Benign prostatic hypertrophy (BPH) is a condition in which the prostate gland becomes much enlarged and may cause problems associated with urination. BPH can raise PSA (prostate-specific antigen) levels two to three times higher than the normal level. An increased PSA level does not indicate cancer, but the higher the PSA level, the higher the chance of having cancer.
Some of the signs of benign prostatic hypertrophy and prostate cancer are the same however, having BPH does not seem to increase the chances of developing prostate cancer. A man who has benign prostatic hypertrophy may also have undetected prostate cancer at the same time or may develop prostate cancer in the future.
How does benign prostatic hypertrophy develop?
The prostate goes through two main periods of growth. In early puberty, the prostate doubles in size. Then, around age 25, the prostate begins to grow again and continues to grow throughout most of a man's life.
The continuing enlargement of the prostate does not usually cause problems until later in life. However, the second period of growth may, many years later, result in benign prostatic hypertrophy.
What are the symptoms of benign prostatic hypertrophy?
The following are the most common symptoms of benign prostatic hyperplasia. However, each individual may experience symptoms differently. Symptoms may include:
- Leaking or dribbling of urine
- More frequent urination, especially at night
- Urgency to urinate
- Urine retention (inability to urinate)
- A hesitant, interrupted, weak stream of urine
These problems may lead to
incontinence,
kidney damage, bladder damage, urinary tract infection, bladder stones or inability to pass urine at all.
The symptoms of benign prostatic hyperplasia may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
How is benign prostatic hyperplasia diagnosed?
Diagnosing benign prostatic hyperplasia in its earlier stages can lower the risk of developing complications. Delay can cause permanent bladder damage for which benign prostatic hyperplasia treatment may be ineffective. In addition to a complete medical history and physical examination, diagnostic procedures for benign prostatic hyperplasia may include the following:
- Digital rectal exam: A procedure in which the doctor inserts a gloved finger into the rectum to examine the rectum and the prostate gland for signs of cancer.
- Intravenous pyelogram: A series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein to detect tumours, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.
- Cystoscopy: An examination in which a scope-a flexible tube and viewing device-is inserted through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumours or stones.
- Urine flow study: A test in which the patient urinates into a special device that measures how quickly the urine is flowing. A reduced flow may suggest benign prostatic hyperplasia.
What are the treatment options for benign prostatic hyperplasia?
Specific
treatment for benign prostatic hyperplasia will be determined by your doctor on the basis of your age, overall health, and medical history extent of the disease your tolerance for specific medications, procedures, or therapies expectations for the course of the disease and your opinion. Medication is the most common treatment for mild to moderate symptoms of
prostate enlargement. The options include:
- Alpha blockers: These medications relax bladder neck muscles and muscle fibres in the prostate, making urination easier.
- 5-alpha reductase inhibitors: These medications shrink your prostate by preventing hormonal changes that cause prostate growth.
- Combination drug therapy: Your doctor might recommend taking an alpha blocker and a 5-alpha reductase inhibitor at the same time if either medication alone isn't effective.
- Tadalafil (Cialis): Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement. However, this medication is not routinely used for benign prostatic hyperplasia and is generally prescribed only to men who also experience erectile dysfunction.
Minimally invasive or surgical therapy might be recommended if:
- Your symptoms are moderate to severe
- Medication hasn't relieved your symptoms
- You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems
- You prefer definitive treatment