Enlarged Prostate Gland or Benign Prostatic Hyperplasia (BPH)

Summary

Benign prostatic hyperplasia (BPH) is an age-related enlargement of the prostate gland, which surrounds the urethra and can obstruct urine flow. This condition can lead to symptoms such as frequent urination, weak urine stream, straining, and nighttime urges, and if left untreated, may cause bladder or kidney damage, infections, stones, or blood in urine. Risk factors include age over 40, family history, obesity, cardiovascular disease, diabetes, lack of exercise, and erectile dysfunction. Management ranges from watchful waiting for mild cases, medications to relax muscles or shrink the prostate, to surgical procedures like TURP or open prostatectomy. Lifestyle adjustments can also help alleviate symptoms.

Takeaways

• 🧠 BPH, or benign prostatic hyperplasia, is the enlargement of the prostate gland in men, commonly occurring as they age.
• ⚠️ An enlarged prostate can compress the urethra, slowing urine flow and causing difficulty urinating.
• 👨‍⚕️ Risk factors for BPH include age 40 or older, family history, obesity, heart or blood vessel disease, type 2 diabetes, lack of exercise, and erectile dysfunction.
• 🚽 Common symptoms include frequent urination, especially at night, urgent need to urinate, weak or interrupted urine stream, and straining to urinate.
• ❗ Untreated BPH can lead to serious complications like inability to urinate, bladder and kidney damage, urinary tract infections, bladder stones, and blood in urine.
• 🔍 Mild or asymptomatic BPH is often managed with 'watchful waiting,' involving annual prostate checks.
• 💊 Medications for BPH include alpha blockers, PDE5 inhibitors, and 5-alpha-reductase inhibitors, which help relax muscles or reduce prostate size to improve urine flow.
• 🛠️ Surgical options for BPH include TURP (transurethral resection of the prostate) and minimally invasive procedures using lasers, microwaves, or radio waves.
• 🏥 For very large prostates, an open prostatectomy may be performed, involving removal of prostate tissue through an abdominal incision.
• 🌿 Lifestyle changes can help manage symptoms: avoid certain medications, reduce fluid intake before bedtime, limit alcohol and caffeine, and practice double voiding.
• 🚨 Seek immediate medical attention if unable to urinate, as this can be a medical emergency.

Q & A

What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia, or BPH, is a condition in which the prostate gland enlarges, potentially compressing the urethra and affecting urine flow.

Where is the prostate gland located and what is its function?

The prostate gland is a walnut-sized gland in men located just beneath the bladder. It surrounds the urethra and, together with the seminal vesicles, produces fluid that combines with sperm to create semen.

Why does an enlarged prostate affect urination?

As the prostate enlarges, it can compress the part of the urethra that passes through it, slowing urine flow and making it difficult to fully empty the bladder.

Who is at higher risk of developing BPH?

Men aged 40 or older, those with a family history of BPH, other health problems like obesity, heart disease, type 2 diabetes, or erectile dysfunction, and those who do not exercise are at higher risk.

What are common symptoms of BPH?

Symptoms include frequent urination, especially at night, a weak or interrupted urine stream, and straining to urinate.

What complications can arise from untreated BPH?

Untreated BPH can lead to an inability to urinate, bladder and kidney damage, urinary tract infections, bladder stones, and blood in the urine.

What is 'watchful waiting' in the management of BPH?

Watchful waiting is recommended for men with mild or no symptoms. It involves regular prostate check-ups to monitor if symptoms or health issues are worsening.

What medications are commonly prescribed for BPH?

Doctors may prescribe alpha blockers or PDE5 inhibitors to relax muscles in the bladder, urethra, and prostate. Five-alpha reductase inhibitors may also be used to reduce prostate size over several months. Sometimes a combination of these drugs is used.

What surgical options exist if medication does not work?

Surgical options include transurethral resection of the prostate (TURP), which uses a resectoscope to remove prostate tissue, minimally invasive procedures using lasers, microwaves, or radio waves, and open prostatectomy for very large prostates.

How is a TURP procedure performed?

During TURP, a resectoscope is inserted through the urethra to reach the prostate. A wire loop is used to shave off tissue, widening the urethra and improving urine flow.

What lifestyle changes can help manage BPH symptoms?

Helpful changes include avoiding medications that make urination harder (like antihistamines and decongestants), stopping fluids a few hours before bedtime, avoiding alcohol and caffeinated drinks, and using double voiding techniques to empty the bladder completely.

Can BPH be prevented?

BPH cannot be completely prevented, but adopting healthy lifestyle habits and managing risk factors may help reduce the severity of symptoms.