While it is not often discussed, the most common prostate disease is Benign Prostatic Hyperplasia (BPH), a non-cancerous condition. Some estimates suggest BPH affects 50% of men aged over 50 years. Although BPH is not usually life-threatening, for some men, BPH can significantly impact their quality of life due it symptoms. If ignored for a prolonged period of time, it may cause more serious health issues.
BPH can cause pain, sleep deprivation from frequent nighttime urinations, and an on-going feeling of urgency to pass urine. The symptoms have been known to create significant anxiety and bother to men who suffer from BPH. Once your doctor has confirmed that you are not suffering from prostate cancer, you can decide on whether or not to treat BPH. If symptoms are not overly bothersome, some men may decide against treatment, for others with more bothersome symptoms, effective treatments are available and worth considering for your general well-being.
When deciding upon treatment, men need to be fully informed about the different risks and benefits associated with the different options. Prostate related problems are a significant part of men’s health and well-being. Although prostate related problems can have a profound impact on your quality of life, current treatments mean there is no need to suffer in silence.
What is Benign Prostatic Hyperplasia?
As men get older, most of them will develop an enlarged prostate, a condition known as Benign Prostatic Hyperplasia or BPH. “Benign” means that it is not cancerous, and “hyperplasia” means excess growth. BPH is so common that a 50-year-old man has more than a 50% chance of developing symptoms; this increases to over 90% in men older than 80 years. BPH is not normally a life threatening condition but symptoms can impact significantly on your quality of life. If severe and left untreated for a prolonged period of time, it could cause very serious problems with the function of the bladder, and, less commonly, the kidneys.
For those with BPH, the enlarged prostate squeezes the urethra (the tube where urine exits the bladder) tighter than normal, like a clamp around a hose, and begins to block the flow of urine from the bladder. When this occurs, the bladder becomes thicker and stronger, and must work harder to push the urine past the obstruction. The urethra may eventually become so narrow that the bladder is unable to empty completely, allowing urine to remain in the bladder. At this stage the bladder will fill up again that much sooner, causing more frequent urination. When this problems worsens, it is sometimes known as “prostatism” or lower urinary tract symptoms “LUTS”. Someone suffering from this problem will notice:
- a weak, hesitant urine stream
- a need to strain when urinating
- a sense that the bladder is not empty
- dribbling or leaking after urination
- an inability to completely empty the bladder
- frequent urination, including several times during the night
Occasionally, an enlarged prostate may bleed a little bit into the urine. This is known as “hematuria” and is usually painless. It happens because small, fragile blood vessels on the surface of the prostate stretch and rupture, usually due to the pressure caused when urinating or having a bowel movement. Sometimes a blood vessel may break as the result of heaving lifting or crouching. In most cases the amount of blood is so small that it can only be seen under a microscope. It is rare for anyone to lose a significant amount of blood from a small vessel on the prostate gland.
Enlarged prostates are not the only condition that may causes blood to be present in the urine. Other more serious conditions such as bladder or kidney cancer commonly cause bleeding. Any man who sees blood in his urine should see his doctor immediately and ask to be referred to a urologist to rule out more serious possibilities before assuming that “it’s nothing” or “it’s just my prostate”.
What causes Benign Prostatic Hyperplasia?
To date, the exact causes of BPH are not known. However, research has identified several factors that increase the risk of BPH. You could be at higher risk of BPH if:
- you are over the age of 45
- you are still producing testosterone
- it runs in your family
- you are obese
What are the symptoms of Benign Prostatic Hyperplasia (BPH)?
For the majority of patients, urinary symptoms are the first sign of BPH. When urinary symptoms are present, a digital rectal exam (DRE) must take place. This is where the doctor places a finger inside the rectum to check for changes to the size and surface of the prostate. Most men find the digital rectal exam to be uncomfortable, but an untreated prostate will become even less comfortable. Your doctor will then conduct a blood test to determine if the prostate is inflamed.
The doctor may also check the amount of urine left in the bladder after urinating by using an ultrasound bladder scanner or a catheter. In some cases a flow measurement or even urodynamics may be required to properly diagnose BPH.
If there is concern about kidney function or abnormalities in the urine, an ultrasound of the kidneys and/or a cystocopic examination of the bladder may be required to rule out more serious problem.
How is Benign Prostatic Hyperplasia (BPH) treated?
There are a number of treatment options depending on the degree of discomfort and bother associated with BPH, lifestyle factors, and complications from the enlarged prostate or the blockage of urine. Treatment options include the following:
- no treatment or watchful waiting
Is it Possible to Have Both BPH and Prostate Cancer?
Men with benign prostate disease can still develop prostate cancer. Doctors may perform regular prostate checks to monitor any changes to the prostate.