Benign prostate enlargement, also referred to as benign prostatic hyperplasia (BPH), is a common disorder that affects men over the age of fifty. It can cause discomfort in passing urine as well as cause bladder, urinary tract or kidney problems.
What is the prostate gland?
The prostate is a small gland located between the bladder and the penis. The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it is expelled with sperm as semen. If the prostate becomes enlarged, it can place pressure on the bladder and urethra, the tube through which urine passes.
Many men worry that having an enlarged prostate means they have an increased risk of developing prostate cancer. This is not the case.
The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate.
What causes benign prostate enlargement?
It is not entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.
Some risk factors for prostate gland enlargement include:
Age. About one-third of men experience moderate to severe symptoms by age 60, and about half do so by age 80.
Family history. Having a blood relative, such as a father or a brother, with prostate problems means you are more likely to have problems.
Diabetes and heart disease. Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.
Lifestyle. Obesity increases the risk of BPH, while exercise can lower the risk.
What are some symptoms of BPH?
The size of your prostate does not necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.
Common signs and symptoms of BPH include:
• Frequent or urgent need to urinate
• Increased frequency of urination at night (nocturia)
• Difficulty starting urination
• Weak urine stream or a stream that stops and starts
• Dribbling at the end of urination
• Inability to completely empty the bladder
Less common signs and symptoms include:
• Urinary tract infection
• Inability to urinate
• Blood in the urine
Making the diagnosis
During a regular medical check-up, or if you are seeing your doctor for symptoms suggestive of prostate enlargement, the diagnosis might be made. Your doctor would first take a detail history and carry out a complete physical examination. This examination would include a digital rectal examination. Most men hate this simple procedure, but it is very important in making the diagnosis. Your doctor will also arrange for several tests to include a Prostate-specific antigen (PSA) blood test. PSA is a substance produced in your prostate. PSA levels increase when you have an enlarged prostate. However, elevated PSA levels can also be due to recent procedures, infection, surgery or prostate cancer.
After that, your doctor might recommend additional tests to help confirm an enlarged prostate and to rule out other conditions.
Treating benign prostate enlargement
Treatment for an enlarged prostate will depend on the severity of the symptoms.
If you have mild symptoms, you do not usually need immediate treatment, but you will have regular prostate check-ups.
You will also be advised to make lifestyle changes, such as:
• drinking less alcohol, caffeine and fizzy drinks
• limiting the intake of artificial sweeteners
• exercising regularly
• drinking less in the evening
Medicine to reduce the size of the prostate, and relax your bladder, may be recommended to treat moderate to severe symptoms of an enlarged prostate.
Surgery is usually only recommended for moderate to severe symptoms that have failed to respond to various medical therapies.
What are some complications of untreated BPH?
Benign prostate enlargement can sometimes lead to complications such as:
• a urinary tract infection
• an acute urinary retention
Acute urinary retention (AUR) is the sudden inability to pass any urine.
Symptoms of AUR include:
• suddenly not being able to pee at all
• severe lower abdominal pain
• swelling of the bladder that you can feel with your hands
If you have these symptoms you should go to hospital for urgent treatment.
Conclusion
Benign enlargement of the prostate, also called benign prostatic hyperplasia (BPH), is common in men older than 50 years. When benign enlargement occurs, it causes the prostate gland to swell, which squeezes the urethra and limits the flow of urine. BPH is not the same as prostate cancer and does not increase the risk of cancer. However, it can cause symptoms that can affect your quality of life. Various treatment options are available for those with moderate to severe symptoms.
Ask Your Dr 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 with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
