a urologist.
  • Prescription drugs
  • Less invasive or minimally invasive surgical treatments, often performed on an outpatient basis.
  • In severe cases or when other options fail, more invasive surgery may be recommended.

Preventing Recurrence 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.

Preventive Measures for 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 active also aids in weight management and hormone regulation.

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