Benign prostatic hyperplasia
(also called BPH) is a condition
that affects the prostate gland
in men. The prostate is a gland
found between the bladder
(where urine is stored) and the
urethra (the tube urine passes
As men age, the prostate gland slowly
grows bigger (or enlarges). As the
prostate gets bigger, it may press on
the urethra and cause the flow of urine
to be slower and less forceful.
Most symptoms of BPH start gradually.
These symptoms can be caused by
other things besides BPH. Tell your
doctor if you have any of these
symptoms, so he or she can decide on
the tests to find the possible cause.
BPH is extremely common. Half of all
men over 50 develop symptoms of
BPH, but only 10 percent need medical
or surgical intervention.
Is BPH a type of cancer?
No. BPH is completely benign.
It is not a precursor (a forerunner)
to prostate cancer.
After taking a history of your symptoms, a rectal exam is the next step. In a rectal exam, your doctor checks your prostate by putting a gloved, lubricated finger into your rectum to feel the back of your prostate gland. This allows him to feel the size of the prostate gland and especially assess for hard lumps which may indicate cancer.
To make sure that your prostate problem is benign and not cancer, your doctor may do a blood test called PSA or prostatic specific antigen.
What are the consequences of BPH?
Mild cases usually have no consequence to life. If the enlargement gets moderate, symptoms related to difficult urination become troublesome. In severe cases, a sudden inability to urinate may require an immediate visit to a doctor to insert a urine tube or catheter into the urethra to drain out the urine.
Even if BPH sufferers manage to pass urine, some amount of urine may be left behind, which easily gets infected, making moderate to severe BPH sufferers prone to urine infections.
Sometimes mild symptoms get better on their own. Many people believe that a healthy lifestyle and diet with less processed foods rich in fibre, fruit, vegetables will cause the prostate to enlarge less, by decreasing oestrogens and increasing testosterone levels both of which affect prostate size. Some herbal products like saw palmetto are even available commercially. In any case, it is always good to adopt a healthy lifestyle whether these measures make a noticeable difference or not.
If your symptoms get worse, your doctor may suggest drug treatment.
Finasteride and dutasteride block conversion of testosterone to dihydrotestosterone, which makes the prostate enlarge.
The side effects of finasteride are rare and mild and usually affect sexual function. The side effects cease when the medication is stopped. The prostate may enlarge again when the medicine is stopped, so your doctor may suggest another treatment.
Another kind of medicine, called
alpha-blockers, can also help relieve
the symptoms of BPH. Alpha-blockers
have been used for a long time to treat
high blood pressure, but they can
also help the symptoms of BPH, even
in men with normal blood pressure.
Some of these drugs are terazosin,
doxazosin, tamsulosin and alfuzosin.
The side effects of alpha-blockers
include dizziness, fatigue and
lightheadedness due to lowered blood
pressure. Doctors therefore start with a
low dose first.
How can a Urologist help me in
further treatment of BPH?
A referral to a urologist (a surgeon
of the urinary-genital system) may
be neccessary to explore surgical
A urologist will perform an ultrasound
exam of the prostate by inserting a
well-lubricated probe into the anus.
This will measure the size of the
prostate gland, check for cancer if
suspected and assess the need for
surgery. Biopsy of the prostate is
done though the rectum if cancer is
A urologist can also perform an
ultrasound of the bladder to see how
much urine is retained after urinating,
due to the obstruction by the prostate.
One treatment option is a minimally
invasive treatment. Most of these
treatments use heat such as
microwave or laser to destroy prostate
tissue applied through the urethra.
Surgery is considered the most
effective treatment and is used in
men with symptoms that persist
after other treatments are tried. This
is also the best way to diagnose and
cure early cancer of the prostate.
Surgery is usually done via a
tube passed through the urethra,
thus leaving no abdominal scars
(Transurethral resection of prostate
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