Chronic Conditions

Benign Prostatic Hyperplasia

The prostate gland surrounds the urethra (the tube that carries urine from the bladder through the penis in males).The walnut size prostate gland produces secretion which nourishes the sperms in the semen. Benign prostatic hyperplasia (BPH) refers to a benign nodule (prostate adenoma) growing in the prostate gland. BPH tends to worsen over time, as the patient ages.

Common symptoms are the result of compression against the urethra, and they include: 

    • Frequent urination, especially at night 

    • Difficulty in starting to urinate (having to wait or strain) 

    • A weak urine stream 

    • Bladder does not feel empty even after urination

However not all patients with the above symptoms have BPH, and about half of all men with BPH may not have symptoms

 

Diagnosis 

 

It is usually diagnosed after a careful review of the patient's medical history, a physical evaluation as well as various blood and urine tests (to verify that the patient does not have any other conditions similar to BPH). Sometimes ultrasound and uroflow (a special test to determine the speed and amount of urination) tests can help to make a diagnosis of BPH.  



 


A wide variety of treatments are available for BPH. They include medications and surgical options. The best treatment choice for you depends on several factors, including how much your symptoms bother you, the size and shape of your prostate, other health conditions you may have, your age and your preference. If your symptoms aren't too severe, and there is no significant blockage of the bladder by the prostate, you may elect not to have treatment and wait to see whether your symptoms become more bothersome over time, or the blockage may become more severe and you may not be able to empty your bladder completely. This result in large amount of urine left in your bladder after urination (residual urine) and may cause infection and harm to your kidneys if left unattended.

Medications include a) those that relax the muscles around the urethra, and b) those that keep the prostate from growing and aid in shrinking it. These two types of medications are sometimes used together.

Surgery may be recommended when medication isn’t effective, and there is ineffective bladder emptying resulting in large amount of residual urine. There are several types of surgical treatment which help to reduce the size of the prostate, and open up the urethra. Transurethral Resection of the Prostate (TURP) is one of the most effective surgical treatments available, and it involves removing pieces of the enlarged prostate gland through the urethra. Your family doctor may refer you to an Urologist to discuss the various options.

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  1. Am I at greater risk of prostate cancer if I have an enlarged prostate due to BPH?

There is no evidence to show that you’re more likely to develop prostate cancer if you have benign prostatic hyperplasia (BPH).

Some of the symptoms of an enlarged prostate can be very similar to those of prostate cancer, so it can be easy to think that the two are linked.

As prostate cancer risk increases with age, your doctor will be able to share with you some ways to screen for it.

  2. Will my symptoms get worse if I don’t have treatment for enlarged prostate?
It’s impossible to say for certain whether your symptoms will get worse without treatment, as everyone’s condition progresses differently. In general, most men’s symptoms get worse slowly over time. Self-help measures, such as reducing caffeine intake and the amount of fluid drunk, and bladder training, may help to improve your symptoms.

If your symptoms aren't too troublesome, and there is no significant blockage to your bladder, you may decide not to have any treatment for now. If you decide not to have treatment, your doctor will ask you to monitor your symptoms and blockage and have a regular review of your condition. This may happen once a year. If your symptoms or blockage get worse, your doctor may suggest starting treatment.
  3. Is there anything I can do to prevent an enlarged prostate?
The exact reasons why some men develop an enlarged prostate aren’t fully understood at present. However, there are two factors that affect your likelihood of developing BPH; your age and the level of hormones in your body.

You may be able to reduce your urinary symptoms by being more physically active. According to some studies, a physically active person may be less likely to develop urinary symptoms. Being physically active is ultimately an important part of a healthy lifestyle and can help to reduce your risk of numerous other conditions, such as heart disease, stroke and cancer. Hence, it's always worth trying to keep active.