Benign Prostatic Hyperplasia (BPH): Common Disorder of the Prostate

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Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that commonly occurs as men age. It can cause urinary symptoms that affect quality of life, but it does not increase the risk of prostate cancer. BPH is highly prevalent in older men, especially those over the age of 50.

Signs & Symptoms

The symptoms of BPH are primarily urinary-related due to the enlargement of the prostate, which presses on the urethra:

  • Frequent urination: Especially at night (nocturia).
  • Urgency: A strong, urgent need to urinate.
  • Weak urine stream: Difficulty starting or maintaining urination.
  • Incomplete bladder emptying: Feeling like the bladder is not fully emptied.
  • Straining to urinate: A feeling of needing to push to get the urine out.
  • Dribbling: Leakage after finishing urination.

Anatomy Affected

BPH affects the prostate gland, which is located below the bladder and surrounds the urethra in men. As the prostate enlarges, it presses on the urethra, which interferes with the normal flow of urine from the bladder.

Causes/Transmission

BPH is not inherited in a straightforward manner, but genetic factors may play a role. Its development is linked to several factors:

  • Age: The risk increases with age, particularly after age 50.
  • Hormonal Changes: An increase in dihydrotestosterone (DHT), a derivative of testosterone, has been linked to prostate enlargement.
  • Family History: Having a first-degree relative with BPH can increase risk.
  • Lifestyle Factors: Obesity, lack of physical activity, and poor diet may contribute.

Treatments

Treatment for BPH aims to relieve symptoms, improve urinary flow, and prevent complications:

  1. Medications:
    • Alpha-blockers: Relax the muscles of the prostate and bladder neck (e.g., tamsulosin).
    • 5-alpha-reductase inhibitors: Reduce the size of the prostate by blocking the hormone responsible for prostate growth (e.g., finasteride).
    • Combination therapy: Using both types of medications for greater efficacy.
  2. Minimally Invasive Procedures:
    • Transurethral resection of the prostate (TURP): A common surgical procedure where part of the prostate is removed through the urethra.
    • Laser therapy: Uses high-energy laser to remove excess prostate tissue.
    • Prostatic Urethral Lift (PUL): A less invasive procedure where implants are used to lift and hold the enlarged prostate tissue out of the way.
  3. Lifestyle Modifications:
    • Avoiding excessive fluid intake before bedtime.
    • Limiting alcohol and caffeine consumption.

Prevention

There are no guaranteed methods to prevent BPH, but certain lifestyle changes may help manage or delay the onset:

  • Regular exercise: Helps maintain a healthy weight and may reduce symptoms.
  • Healthy diet: A diet rich in fruits, vegetables, and whole grains may support prostate health.
  • Managing chronic conditions: Proper control of diabetes and hypertension may reduce the risk.

Prognosis

  • Outlook: BPH is a progressive condition but is treatable with medication and lifestyle changes. Most men can manage symptoms and continue living a healthy life.
  • Complications: If left untreated, BPH can lead to urinary retention, bladder infections, kidney damage, and bladder stones.
  • Mortality Rate: BPH itself is not life-threatening, but complications like kidney failure can occur if not properly managed.

BPH is a manageable condition, and with timely medical intervention, most men experience significant relief from symptoms and maintain good quality of life. Regular check-ups and lifestyle modifications can help minimize symptoms and complications.

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