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About Benign Prostatic Hyperplasia (BPH)
BPH or an enlarged prostate, is a non-cancerous condition where the prostate gland grows larger, potentially causing urinary problems. It’s also called an enlarged prostate. The prostate is a small gland that helps make semen. It’s found just below the bladder. And it often gets bigger as you get older.
An enlarged prostate can cause symptoms that may bother you, such as blocking the flow of urine out of the bladder. It also can cause bladder, urinary tract or kidney problems.
What causes BPH?
The prostate gland naturally grows larger with age, however it isn’t clear what causes the prostate to get bigger. It might be due to changes in the balance of sex hormones as you grow older.
Other, factors that may cause BPH are obesity, metabolic syndrome, diabetes, or high blood pressure and a family history of BPH.
Some medicines may also lead to symptoms that seem like those caused by BPH. Such as strong pain-relieving medications (opioids); cold and allergy medicines; medicines for depression called tricyclic antidepressants.
What are the complications of untreated BPH?
Urinary Retention: Inability to empty the bladder completely, which can lead to a build-up of urine and potentially require a catheter.
Urinary Tract Infections: An enlarged prostate can make it harder to empty the bladder completely, which can increase the risk of urinary tract infections.
Kidney Problems: In severe cases, urinary retention can lead to kidney problems.
How is BPH managed?
Many men have minor symptoms which are of no concern to them, and therefore treatment is not required. However, some whose quality of life is being affected, there are several highly effective treatment options. Treatment options for BPH depend on the severity of symptoms and may include:
Lifestyle Changes: Drinking less fluid before bed, avoiding caffeine and alcohol, and practicing bladder training.
Medications: Medications can help relax the muscles in the prostate and urethra, making it easier to urinate.
Surgical Procedures: In some cases, surgery may be necessary to remove part of the prostate gland. The most commonly performed operation for BPH is a TURP (trans urethral resection of prostate).
What are the symptoms of BPH?
The symptoms of BPH tend to slowly get worse. But sometimes they stay the same or even improve over time. The size of the prostate doesn’t always determine how serious the symptoms are.
Common Symptoms:
- Frequent urination, especially at night
- Difficulty starting urination
- Weak urine stream or a stream that stops and starts
- Incomplete bladder emptying
- Urgency to urinate
- Dribbling at the end of urination
Less Common Symptoms:
- Blood in the urine
- Pee changes colour or smells (urinary tract infection)
- Inability to urinate completely
How is BPH diagnosed?
Review of your symptoms and previous medical/family history.
Physical exam including a prostate exam. The doctor will insert a gloved finger into the rectum to feel the back wall of the prostate checking for enlargement, tenderness, lumps or hard spots. It takes around 10-15 seconds to perform the exam.
Blood tests including prostate specific antigen (PSA) level. If raised may be a sign that something is wrong. When the prostate is healthy very little PSA is detected in the blood.
Urine tests including urinalysis, measuring urine left in the bladder after passing urine, measuring the flow of urine and pressure in the bladder during urination.
Ultrasounds, cystoscopy and MRI tests may be performed to see the size and shape of the prostate.