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Benign Prostatic Hyperplasia (BPH): Causes, Symptoms & Treatment

Renal Sciences | by Dr. Pankaj Kumar Gupta | Published on 02/07/2024

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Benign Prostatic Hyperplasia (BPH), also as referred to as benign prostatic hyperplasia (BPH) is among the most common conditions that affects around 50% of men who are above 50 and up to 90% of men over 80. It is normal for the prostate to become enlarged as men age. This enlargement can cause several urinary symptoms like painful urination, difficulty urinating etc., affecting the quality of life of an individual. If you are experiencing such symptoms, book your appointment with one of the best urologists in Kolkata at The CMRI.

This blog will explore the nature of BPH, its types, symptoms, causes, risk factors, diagnosis, and treatment options. Understanding these aspects of BPH helps in the early detection, efficient management, and enhancement of the quality of life for men affected by this condition. However, kindly note that this blog is for informational purposes and does not replace the significance of a urology doctor consultation.

What is Enlarged Prostate Disease?

Enlarged Prostate Disease or Benign Prostatic Hyperplasia (BPH) is a benign condition causing an increase in the prostate gland size. The prostate is a gland that appears as a small, walnut-sized in the male reproductive system, positioned near the bladder and the rectum front. It encircles the urethra, a tube through which urine flows out of the bladder. The exact cause of enlarged prostate disease is not known, but it is identified that growing age and hormonal changes are the main contributors. As the prostate enlarges, it can put pressure against the urethra and bladder base causing urinary problems.

What are the Types of Enlarged Prostate Disease?

Prostate enlargement disease is categorised into two main types that are:

BPH, or benign prostatic hyperplasia: It is a benign enlargement of the prostate. For most men, BPH is a normal part of ageing and is not related to prostate cancer directly. However, the symptoms of an enlarged prostate can be worrisome causing difficulties when not managed appropriately.
Prostate Cancer: It is not as common as Benign Prostatic Hyperplasia, however, it also involves prostate enlargement. The primary difference is that this type is not benign, indicating that the growth is cancerous and can affect the other body parts as well. It is essential to identify the differences between BPH and prostate cancer, as the treatment and symptom management for both are hugely different.

What Are the Symptoms of Enlarged Prostate Disease?

When enlarged prostate disease causes the prostate to grow, then it causes obstructions in the urethra. The symptoms occur because the enlarged prostate gland presses against the urethra, narrowing it and making it harder for urine to pass through. As a result, the symptoms of enlarged prostate disease include:

A strong and sudden urge to urinate, mainly at night
Difficulties while urinating like resistance or delay when starting to urinate
A weak or interrupted urine flow
Always have a feeling as if the bladder is not empty despite urinating often
Dribbling at the end or urination
Experiencing severe pain during urination

What Are the Causes of Enlarged Prostate Disease?

The precise cause of enlarged prostate disease is unknown, but several factors are determined to contribute to developing the enlarged prostate disease:

Ageing: The risk of this condition aggravates with age greatly. Most men over the age of 50 will experience some degree of prostate enlargement.
Hormonal Changes: Hormones like testosterone and dihydrotestosterone (DHT) are known to be one of the primary contributors to prostate growth. Variations in the balance of these hormones cause prostate enlargement as men age.
Genetics: A family history of prostate problems enhances the probability of growing BPH.
Lifestyle Changes: It involves obesity, lack of physical activity, and dietary options contribute to the development of BPH.

What Are the Risk Factors for Enlarged Prostate Disease?

Certain factors increase the risk of developing BPH:

Age: BPH is rare in men under 40 but becomes increasingly common with advancing age.
Family History: A family history of BPH or prostate cancer can increase the risk.
Diabetes and Heart Disease: Studies have shown a correlation between BPH and conditions such as diabetes and heart disease.
Lifestyle: Obesity, lack of physical activity, and poor dietary habits can contribute to the development of BPH.

What Are the Diagnosis of Enlarged Prostate Disease?

Here is what healthcare professionals do to diagnose enlarged prostate disease to rule out other conditions and ensure the presence of an enlarged prostate:

Medical History and Physical Examination: A comprehensive medical history is obtained, and a physical assessment is performed, including a digital rectal exam (DRE) to feel the prostate's size and form.
Urinalysis: A urine test is performed to check for infection or other conditions leading to enlarged prostate disease symptoms.
Prostate-Specific Antigen (PSA) Test: It is a blood test that assists in measuring the PSA levels, a protein formed by the prostate. Increased levels can signify BPH, prostate cancer, or other prostate conditions.
Urinary Flow Test: With this test, the doctor can evaluate the strength and amount of urine flow.
Postvoid Residual Volume Test: Helps evaluate the amount of urine left in the bladder after urination.
Imaging: Ultrasound or other imaging tests are performed to assess the size of the prostate and rule out other conditions.

What Are the Treatment Options for Enlarged Prostate Disease?

The treatment for enlarged prostate disease depends on the extent of symptoms and the impact on quality of life. Some of the effective treatment options recommended are:

Watchful Waiting: Regular monitoring and lifestyle changes are often sufficient for mild symptoms. This option is usually recommended for men with minimal symptoms that are not specifically problematic.
Medications: Various medications can help manage enlarged prostate disease symptoms such as alpha-blockers, 5-alpha reductase inhibitors, and combination therapy.
Minimally Invasive Procedures: Minimally invasive procedures are performed to reduce urinary obstruction for moderate to severe symptoms. Some of the recommended procedures are Transurethral Microwave Thermotherapy (TUMT), Transurethral Needle Ablation (TUNA), and UroLift.
Surgery: Surgical options are involved for severe cases or when other treatments are not effective. Common options involved are Transurethral Resection of the Prostate (TURP), Simple Prostatectomy, and Laser Surgery.

Conclusion

Enlarged Prostate Disease, or Benign Prostatic Hyperplasia (BPH), is among the most common conditions that affect ageing males. Even though the exact cause is not completely understood yet, various factors including ageing, hormonal variations, genetics, and lifestyle, contribute to its growth. Symptoms of this condition range from mild to severe, affecting the quality of life of an individual and causing complications if left untreated. With proper diagnosis and effective treatment, most males can find relief from symptoms and maintain a good quality of life.

Faq -

Is prostate enlargement curable?

There is no cure available for prostate enlargement disease, or BPH, but is manageable with medications, minimally invasive procedures, or surgery. Treatment helps relieve symptoms and improve quality of life rather than removing the condition.

Is prostate enlargement dangerous?

Prostate enlargement disease is not a dangerous condition but can cause serious complications such as urinary retention, bladder infections, and kidney damage if not treated on time. Immediate management is essential to avert these problems.

Does prostate enlargement cause erectile dysfunction?

Prostate enlargement does not lead to erectile dysfunction, but the linked symptoms and treatments, specifically certain medications and surgeries, can impact sexual function in some males.

Can prostate enlargement be reversed?

Prostate enlargement cannot be reversed, but its symptoms can be efficiently managed and mitigated with proper treatment, including lifestyle changes, medications, and medical procedures.

Does prostate enlargement cause pain?

The prostate enlargement often does not cause pain. However, complications like urinary tract infections or bladder stones that result from BPH can cause discomfort or pain.