The prostate is an organ located beneath the bladder, and its function is limited to the formation of semen. Many men have an...
Many men have a continuous growth of the prostate throughout their lives, this can cause an outlet obstruction of urine from the bladder.
Prostate enlargement or benign prostatic hyperplasia (BPH) can cause bothersome urinary symptoms like bladder outlet obstruction. If not treated on time, benign prostatic hyperplasia can damage the bladder and kidneys along the time.
BPH symptoms
- Weak urinary stream and frequent urination:
Prostatic hyperplasia causes the need to urinate frequently. Patients with BPH have a weak and thin urine stream.
- Feeling of incomplete emptying of the bladder:
Sometimes patients with BPH feel that they do not empty their bladder completely when they go to urinate. Feeling of incomplete emptying of the bladder:
- Nocturia:
When patients have BPH, they need to urinate frequently at night, this symptom is called nocturia.
- Urgency:
The strong desire to urinate without waiting is known as urgency. Sometimes the urge is so strong that it can cause urinary incontinence.
Causes of BPH
The precise mechanism of how prostatic hyperplasia occurs is unknown, but some risk factors have been identified:
- Aging: The growth of the prostate begins before the age of 40, however, urinary symptoms begin to be reflected until the age of 50 or more. About 80% of adults in their 80s have BPH with moderate to severe symptoms.
- Family history: having a direct relative with prostatic hyperplasia, such as our father, grandfather or brother, it is more likely that symptoms of prostatic hyperplasia will appear.
- Lifestyle: patients with a sedentary lifestyle and obesity have a higher risk of presenting prostatic hyperplasia.
Diagnosis
To know if the urinary symptoms are caused by benign prostatic hyperplasia (BPH), a complete medical history should be taken including:
- Interrogation to find out family history, lifestyle.
- Physical prostate examination via a digital rectal exam (DRE).
- Application of validated questionnaires for the diagnosis of prostatic hyperplasia such as IPSS *.
- Diagnostic Services: Laboratory tests including urinalysis, prostate-specific antigen (PSA) testing, prostate ultrasound, and magnetic resonance imaging (MRI).
Treatment for BPH
There are different forms of treatment for prostate diseases, they are divided into pharmacological and surgical. If a patient does not respond to pharmaceutical treatment, surgical treatment should be employed.
Drug Therapies:
- Alpha blockers; alfuzosin, tamsulosin, prazosin
- 5-alpha reductase inhibitors: dutasteride, finasteride
- Herbs: saw palmetto, urtica dioica, serenoa repens
- Phosphodiesterase 5 inhibitors (PDE5 inhibitors): Tadalafil, sildenafil, vardenafil, avanafil
Surgical:
- Transurethral resection of the prostate (TURP)
- Open prostatectomy
- Anatomical endoscopic enucleation of the prostate: HoLEP, BiLEP, ThuLEP, GreenLEP
- Laser vaporization
- Urolift
- Rezūm
