What is Benign Prostatic Hyperplasia?
When the prostate and surrounding tissues enlarge, it is known as benign prostatic hyperplasia (BPH). BPH is harmless, which indicates that neither it is cancer nor does it cause cancer. However, BPH and cancer can occur simultaneously, the first happening when the prostate doubles in size during early adolescence. As a man ages, the prostate has two major growth phases. The prostate increases in size during the first stage of puberty, and the second starts at 25 and lasts most of a man's lifetime.
As the prostate gland grows it squeezes the urethra. A thickening of the bladder wall occurs. The bladder may weaken and lose its capacity to empty urine with time. The bladder still has urine in it. It causes various lower urinary tract symptoms (LUTS) of BPH. If you suffer renal failure or cannot pass urine (a condition known as retention), you need to get medical help.
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Symptoms
Several signs of benign prostatic hyperplasia can interfere with urine flow. It is possible to experience multiple symptoms simultaneously. Some of the typical symptoms include:
If your condition worsens with time. You might experience:
- Development of bladder stone
- Bladder infection
- Damage to kidneys because of backpressure caused due to the retention of large amounts of urine in the bladder
- Blood in urine
- Pus in urine
- Experiencing pain in the lower part of the abdomen or genitals during urination
- Inability to urinate
- Chills or fever while urinating
BPH can lead to infection and bladder damage in extreme situations, and blood can be seen in the pee in certain conditions. If neglected for an extended period, it can harm the kidneys, resulting in chronic kidney disease and renal failure.
When to visit a doctor?
Talk to the doctor about your urinary problems even if you don't find urine symptoms troublesome. Urinary tract blockage might result from untreated urinary issues. Seek emergency medical help if you are unable to urinate at all.
Causes
Doctors do not know precisely why BPH happens. It is hypothesized that a significant cause of BPH is the hormone testosterone, which is produced by the testicles. In addition to a small amount of estrogen, men continuously have testosterone, the primary hormone. The body's ability to make testosterone declines with age. As a result, the level of estrogen in the body rises. This imbalance between estrogen and testosterone has been linked in studies to benign prostatic hyperplasia. The prostate's high estrogen level activates prostate hormones that promote prostate cell development.
Dihydrotestosterone (DHT), a hormone byproduct of testosterone, is also thought by experts to be extremely important for the development of the prostate gland. According to research, older people still produce DHT, which builds up in the prostate despite declining testosterone levels, and this rise in DHT may promote prostate cell development.
Risk factors
Benign Prostatic Hyperplasia risk factors include:
- Age :
BPH is most commonly seen in men over 50.
- Family history :
A man's risk of developing BPH increases if a close relative has the condition.
- Hormonal imbalances :
Testosterone and dihydrotestosterone levels play a role in the development of BPH.
- Obesity :
Obesity : Men who are overweight or obese have a higher risk of developing BPH.
- Lifestyle factors :
A sedentary lifestyle and a high-fat diet & low in fiber have been linked to an increased risk of BPH.
- Medical conditions :
Chronic conditions like heart disease and diabetes may increase the risk of BPH.
- Certain medications :
Long-term use of medicines like alpha-blockers and 5-alpha reductase inhibitors may increase the risk of BPH.
- Smoking :
It has been linked to an increased risk of BPH and may worsen symptoms.
- Alcohol consumption :
Heavy alcohol consumption has been associated with an increased risk of BPH.
Complications
Complications of an enlarged prostate can include:
- Sudden inability to urinate (urinary retention) :
To empty the urine from your bladder, patients might need to have a catheter placed. Surgery is required in some men with an enlarged prostate to treat urinary retention.
- Urinary tract infections (UTIs) :
Urinary tract infections (UTIs): The chance of developing a urinary tract infection may rise if you cannot fully empty the bladder. Patients may require surgery to remove a portion of the prostate if UTIs happen regularly.
- Bladder stones :
Bladder stones : These are caused by an inability to empty the bladder. Infection, bladder irritation, blood in the urine, and restriction of urine flow are all various consequences of bladder stones.
- Bladder damage :
A partly empty bladder can stretch and get weaker over time. It's more difficult to empty your bladder as a result of the muscular wall of the bladder failing to relax correctly.
- Kidney damage :
- Urinary retention can cause pressure in the bladder that can harm the kidneys directly or allow bladder infections to spread to the kidneys.
- The majority of men with enlarged prostates do not experience these issues. Acute urine retention and renal damage can pose real health risks.
Prevention
There is no known way to prevent Benign Prostatic Hyperplasia (BPH); however, the following lifestyle changes may help reduce the risk or slow down the progression of the condition:
- Maintaining a healthy diet and weight
- Regular exercise
- Limiting alcohol and caffeine consumption
- Avoiding prescription medications that can worsen BPH symptoms, such as decongestants and antihistamines
- Managing stress through relaxation techniques or counseling.
It is always best to consult a healthcare professional for personalized recommendations and treatment options.
Diagnosis
To rule out conditions that mimic the symptoms of benign prostate hyperplasia, your doctor will take into account your symptoms and perform some tests.
- Digital rectal exam :
This examination gives an idea that the prostate has an average size or is more enlarged than usual.
- Cystoscopy :
This technique enables a medical professional to look at the lining of your urethral tube and bladder. This procedure is used to examine and treat problems in the bladder or urethra.
- Intravenous pyelogram (IVP) :
A form of x-ray called an intravenous pyelogram (IVP) captures images of the urinary system. IVP is less frequently utilized nowadays since there are better alternatives available.
- Urine tests :
Urine testing may be recommended by your doctor. By doing so, they can rule out urine infections or other urinary disorders that have similar symptoms.
- Prostate-specific antigen (PSA) test :
The substance your prostate secretes is known as a prostate-specific antigen. Although it performs better in detecting prostate cancer it is not 100% accurate. A recent operation, surgery, or illness can increase PSA levels.
- Urinary flow test :
This examination measures urine flow. You'll be asked to relieve yourself into a receptacle connected to a machine. This device will assess the volume and force of your urine flow and evaluate if your condition improves or worsens over time.
- Postvoid residual volume :
This test determines if you can urinate while completely emptying your bladder. Once you've finished peeing, a catheter can be inserted into your bladder to do the test through ultrasonography. This will make it possible to measure how much pee is still in your bladder.
- Prostate biopsy :
A prostate biopsy is recommended after other diagnostic tests indicate prostate gland problem. It is used to diagnose prostate cancer.
- Urodynamic and pressure flow studies :
This examination is done to measure and evaluate the efficiency of the bladder muscles.
Treatment
The severity of the symptoms often determines the type of treatment. Sometimes no treatment may be needed. Doctors could elect to monitor the prostate if the patient has minimal or no symptoms. A yearly prostate exam and an assessment of symptoms may be part of this monitoring. Various therapies are offered if necessary.
Medication
Medications that treat BPH include:
- Alpha-blockers: It increase urine flow by unwinding the urethral and bladder neck muscles. Dizziness and low blood pressure are possible side effects.
- 5-alpha reductase inhibitors: These can shrink the prostate and lessen urological symptoms. According to the study, they may also lower the risk of prostate cancer by roughly 25%. A doctor may occasionally recommend a medicine combination.
Minimally invasive surgery
Surgery may be possible if the medicine is ineffective. Frequently, this will include a minimally invasive technique, like
- A prostatic urethral lift: The surgeon inserts implants that elevate the prostate so that it does not obstruct the urethra using a needle.
- Convective water vapor ablation: During this procedure, unwanted prostate tissue is eliminated using steam. A surgeon inserts a needle into the prostate to provide heat energy from the steam.
- Transurethral microwave therapy (TUMT): Through the urethra, the physician inserts a catheter equipped with an antenna. The unwanted tissue is eliminated by the microwaves the antenna emits.
- Catheterization: A tube that allows urine to pass through the bladder will be placed by a doctor. Bladder drainage is made possible through catheterization.Although these therapies often increase urine flow, subsequent therapy may be required. Taking medication may help reduce the risk of BPH reoccurring.
Surgery
Surgery may be required to remove any tissue obstructing blood flow in a patient with severe symptoms. There are several types of surgery, some of which are more invasive than others.
Do’s and Don’ts
BPH is benign prostatic hyperplasia, a condition that eventually affects most men. 90% of men with BPH symptoms around age 70 and more than 50% of men in their 60s experience problems. As you age, your prostate gland begins to enlarge. Because your prostate gland is located directly where your bladder empties, the amount of pee you pass decreases as your prostate grows larger. About 25% of BPH-afflicted males require medical attention. Here are some do's & don'ts for managing BPH:
| Do’s | Don’ts |
| Maintain a healthy diet that is low in fat and high in fiber. | Avoid consuming alcohol, caffeine, and spicy foods. |
| Stay physically active and engage in regular exercise. | Engage in activities that put pressure on the bladder, such as heavy lifting |
| Stay hydrated and consume plenty of water to help flush out any urinary tract blockages. | Self-medicate without consulting with a healthcare provider. |
| Practice good hygiene habits to prevent infection. | Engage in activities that irritate the prostate, such as cycling for extended periods. |
| Follow medications and treatments prescribed by the healthcare provider. | Avoid going to the bathroom when you feel the urge to urinate. |
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Barrett's Esophagus Care at Medicover
At Medicover hospitals, we have the best team of Urologists who provide Benign Prostatic Hyperplasia treatment with utmost precision. Our highly skilled healthcare team utilizes the latest medical approach, diagnostic procedures, and technologies to treat various conditions and ailments. For treating Urethritis, we adopt a multi-disciplinary approach, provide comprehensive care to the patients, and attend to all their medical needs for faster and sustained recovery.
References
https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)
