Enlarged Prostate (BPH)
BPH: what is it, how is it diagnosed, what are the symptoms, what are the treatment options
As men age, the health of their prostate gland begins to deteriorate. It is important for men to receive regular checkups in order to catch any underlying issues early. For most men, prostate issues are easily managed. It is simpler and more effective to manage symptoms when a patient is diagnosed in a timely manner. The most common problem is an enlarged prostate gland. The enlargement of the prostate gland is often referred to as benign prostatic hyperplasia (BPH).
Due to the location of the prostate gland, enlargement of this gland can cause numerous urinary issues, difficult and feeble urination, failure to fully vacate urine, and frequency during day or night. These initial symptoms can lead to further medical issues, such as bladder stones, urinary tract infections, bladder damage and even kidney damage. The prostate’s location is the primary reason enlargement causes urinary issues, so the size of the enlargement is not directly related to the overall symptoms. Some men with trivial swelling can have complete blockage while others with a much larger prostate can have insignificant symptoms.
Although there is no definitive or singular source for prostate enlargement, there are key signs that may indicate a man’s likelihood of developing prostate problems. Chances of suffering from prostate enlargement increase with age. Men under 40 tend to see little to no problems with enlargement; however, by age 60, almost 33 percent of men suffer from moderate to severe prostate enlargement difficulties. Once men reach 80, more than 80 percent of men experience significant prostate enlargement issues.
Age has the strongest correlation with prostate conditions, but family history also point to future prostate problems. Men with a family history of prostate difficulties—not just prostate enlargement, but other conditions like prostatitis and prostate cancer—are more likely to develop BPH. In addition to family history, ethnicity can also signal an increased risk of prostate enlargement. African American men have a higher chance of experiencing prostate problems and tend to do so earlier in life than other ethnicities. While Asian men are less likely overall to experience prostate enlargement compared to Caucasians and African Americans.
As with most health conditions, a man’s lifestyle can play a role in his odds of developing prostate enlargement. Men who are classified as obese have a higher chance of developing prostate enlargement. Exercise has been shown to decrease this risk when practiced regularly. Men who suffer from other medical conditions that are treated with beta blockers, such as diabetes or heart disease, may also be more prone to prostate enlargement.
Since male urinary symptoms are similar for multiple urinary conditions, ranging from urinary tract infections all the way to prostate cancer, it is important for men to see a doctor when urinary problems occur. Once the doctor knows the specific symptoms associated with the urinary discomfort, a test may be necessary. To determine the exact cause, doctors have a few examinations and procedures that they can use to identify the exact problem: digital rectum exam, urine test, blood test, prostate-specific antigen (PSA) test or neurological exam. If these checks point to an enlarged prostate, the doctor may then choose to do a urinary flow test, postvoid residual volume test (which determines whether or not the bladder can be emptied completely) or the 24-hour voiding diary (which records the frequency and total urination). All of these assessments allow doctors to understand the prostate’s impact.
Once a man is diagnosed with prostate enlargement, treatment may vary based on severity, age and health. Options range from active monitoring, medications, herbals or various procedures. For men without severe symptoms, medication is most commonly used to treat prostate enlargement. If a man’s diagnosis is more severe, the doctor may suggest minimally invasive surgery to address the enlargement. Procedures can range from heating or removing the center of the prostate to making a few small cuts in the gland to allow urine to flow more easily. Doctors will discuss and suggest the best option in each case as it can vary widely due to the severity of the dysfunction and the possible complications of a treatment.
Prostate enlargement affect the bulk of aging males, so it is important to monitor. Though enlargement rarely causes discomfort of the urinary system, subtle changes over years indicate the impact of the prostate. With medications and minimally invasive surgeries, each case of prostate enlargement can be successfully managed, improving quality of life and health.
For information regarding BPH or any other prostate cancer specific topics, please contact HIFU Prostate Services HERE.
Reviewed by Dr. Samuel Peretsman