Enlarged Prostate | Benign Prostate Hyperplasia (BPH) Treatment

What is Benign Prostatic Hyperplasia (BPH)?

Benign Prostatic Hyperplasia (BPH), also known as, benign prostate enlargement, is a common condition where the prostate gland becomes enlarged. This condition is non-cancerous and is particularly prevalent in older men.

As the prostate enlarges, it can press against the urethra, leading to a narrowing of the urethral passage and restricting the flow of urine. BPH does not increase the risk of developing cancer.

Signs & Symptoms of BPH

BPH can lead to various uncomfortable and sometimes serious urinary symptoms, collectively known as lower urinary tract symptoms (LUTS). These include:

Difficulty Starting Urination (Hesitancy)

Many men with BPH experience difficulty beginning the flow of urine.

Urgent Need to Urinate

There may be a sudden and strong urge to urinate that is difficult to postpone.

Weak or Interrupted Urine Stream

The urine stream may be weak, or it may start and stop intermittently.

Incomplete Bladder Emptying

Some men feel as though their bladder is not completely empty after urinating.

Dribbling at the End of Urination

Men with BPH may notice a prolonged dribbling of urine after they have finished urinating.

Straining While Urinating

Men with BPH may need to strain or push to begin urination or to maintain the flow of urine.

Frequent Urination

The need to urinate more frequently, especially at night (a condition known as nocturia), is a common symptom.

These symptoms can be bothersome and, if severe, can significantly impact one’s daily life. It is therefore important for men experiencing these symptoms to seek medical evaluation, as early intervention can prevent further complications.

Complications of BPH

In severe cases, BPH can lead to more serious complications, such as:

Acute urinary retention (the sudden inability to urinate)

Recurrent urinary tract infections (UTIs)

Bladder stones

Kidney damage

Blood in the urine

To prevent complications from developing, please seek prompt medical attention from a urologist should you experience symptoms of BPH.

Causes of BPH

The actual causes of BPH are still unknown, but are believed to be linked to the natural ageing process and hormonal changes in men.

As men age, their levels of testosterone decrease, while levels of oestrogen remain relatively stable. This change in hormone levels is thought to contribute to the growth of the prostate gland.

Another theory has to do with the dihydrotestosterone (DHT) hormone, which plays a significant role in prostate development. Some studies found that older men have higher levels of DHT, which may have an effect in stimulating the growth of prostate cells.

Genetic factors also play a role; men with a family history of BPH are more likely to develop the condition.

Risk Factors of BPH

Several factors increase the risk of developing BPH:

Age

BPH is rare in men under 40 but becomes increasingly common with age, particularly after the age of 50. By the age of 60, about half of men have some signs of BPH; and by the age of 85, the majority of men are affected.

Family History

A family history of BPH increases the likelihood of developing the condition.

Lifestyle Factors

Obesity, a sedentary lifestyle, and a diet high in red meat, fats, and low in fruits and vegetables are associated with an increased risk of BPH.

Medical Conditions

Conditions such as diabetes and heart disease, particularly those treated with certain medications like beta-blockers, may be linked to an increased risk of BPH.

How is BPH Treated

The treatment of BPH depends on the severity of symptoms, the size of the prostate, the patient’s age, and overall health. While there isn’t a cure for BPH, many treatment options are available to alleviate one’s symptoms and improve quality of life.

Alpha-Blockers

These medications relax the muscles in the prostate and bladder neck, making it easier to urinate. They provide symptomatic relief but do not reduce the size of the prostate.

5-Alpha-Reductase Inhibitors

These medications can shrink the prostate by reducing levels of DHT.

Combination Therapy

For men with larger prostates or more severe symptoms, a combination of alpha-blockers and 5-alpha-reductase inhibitors may be recommended.

Convective Water Vapour Thermal Therapy (Rezum™)

This technique restores normal urine flow by creating an open channel through the prostate using steam injections. These injections cause the targeted prostate cells to die, reducing the size of the prostate and alleviating symptoms of BPH.

Prostatic Urethral Lift (UroLift®)

This newer technique involves placing small implants to hold the enlarged prostate tissue away from the urethra. This opens up the urethra and improves urine flow.

Transurethral Resection of the Prostate (TURP)

TURP is the most common and effective surgical treatment for BPH, especially for large and highly obstructing prostates. During the procedure, excess prostate tissue is removed through the urethra, relieving the blockage.

Laser Therapy

This uses a laser beam to remove excess prostate tissue that is blocking the flow of urine.

Simple Prostatectomy

A simple prostatectomy is a surgical procedure to treat significant enlargement of the prostate, usually when other procedures are not suitable or have failed to offer symptomatic relief. It involves the surgical removal of the inside part of the prostate gland.

Enlarged Prostate (BPH) Treatment