Benign prostatic hyperplasia (BPH), also called prostate gland enlargement, is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.
Benign prostatic hyperplasia and prostate cancer are two completely different diseases. BPH never turns into prostate cancer even when untreated. However, the person may have both benign prostate enlargement and prostate cancer at the same time. Because these two diseases are age-related diseases.
Signs and Symptoms
When the prostate enlarges, it may constrict the flow of urine. Nerves within the prostate and bladder may also play a role in causing the following common symptoms:
- Urinary frequency
- Urinary urgency
- Needing to get up frequently at night to urinate (Nocturia)
- Hesitancy – Difficulty initiating the urinary stream; interrupted, weak stream
- Incomplete bladder emptying – The feeling of persistent residual urine, regardless of the frequency of urination
- Straining – The need strain or push (Valsalva maneuver) to initiate and maintain urination in order to more fully empty the bladder
- Decreased force of stream – The subjective loss of force of the urinary stream over time
- Dribbling – The loss of small amounts of urine due to a poor urinary stream as well as weak urinary stream.
Diagnosis
Digital rectal examination
Urinalysis
Urine culture
Prostate-specific antigen (PSA)
Electrolytes, blood urea nitrogen (BUN), and creatinine
Ultrasonography
Endoscopy of the lower urinary tract
IPSS/AUA-SI
Treatments
There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. It is necessary to consider your complaints, size of your prostate, other health conditions and preferences of you to determine the most appropriate treatment option.
Pharmacologic treatment
Agents used in the treatment of BPH include the following:
- Alpha-adrenergic receptor blockers
- 5-alpha reductase inhibitors
- Phosphodiesterase-5 enzyme inhibitors
- Anticholinergic agents
Surgery
- Transurethral resection of the prostate (TURP)
- Open prostatectomy
Minimally invasive treatment
- Transurethral incision of the prostate (TUIP)
- Laser treatment
- Transurethral microwave therapy (TUMT)
- Transurethral needle ablation of the prostate (TUNA)
- High-intensity ultrasonographic energy therapy
- Prostatic stents
- Laparoscopic prostatectomy
- Robotic prostatectomy
