Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is where the prostate gland expands, Causing the prostate to grow from the size of a walnut to the size of an apricot or a lemon. The prostate then pinches or partially blocks the urethra, causing the bladder to weaken and be unable to empty completely, making it difficult to urinate. This condition can cause several urinary tract, kidney, and bladder problems.

Causes

There is no known singular cause of BPH. What is known is that it occurs mostly in older men. This could be due to changes in hormones as men grow older and the amount of testosterone in their blood decreases. Some research suggests that after a certain age, men have more estrogen in the prostate, which increases substance activity that produce cell growth. Other studies theorize that as men age, they continue to produce dihydrotestosterone (DHT), a hormone that contributes to prostate development and growth. Continued accumulation of DHT could encourage prostate cells to grow.

Symptoms

The symptoms of benign prostatic hyperplasia can vary depending on the cause and severity of the condition, but common symptoms include:

  • Constant urge to urinate

  • Difficulty urinating

  • Increased frequency to urinate at night (nocturia)

  • Urine stream starts and stops

  • Weak stream of urine

TREATMENTS

A urologist may prescribe medications that either stop the growth of or shrink the enlarged prostate. These medications can also reduce BPH symptoms. These medications include:

  • Alpha blockers: These medications can relax the prostate muscles and bladder neck to improve urine flow and reduce any blockage in the bladder.

  • Phosphodiesterase-5 inhibitors: Urologists often prescribe these medications for patients who struggle with erectile dysfunction. However, this class of medications can reduce lower urinary tract symptoms by relaxing the urinary tract’s muscles.

  • 5-alpha reductase inhibitors: These medications block DHT production, which can accumulate in the prostate and cause it to grow. They can prevent the growth of the prostate or may even shrink the prostate for some patients.

  • Combination medications: Research shows that the combination of two classes of medications can improve symptoms, urine flow, and the patient’s overall quality of life. For example, a urologist may prescribe alpha-blockers and antimuscarinics for patients with an overactive bladder.

If a patient has severe enough symptoms and medication has not helped, there are also surgical therapy options to treat BPH. These options include scopes or electrodes being inserted into the patient's urethra to shrink, cut, or send radio waves into the prostate. The patient’s urologist may recommend a simple prostatectomy, which removes the part of the prostate that is blocking urine flow.