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What is BPH?

BPH—or benign prostatic hyperplasia, refers to the non-cancerous enlargement of the prostate and its surrounding tissue, which may be mistaken for a more serious disorder. BPH is commonly diagnosed by experts like Best urologist in Islamabad in old age, as the prostate enlarges under hormone influence. Read on to know more about BPH, its diagnosis and treatment:

What is BPH?

When the prostate and its surrounding tissue expands under the influence of testosterone, this non-cancerous or benign growth is called benign prostatic hyperplasia. Normally, the prostate expands twice in the lifetime of a man: around puberty and mid-life. Thereafter, the prostate continues to grow, but when the prostate becomes too big, there are problematic symptoms.

The normal function of prostate is in the reproductive health of a man. Prostate, along with seminal glands make up semen, and is situated just below the bladder. The urethra passes from the bladder, through the prostate and out through the penis. This anatomical location explains the urogenital symptoms that occur in benign prostatic hyperplasia.

What are the symptoms of BPH?

As mentioned before, urethra from the bladder passes through the prostate. This means that an enlarged prostate can press on it, and cause obstruction to urinary outflow. Consequently, the symptoms seen are:

  • Increased frequency of urination
  • Feeling of incomplete voiding even after passing urine
  • Increased frequency of nocturnal voiding with patient waking up more than twice at night to void
  • Increased urgency as the prostate irritates the bladder wall
  • Weak stream of urine as the prostate presses into the bladder
  • Trouble starting the stream of urine
  • Interrupted stream when passing urine and dribbling at the end of urination
  • Less commonly, there is increased frequency of urinary tract infections (UTIs) and even blood in the urine.
  • In severe cases, as the prostate presses into the bladder, there is inability to urinate. This can impact the kidneys and needs urgent treatment.

What are the risk factors of benign prostatic hyperplasia?

The risk factors associated with BPH include:

  • Aging: in men, prostate enlarges throughout life, but the signs and symptoms arise when it grows beyond a certain size and presses on the urethra. This growth is maximum after the age of 40 years. By the age of 60 years, about 30 percent of men experience the symptoms of BPH and this percentage rises to 50 percent by the age of 80 years.
  • Positive family history: like any other disorder, the incidence is higher with positive family history. In men with blood relative like father, brother or first cousin with prostatic problems means higher chances of having BPH, as well.
  • Obesity: the risk of BPH is higher in obese men. This risk mitigates in men who exercise and have a healthy lifestyle.
  • Metabolic disorders: diabetics and men with heart disease are more likely to suffer from BPH.

How is BPH diagnosed?

The diagnosis of BPH is based on the physical examination of the patient, combined with certain investigations like:

  • Urinalysis
  • Urodynamic pressure flow studies
  • Ultrasound of the pelvis with post-void residual volume
  • Uroflowmetry
  • Cystoscopy
  • MRI
  • PSA
  • 24-hour voiding diary
  • Prostatic biopsy
  • Transrectal ultrasound

How is BPH treated?

The treatment of BPH is based on the age, overall health and the severity of symptoms. For mild to moderate illness, medication alone is used for management. The commonly prescribed drugs include: alpha blockers, 5-alpha reductase inhibitors, and combination therapy like finasteride with doxazosin.

When mediation is insufficient to provide relief, minimally invasive surgery is used for management. Surgical options as preferred by urologists include: transurethral resection of prostate (TURP), transurethral microwave thermotherapy (TUMT), transurethral incision of the prostate (TUIP) and laser therapy—with ablative or enucleation procedures. More information is available at Metropolis Health Hospital.

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