Benign prostatic hyperplasia (BPH) affects many men in Anguilla. In fact it has been estimated, worldwide, that more than half of men over age 60 have this condition. Some men have symptoms and others do not. The exact causes are unknown, but one thing is sure: BPH is not cancer and it does not lead to cancer.
Who gets BPH?
The vast majority of men will have an enlarged prostate over the age of 60 but, fortunately, most of them do not have any symptoms. It is estimated that only a third of men with BPH have symptoms. It is also unclear why some men with BPH will have symptoms while others do not.
The prostate gland grows throughout most of a man’s life, first at puberty and then from about age 25 on. It usually does not cause symptoms before the age of 40.
Symptoms of BPH
Many men with benign prostatic hyperplasia (BPH) have no symptoms. When symptoms occur they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement is not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms and some men with a great deal of enlargement have few symptoms. Symptoms include the following:
• Difficulty starting a urine stream (hesitancy and straining).
• Decreased strength of the urine stream (weak flow).
• Dribbling after urination.
• Feeling that the bladder is not completely empty.
• An urge to urinate again soon after urinating.
• Pain during urination (dysuria).
• Waking at night to urinate (nocturia).
• Frequent urination.
• A sudden, uncontrollable urge to urinate.
These symptoms are not always related to prostate enlargement and can be caused by other conditions. Other conditions that may cause similar symptoms include urinary tract infections, prostatitis, prostate cancer, diabetes, heart failure and neurologic diseases.
Diagnosis
If you have symptoms suggestive of BPH you should see your trusted and confidential physician. After a careful history, physical examination is done to include a digital rectal exam to check for prostate enlargement or irregularities. Most men are reluctant to have this exam but it is extremely necessary. Various other tests and examinations will be arranged to confirm the diagnosis.
Ruling out prostate cancer
Symptoms of BPH can be scary because some of them are the same as those for prostate cancer. BPH (an enlarged prostate) is much more common than prostate cancer. If you have BPH, you are no more likely than other men to develop prostate cancer. As the two conditions share some symptoms, and can occur at the same time your doctor will need to evaluate you to rule out prostate cancer.
Treatment
Once prostate cancer and other disorders with similar presentation are ruled out a decision will be made on the best treatment plan. Whether you need to treat BPH depends on your symptoms. If your symptoms are not severe, you probably would not need treatment, but will need to have regular medical check-ups. Up to a third of all mild cases of BPH have symptoms that clear up on their own.
Difficulty urinating, recurring infections, kidney damage, or a leaky bladder can really impact your quality of life and, in these cases, medications or sometimes surgery will help.
If you have bothersome symptoms you should know that there are many options for treating them to help you maintain a high quality of life. The most important thing is to see your doctor as soon as you notice symptoms.
Various lifestyle changes can also help to improve the symptoms of BPH. These include the following:
• Decrease your alcohol consumption.
• Cut down on caffeine.
• Exercise regularly.
• Avoid fluids at bedtime.
• Avoid decongestants and antihistamines.
• Double void: empty your bladder, wait a moment, then try to empty it again.
• Relax. Stress can trigger the urge to urinate.
Will BPH affect my sex life?
There is some evidence that older men with severe BPH symptoms may be more likely to have problems in their sex life. Some of the medications commonly used to treat BPH have been associated with problems getting an erection and ejaculating. If you develop sexual issues, discuss this with your doctor. Very often a change in medications may be enough to correct the problem.
Complications of BPH
Many men have BPH and do not have any symptoms and live to a ripe old age. In some men with BPH complications do occur and these men require urgent treatment. Complications of BPH include the following:
• Ongoing inability to urinate
• urinary tract infections
• bladder stones
• kidney damage
• Ongoing blood in your urine.
Conclusion
Benign prostatic hyperplasia (BPH), or more commonly called enlarged prostate, occurs in many men over the age of 60. Fortunately, it is not a cancer and does not cause cancer of the prostate. Symptoms of this disorder resemble the symptoms of prostate cancer, so in all cases prostate cancer must be ruled out. BPH cannot be cured, so treatment focuses on reducing symptoms if they are bothersome or if there are complications. If you have symptoms of BPH see your doctor for a full evaluation.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge, MB BS DGO MRCOG is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
