The prostate gland is a walnut-sized organ found in men between the penis and the bladder, in front of the rectum. The prostate gland produces the seminal fluid which serves as nourishment and protection of the sperm cells. During ejaculation, the prostate gland expels seminal fluid with the sperm.
Prostate enlargement or benign prostatic hyperplasia (BPH) often occurs in aging men. Since the passageway of the urine (urethra) is found in the middle of the prostate, enlargement of the gland causes obstruction in the flow of urine. BPH causes uncomfortable urinary symptoms and may be associated with problems in the bladder, urinary tract or kidneys.
The signs and symptoms of BPH vary among men, with the size of the prostate gland not necessarily correlating with the severity of the condition.
The most common signs and symptoms of BPH include:
Other less common signs and symptoms include:
In most men, the prostate gland continues its growth. BPH may be due to the imbalance in male hormones as men age. The risk for BPH increases from age 40 years old onwards.
Patients with a father or brother with BPH have higher risk for BPH. Other risk factors include obesity, erectile dysfunction, diabetes, heart disease, and the intake of beta blockers.
BPH is diagnosed based on the symptoms of the patient, and the findings after the digital rectal examination (DRE) to determine the size of the prostate. Analysis of the urine (urinalysis) is conducted to screen for UTI and hematuria. In select patients, physicians may request for serum prostate-specific antigen (PSA), a blood marker. Other tests include: urinary flow test, post-void residual volume test, and 24-hour voiding diary.
Additional examinations for complicated cases and/or to rule out other conditions include: transrectal ultrasound, prostate biopsy, urodynamic and pressure flow studies, and cystoscopy (insertion of a scope to visualize the urethra and bladder).
Treatment for BPH depends on the severity of the condition, age of the patient, size of the prostate, and accompanying medical conditions.
Medications for mild to moderate BPH include:
Patients with moderate to severe BPH may need to undergo:
*Patients taking alpha blockers should inform their physicians if they plan to undergo cataract surgery.
BPH may affect the quality of life of patients. The symptoms typically worsen with age in most men. However, symptoms may improve and the condition may stabilize with the proper intake of medications.
Most men do not develop complications such as urinary retention, frequent UTIs, bladder stones, and bladder and/or kidney damage. If these occur, more invasive surgeries may be advised.
BPH is not believed to be associated with increased risk for prostate cancer.
For more information on BPH, consult your physician.