As men age, the prostate gland grows larger. With the cells growing so quickly, prostate cancer, prostatitis and benign hypertrophy can all become issues that interfere with personal health.
The term benign prostatic hypertrophy sounds frightening, and brings with it a complex array of problems. However, with a little knowledge about its causes, side effects and how it’s managed, you can alleviate any anxiety your diagnosis may cause.
Remember, medical issues affect every person differently, based on unique health history and responses to treatments.
This article should be used as a resource to help you better understand benign prostatic hypertrophy. You should always consult with physician before undergoing any treatment for this ailment.
What is Benign Prostatic Hypertrophy?
The term benign is used in the medical community to refer to a tumor that is malignant, or noncancerous. These types of tumors grow slowly, and do not tend to metastasize as cancerous tumors do.
Hypertrophy is the enlargement of organ or tissue due to an increase in cell size.¹ While this may seem alarming, many parts of the body undergo hypertrophy. for example, weight training exercises create small tears in your muscles, which are then repaired through proteins. These proteins add more nuclei to the muscles, giving them mass.²
In terms of cells, hypertrophy is normal. The cells in our bodies are constantly growing, dividing and dying. However, sometimes your body continues to produce new cells, without killing the old ones. These cells form a mass, called a tumor.
Prostatic simply refers to the prostate. So, benign prostatic hypertrophy – sometimes known as benign prostatic hyperplasia – is essentially a noncancerous growth of prostate tissue.
What are the Symptoms of BPH?
Because the tumor formed by BPH is benign, it only grows in one place and may not cause any problems. In fact, less than half of men with benign prostatic hyperplasia experience no symptoms.³
However, if the prostate tissue grows too large, it can press on the bladder and urethra and interfere with their functions. These symptoms are called lower urinary tract symptoms (LUTS) and include:
- A decrease in the size and strength of the urine stream
- pushing or straining during urination
- dribbling after urination
- difficulty beginning urination
- the sensation that the bladder is never fully empty
- a frequent need to empty the bladder
- the inability to stop urine stream once it begins
These symptoms can range in severity. A weak or small urine stream may not necessarily be cause for concern; however, If there is blood in your urine, a burning sensation during urination or if you find that you cannot urinate at all, seek medical attention immediately.
Are There Risk Factors?
Just as with prostate cancer, there are factors that can increase your risk of developing BPH.
Obesity, lack of physical activity, erectile dysfunction, age, and family medical history can all contribute to the development of BPH.⁴
Age, especially is a risk factor because the prostate grows during this time. Additionally, a lack of physical activity and erectile dysfunction are common with age. Regular visits to the doctor and a moderate diet and exercise program can manage and lower your risk.
How is Benign Prostatic Hypertrophy Diagnosed?
There are a multitude of noninvasive ways to diagnose BPH.
Digital rectal exams and prostate specific antigen (PSA) tests are commonly used to asses the growth of the prostate and to rule out the possibility of cancer.
Because BPH can put pressure on the urethra or irritate the bladder, it commonly interferes with a man’s ability to urinate. Testing urine is a common way for doctors to diagnose the severity of BPH and assess how to treat its symptoms. Your doctor may recommend a urinary cytology test, to rule out the possibility of bladder cancer. Uroflowmetry and urodynamic pressure flow studies are both used to gauge the severity of your symptoms,
Uroflowmetry, or a urine flow study, measures how fast your urine flows. For this test, your doctor will ask you to urinate into a toilet containing a scale and collection device. This device creates a graph charting changes in your flow rate, from second to second.
Additionally, your doctor may use a stopwatch to time your urination. To asses your average flow rate, the volume of the urine voided will then be divided by the time kept on the stopwatch. Urodynamic pressure flow studies to test the pressure exerted inside your bladder during urination may also be used in conjunction with uroflowmetry tests.⁵
If you feel the constant need to empty your bladder or experience the sensation that your bladder is never fully empty, even after you’ve finished urinating, a PVR – or post-void residual volume measurement – can assess the amount of urine left in your bladder after urination. This is usually measured through a bladder ultrasound or a by inserting a catheter into the urethra.
Because PVR testing involves a catheter, mild discomfort and infection are possible side effects. Your doctor will prescribe a regimen to alleviate discomfort and an antibiotic to prevent infection.⁶
How is BPH Treated?
Treatment for BPH depends on your symptoms and prognosis.
In most men, active surveillance, or the process of “watchful waiting” is the best course of treatment. Your doctor will assess your symptoms and regularly schedule checkups to ensure that benign prostatic hypertrophy does not grow or interfere with the function of your urethra or bladder.
In some cases, your doctor may recommend a diet and lifestyle change to treat mild symptoms of BPH. Avoiding caffeine and alcohol, spacing out your fluid intake throughout the day or avoiding certain medications can control most mild symptoms.⁷
Medications, such as alpha blockers, are used to relax the muscle of the bladder and improve urine flow. In some cases, alpha blockers are used alongside medications 5 alpha reductase inhibitors (such as Finasteride), which can shrink the size of the prostate. Common side effects of these medications are decreased libido, erectile dysfunction and a decrease in semen production.
If your symptoms are severe, mildly invasive treatments may be necessary to restore bladder and urethral function.
Transurethral needle ablation (TUNA) can reduce prostate size and alleviate symptoms caused by the gland pressing on the bladder or urethra. A small cytoscope, emitting low radio waves, will be inserted into the prostate.⁸
These waves create heat to kill and shrink the prostate tissue. This is typically performed as an outpatient procedure and has little-to-no sexual side effects. However, TUNA is only effective short-term, and other medications or treatments may be needed in the future.⁹
For men with significantly enlarged prostates, a radical prostatectomy to completely remove the gland may be a viable course of treatment.
Benign prostatic hypertrophy does not have to interfere with your life. If you have mild to severe BPH symptoms, talk to your doctor today to see which course of treatment is best for you.
- Cellular Adaptation. (2014, December 13). http://en.wikipedia.org/wiki/Cellular_adaptation#Hypertrophy
- Benign Prostatic Hypertrophy . (2014, January 1). http://emedicine.medscape.com/article/437359-overview
- How Do Muscles Grow? The Science Of Muscle Growth. (2013, September 17). http://www.builtlean.com/2013/09/17/muscles-grow/
- BPH (Enlarged Prostate) Causes, Symptoms, Treatments, and More. (2013, November 7). http://www.webmd.com/men/prostate-enlargement-bph/benign-prostatic-hyperplasia-bph-topic-overview?page=1
- Urodynamic Testing. (2006, November 1). http://www.kidneyurology.org/Library/Urologic_Health.php/Urodynamic_Testing.php
- Kelly, C. (2004, January 1). Evaluation of Voiding Dysfunction and Measurement of Bladder Volume. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472847/
- Enlarged prostate: MedlinePlus Medical Encyclopedia. (2013, October 2). http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm
- Benign Tumors: MedlinePlus. (2014, November 3). http://www.nlm.nih.gov/medlineplus/benigntumors.html
- Urology Care Foundation The Official Foundation of the American Urological Association. (2013, July 1). http://www.urologyhealth.org/urology/index.cfm?article=144