Understanding Benign Prostatic Hyperplasia (BPH): Causes, Symptoms, and Treatment

Posted on Apr 26, 2024 in Medicine & Health

Understanding Benign Prostatic Hyperplasia (BPH)

Anatomy of the Prostate Gland

The prostate gland is a part of the male genitourinary system. It is not a homogeneous gland and can be divided into different zones:

  • Peripheral Zone: This zone is where 90-95% of prostate cancers originate.
  • Transition Zone: This zone is where benign prostatic hyperplasia (BPH) or adenomas develop. It is also a less common site for prostate cancer.
  • Central Zone: Cancer rarely occurs in this zone.
  • Fibromuscular Stroma: This zone does not contain glands.

Benign Prostatic Hyperplasia (BPH)

BPH, also known as adenomyofibroma, is a non-cancerous enlargement of the prostate gland that commonly affects men over the age of 50. The hyperplasia can occur in both the glandular tissue and the stroma (connective tissue) of the prostate.

Symptoms of BPH

As the prostate enlarges, it can compress the urethra and obstruct the flow of urine, leading to various symptoms such as:

  • Decreased force of the urinary stream
  • Dribbling at the end of urination
  • Urinary retention
  • Bladder irritability
  • Frequent urination
  • Nocturia (frequent urination at night)

Complications of BPH

If left untreated, BPH can lead to complications such as:

  • Hydronephrosis: Swelling of the kidneys due to urine backup.
  • Bladder Diverticula: Formation of pouches in the bladder wall.
  • Urinary Tract Infections: Increased risk due to incomplete bladder emptying.
  • Bladder Stones: Formation of stones in the bladder.

Diagnosis of BPH

Several tests can help diagnose BPH and rule out other conditions:

  • Digital Rectal Exam (DRE): Assesses the size, consistency, and mobility of the prostate.
  • Abdominal Ultrasound: Evaluates the kidneys, bladder, and prostate.
  • Transrectal Ultrasound: Provides a more detailed image of the prostate.
  • Urodynamic Studies: Assess bladder function and urine flow.
  • Prostate-Specific Antigen (PSA) Test: Measures the level of PSA in the blood, which can be elevated in BPH and prostate cancer.

Treatment of BPH

Treatment options for BPH depend on the severity of symptoms and the presence of complications. Options include:

Conservative Treatment

  • Watchful Waiting: Monitoring symptoms and prostate growth over time.
  • Lifestyle Changes: Reducing fluid intake before bedtime, avoiding caffeine and alcohol, and managing constipation.
  • Medications:
    • Alpha-blockers: Relax the muscles in the prostate and bladder neck to improve urine flow.
    • 5-alpha reductase inhibitors: Block the conversion of testosterone to dihydrotestosterone (DHT), which helps shrink the prostate.

Surgical Treatment

Surgery may be recommended if conservative treatments are ineffective or if complications develop. Surgical options include:

  • Transurethral Resection of the Prostate (TURP): Removal of prostate tissue through the urethra using a resectoscope.
  • Open Prostatectomy: Removal of the prostate gland through an incision in the abdomen.
  • Minimally Invasive Procedures: Laser surgery, transurethral microwave therapy (TUMT), and prostatic urethral lift (PUL).

Conclusion

BPH is a common condition that can significantly impact a man’s quality of life. Early diagnosis and appropriate treatment can help manage symptoms, prevent complications, and improve overall well-being.