Benign Prostatic Hyperplasia: Causes, Symptoms, Diagnosis, Treatment

Benign Prostatic Hyperplasia is characterized by enlargement of the prostate gland which is not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction.

There are two main growth phases of the prostate with aging, with the first phase beginning when the individual is in the initial stages of puberty when the prostate enlarges to almost twice its original dimensions. The second phase of the development starts when the individual is around the age range of 25 to 30 years with the process continuing throughout the entire life of a male. Benign Prostatic Hyperplasia tends to occur during the second phase of development.

With enlargement of the prostate, the prostate gland starts to press the urethra. The bladder walls become thick resulting in the bladder to become weak and thus the ability of the bladder to empty in its entirety is lost resulting in some amount of urinary retention. This urethral stenosis along with retained urine and the inability of the bladder to completely empty itself results in symptoms associated with Benign Prostatic Hyperplasia.

The root cause of Benign Prostatic Hyperplasia is not well known, although it tends to occur usually in the elderly population. This disease does not develop in individuals who have had testicle removal well before adolescence. Hence, it is opined by some researchers that the process of aging along with changes in the testicles may a cause for Benign Prostatic Hyperplasia. Testosterone is a hormone produced by males all through their lives along with small quantities of estrogen which is a hormone found in females. Studies suggest that with aging the amount of testosterone decreases thus causing the estrogen levels to increase in the blood causing Benign Prostatic Hyperplasia as the excess levels of estrogen facilitates cell growth in the prostate gland.

Another study suggests that a hormone called dihydrotestosterone, which is basically a hormone found in males facilitates cell growth in the prostate gland, and with aging even if the individual may not be having enough testosterone levels but the dihydrotestosterone is maintained facilitating continued growth of cells in the prostate gland causing Benign Prostatic Hyperplasia.

• Increased urinary frequency
• Increased urinary urgency
• Problem with constant flow of urine
• Urinary dribbling
• Nocturia
• Urinary retention
• Urinary incontinence
• Pain with ejaculation after sexual intercourse
• Urine with foul odor

Personal and Family Medical History: The first thing that the treating physician does is to take a detailed history and conduct a physical examination of the individual in order to diagnose Benign Prostatic Hyperplasia

Physical Examination: A detailed physical exam will include checking for any abnormal discharge from the urethra, presence of enlarged lymph nodes in the groin area, or tenderness in or around the scrotum. The next step is to do an examination of the prostate. To examine the prostate, the physician will conduct a digital rectal examination to explore the prostate which lies immediately next to the rectum.

The treating physician may then refer the individual to an experienced urologist for further examination and the diagnosis of Benign Prostatic Hyperplasia is made based on the digital rectal examination and the symptoms experienced by the individual. The urologist may also conduct various tests to confirm the diagnosis which includes:

• Urinalysis
• Testing for PSA levels
• Urodynamic tests
• Cystoscopy
• Transrectal ultrasound
• Biopsy

Some of the treatment options available for Benign Prostatic Hyperplasia include

Some of the lifestyle changes recommend in Benign Prostatic Hyperplasia include:

• Reduced intake of liquids, especially before going out or going to bed at night
• Refraining from caffeine and alcohol
• Avoiding medications like decongestants, antidepressants, diuretics, and antihistamines
• Bladder training so that it has the ability to hold urine for a bit longer than normal
• Pelvic floor muscle exercises
• Avoiding constipation

Some of the medications used for treating Benign Prostatic Hyperplasia include

• Alpha blockers
• Phosphodiesterase-5 inhibitors
• Hytrin
• Cardura
• Flomax
• Rapaflo

Some of the least invasive procedures developed for treatment of Benign Prostatic Hyperplasia are:

• Transurethral needle ablation
• High-intensity focused ultrasound
• Prostatic stent insertion

These methods are utilized when the medications do not prove to be effective. These procedures are designed to kill the enlarged prostate tissues or increase the width of the urethra to clear the block and resolve retention of the urine.

In order to treat Benign Prostatic Hyperplasia when medications and the above mentioned procedures fail to yield positive results, the physician resort to surgical correction of the prostate gland which may include removal of the enlarged prostate tissue or widening the urethra by making cuts. Some of the surgical procedures for treatment of Benign Prostatic Hyperplasia are:

• Transurethral resection of Prostate
• Laser surgery
• Prostatectomy

Also Read:

• Bladder Neck Contracture: Causes, Symptoms, Treatment, Diagnosis
• Enlarged Prostate in Young Men: Symptoms, Causes, Natural Remedies, Complications
• Prostate Pain: Classification, Types, Etiology, Risk Factors, Signs, Symptoms, Treatment