Men can experience many health conditions throughout their lives, and one of them is benign prostatic hyperplasia (BPH), a common condition in men as they age. While not cancerous, it can significantly impact quality of life. Therefore, understanding its symptoms, treatment options, and preventative measures is key to effective management, and in this article, we'll delve into everything you need to know to cope with it.
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What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, is a non-cancerous enlargement of the prostate gland. It occurs when prostate cells multiply excessively, which can compress the urethra and make urination difficult.
Degrees
The severity of BPH is primarily classified according to prostate volume, which is measured using ultrasound. A normal adult prostate has a volume of approximately 20-30 grams.
Grade I or mild
The prostate volume is 30 to 50 grams. At this stage, symptoms are usually mild or even imperceptible.
Grade II or moderate
The volume is between 50 and 80 grams. It is common for urinary symptoms to become more noticeable and affect daily life.
Grade III or severe
The volume ranges from 80 to 150 grams. The symptoms are significant, and there is an increased risk of complications, such as urinary retention.
Grade IV or very severe
The volume exceeds 150 grams. The prostate has grown considerably beyond its anatomical limits, causing severe obstruction and almost always requiring surgical intervention.
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Causes and risk factors
The exact cause of BPH is not fully understood, but it is linked to hormonal changes that occur with aging, which is why age is the primary risk factor. BPH is rare in men under 40, but more than half of men in their 60s and up to 90% in their 70s and 80s have some degree of it. Family history is also key; having a relative with BPH increases the risk. Changes in sex hormone levels, specifically an increase in dihydrotestosterone (DHT), are also believed to play a significant role. Obesity, lack of exercise, a generally sedentary lifestyle, and a high-fat diet can also increase the risk.
Symptom
The symptoms of benign prostatic hyperplasia (BPH) result from urethral obstruction and the bladder's effort to compensate. They are divided into two categories: obstructive voiding symptoms and irritative storage symptoms. The most common obstructive symptoms include difficulty starting urination, a weak or interrupted urine stream, dribbling after urination, a feeling of incomplete bladder emptying, and straining to urinate. Irritative symptoms, on the other hand, include increased urinary frequency, especially at night, a sudden and urgent need to urinate, and urge urinary incontinence.
How can you tell if benign prostatic hyperplasia (BPH) is benign or malignant?
It is crucial to understand that prostatic hyperplasia is not prostate cancer and it does not become cancerous. However, both conditions can coexist, as they are distinct diseases. The only way to definitively differentiate between benign and malignant growth is through a medical evaluation, which may include a digital rectal exam that allows the urologist to feel the size, shape, and consistency of the prostate. A PSA test will also be performed, as elevated levels can suggest BPH, prostatitis, or cancer, although further investigation is needed to determine the cause. Therefore, a prostate biopsy, the definitive procedure for diagnosing cancer, may also be performed.
Medical evaluation and diagnosis
Medical history and symptom questionnaire (IPSS)
The doctor will ask detailed questions and may use the International Prostate Symptom Score (IPSS), a standardized questionnaire to assess the severity of symptoms and their impact on quality of life.
Physical examination, rectal examination
This examination is essential to assess the size and consistency of the prostate.
Blood (PSA) and urine tests
The PSA test helps rule out cancer and assess prostate size. A urine test rules out infections.
Additional tests
Some additional tests that are performed include uroflowmetry, which measures the force and volume of the urinary stream, and prostate or abdominal ultrasound, which allows for precise measurement of prostate size and detection of post-void residual urine.
What are the treatments for benign prostatic hyperplasia?
The choice of treatment depends on the severity of the symptoms, the size of the prostate, the patient's age, and their overall health.
Medical treatments
These are used when symptoms are mild to moderate, and there are two main types. Alpha blockers relax the muscles of the bladder neck and prostate, facilitating urine flow, and 5-alpha reductase inhibitors reduce the size of the prostate by blocking the hormone that causes it to grow.
surgical treatments
These treatments are reserved for severe symptoms or when complications arise. The best treatment is transurethral resection of the prostate (TURP), in which an instrument is inserted through the urethra to remove the prostate tissue causing the obstruction. Another option is simple prostatectomy, which is open surgery to remove the central part of the prostate and is used for enlarged prostates.
Minimally invasive treatments
These treatments offer a faster recovery and fewer side effects than traditional surgery. They include radiofrequency ablation, which uses thermal energy, steam, or pressurized water to remove excess tissue, and laser ablation, which vaporizes or enucleates prostate tissue with high precision and a lower risk of bleeding.
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What are the complications of BPH?
General risks
Hyperplasia has some associated risks, the most likely being acute urinary retention, a sudden and painful inability to urinate requiring emergency catheterization. Other risks include recurrent urinary tract infections, bladder stones, and damage to the bladder or kidneys from constant straining and incomplete emptying.
Benign prostatic hyperplasia and sexuality
BPH and some of its treatments can affect sexual function. Alpha-blockers can cause retrograde ejaculation. In addition, 5-alpha reductase inhibitors can decrease libido and cause erectile dysfunction in some men.
Benign prostatic hyperplasia and ejaculation
The most common sexual complication is retrograde ejaculation, where semen flows into the bladder instead of being ejaculated. This is harmless, but it can cause infertility and a dry feeling after ejaculation. It is a frequent side effect of surgery and some medications.
Prevention and care for prostate health
Maintain a healthy weight and exercise
Obesity is a risk factor. Regular exercise helps maintain a healthy weight and can improve prostate health.
Eat a balanced diet
Rich in fruits, vegetables, and whole grains. Reduce consumption of red meat, saturated fats, and sugars.
Regular urological check-ups
It is essential, especially from the age of 50, or from 40 or 45 if there is a family history, to have annual check-ups that include a digital rectal exam and PSA test.
Avoid excessive fluid intake before bed and limit alcohol and caffeine.
These substances can irritate the bladder and worsen symptoms, especially nocturia or getting up at night to urinate.
Frequently Asked Questions (FAQs)
When should surgery be performed for benign prostatic hyperplasia?
Surgery is considered when symptoms are severe and do not improve with medication, when there is repeated urinary retention, frequent infections, bladder stones, bleeding, or when there is kidney damage.
How long does benign prostatic hyperplasia last?
BPH is a chronic and progressive condition. It does not go away on its own, but its symptoms can be effectively managed with lifelong treatment.
How dangerous is benign prostatic hyperplasia?
It is not a fatal disease in itself. However, if left untreated, it can lead to serious and painful complications that significantly affect quality of life and kidney health.
Can benign prostatic hyperplasia turn into cancer?
No. BPH and prostate cancer are separate diseases that occur in different areas of the prostate. Having BPH does not increase the risk of developing cancer, but it is possible to have both conditions at the same time.
What is the life expectancy of a man with BPH?
BPH does not affect life expectancy. With proper diagnosis and management, men with BPH can lead long and fulfilling lives.
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Conclusion
Benign prostatic hyperplasia (BPH) is a common part of male aging. While it can cause bothersome symptoms and complications, there are multiple treatment options, ranging from lifestyle changes and medications to minimally invasive procedures and surgery. The key is not to normalize the symptoms and to see a urologist without fear for an accurate diagnosis and a personalized management plan, allowing you to maintain an optimal quality of life for many years.
En Doctor T Clinics We do not directly treat this type of pathologies, but if you are noticing chronic fatigue, lack of motivation, problems sleeping, or low libido, it is possible that the origin is a hormonal imbalance, such as a testosterone low.
We offer you tools to detect it early and, if necessary, initiate specialized medical treatment:
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If you are looking for answers and a professional team that will listen to you, Doctor T Clinic is the right place. Schedule your appointment and start your recovery now!
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