What is Benign Prostatic Hypertrophy?
Benign Prostatic Hypertrophy (BPH) is a condition that only affects men. It is non-cancerous cell growth in the prostate gland. Prostate cells increase until nodules form in the urethral area. If they get large enough, the nodules can compress the urethral canal and interfere with urine flow.
- Hormonal factors in the aging male
- Dietary and Lifestyle factors
BPH is very common, and affects an estimated 60% of men over the age of 60 and 80% of men over the age of 80. In 2010, up to 210 million males around the world suffered from BPH.
What are the symptoms of BPH?
BPH can also have the following symptoms:
- Urinary frequency
- Urinating more than 1-2x per night
- Straining to urinate
- Weak or interrupted urine stream
- Urination hesitancy – difficulty starting urination
- Incomplete bladder emptying – the feeling that there is still more urine to come out no matter how frequently you urinate
- Urine leakage or urine dribbling
- Pain or burning sensation when urinating
How is BPH diagnosed?
Doctors can use many methods to diagnose BPH. These include:
- Clinical interview
- Digital Rectal Exam (Finger rectal test)
- Laboratory Tests – urinalysis and urine culture, electrolyte and kidney function tests along with prostate specific antigen (PSA) tests.
- You may recognize PSA testing in relation to prostate cancer. It should be noted that although BPH does not lead to prostate cancer or an increased risk for cancer, PSA level can still be elevated in BPH.
- Ultrasound examinations
- Cystoscopy – Using a cystoscope (small telescope) to do an internal examination of the urethra and bladder.
- Other tests like pressure flow studies, urine volume, flow rates, and urodynamic or bladder function tests.
What are the consequences of untreated BPH?
- Urinary retention (not being able to pee)
- Blood in your urine (aka: Gross Hematuria)
- Bladder infections
- Bladder stones
- Kidney failure
- Failure of the bladder muscle to contract
- With prolonged obstruction the bladder muscle will no longer be able to generate a contraction to push the urine out.
What can be done about BPH?
Doctors can chose from two main approaches to BPH. The severity of symptoms is what determines which approach is used. A questionnaire will be used to determine the severity of your symptoms. If treatment is chosen, your doctor will discuss the possible side effects and potential relief of each treatment option.
- Behavioural changes
- Limiting fluid intake after 6pm
- Limiting bladder irritants: caffeine, spicy foods, acidic foods
- Treating and preventing constipation
- Alpha-Blockers: relax the prostate muscle
- 5-Alpha-reductase inhibitors: shrink the prostate
- Anticholinergic: relax the bladder muscle
- There are an number of approaches for surgical treatment of BPH
- All center around increasing the path for urine to flow through the urethra
- Most commonly is the transurethral resection of the prostate (TURP)
Michelle Strovski, Maple Ridge Urology, Serving Maple Ridge, Coquitlam, Mission, Abbotsford, Langley, and Vancouver.