Benign prostatic hyperplasia (BPH) is a medical condition that is also commonly referred to as prostate gland enlargement. The enlargement caused by BPH has nothing to do with cancer and, contrary to popular belief, does not increase one’s chances of suffering from prostate cancer in the future. In most cases, BPH does not lead to any dangerous consequences. However, a noticeably enlarged prostate may cause some complications related to the urinary tract.
What Causes Benign Prostatic Hyperplasia?
In a sexually healthy man, the prostate gland will undergo two major periods of growth. The first one happens during puberty and causes the gland to grow rapidly, while the second one starts around the age of 25 and causes gradual increases in the gland’s size over the span of multiple decades. Both growth periods are caused by hormonal changes and are not associated with prostate or any other kind of cancer.
In some rare cases, the prostate will become too large during the first growth period, although for most BPH patients the abnormal enlargement occurs in the second phase. The exact BPH causes and risk factors are yet unknown, but healthcare professionals believe that BPH is most likely caused by hormonal imbalances. This theory also explains the correlation between a sedentary lifestyle (most often accompanied by obesity) and an increased risk of experiencing BPH. Men who suffer from erectile dysfunction also seem to be at a higher risk of developing BPH later in life.
How Is Benign Prostatic Hyperplasia Diagnosed?
Most men are diagnosed with BPH after consulting a doctor about experiencing one or more of the following symptoms:
- Struggling to initiate a urine stream
- Having the sensation of a full bladder shortly after urinating
- Having to pause and then go on during urination
- Having a weak flow of urine
- Having to wake up multiple times in one night to urinate
In extremely rare cases, BPH becomes so severe that it prevents the patient from being able to urinate. This condition is a medical emergency that requires urgent medical help.
Healthcare providers can use multiple standardized tests to determine whether a patient suffers from BPH or not. You can take the Symptom Score Index test for BPH (developed by the American Urological Association) and discuss the results with your doctor if they suggest you might have BPH. If your GP needs more information to diagnose you, they may perform a standard physical test. In addition to that, urine and blood tests can help shed some light on whether or not you have BPH. Finally, your doctor may ask you to do one or multiple scan tests, such as a cystoscopy, an ultrasound test, or an MRI test to obtain precise data regarding the shape and size of your prostate gland.
Should Benign Prostatic Hyperplasia Be Treated?
BPH is a very common condition, present in at least 50% of all men aged over 50 and in more than 90% of all men aged over 80. Some patients have a very mild form of BPH and may not even display any symptoms. In such cases, it may take years before BPH is even diagnosed and the condition requires no medical treatment.
Men who experience minor BPH symptoms, such as a slight difficulty urinating, may choose to leave BPH untreated and only have the prostate gland examined on a regular basis. If the condition progresses and the symptoms become more prominent, healthcare providers normally recommend choosing a treatment method and trying to manage BPH with it. There are multiple ways to treat BPH, so it is possible to choose one that works best for you and keep adjusting the treatment according to the development of your BPH. We are now going to look at the two major groups of BPH treatment methods in detail.
Treating Benign Prostatic Hyperplasia Non-Invasively
A high percentage of all BPH patients can have the condition managed effectively with prescription medications. Alpha blockers are a popular choice for treating BPH due to their efficiency and safety. Alpha blocker medications work by relaxing the muscles surrounding the prostate and bladder, thus removing the pressure on the urethra and enabling normal urination. Most alpha blockers users only experience mild side effects such as lightheadedness, dizziness, or fatigue. Some men have trouble ejaculating as a result of taking an alpha blocker. Alpha blockers do not reduce the size of the prostate, but they provide a simple and effective treatment form that starts working almost immediately.
5-alpha reductase inhibitor drugs work by curbing the production of DHT, one of the hormones responsible for enlarging the prostate. 5-alpha reductase inhibitors have to be taken continuously and on a regular basis to work. They do not work right away and may have to be taken for weeks or even months before they can produce a noticeable effect. 5-alpha reductase inhibitors work by reducing the size of the prostate gland, so they are more suitable for patients with significantly enlarged prostates who might need invasive treatment otherwise. The most common side effects of 5-alpha reductase inhibitors include erectile dysfunction and a low sex drive.
Men who suffer from severe BPH benefit the most from a combined treatment plan that includes both an alpha blocker and a 5-alpha reductase inhibitor. Such a combination increases the user’s chances of experiencing side effects, both those typical for either drug and “new” ones that are only associated with the combination. However, combining the medications also increases their efficiency and allows them to manage BPH much better. BPH patients who also suffer from an overactive bladder may need a third medication (an antimuscarinic) to stop the bladder muscles from contracting involuntarily.
You may feel tempted to try out an OTC herbal treatment for BPH, but there is no medical evidence to suggest that any of the popular phytotherapies for this condition work. Thus, it is a better idea to avoid jeopardizing your health and get a prescription for an actual medication instead.
Treating Benign Prostatic Hyperplasia Invasively
Benign prostatic hyperplasia can be treated with a number of invasive procedures. The minimally invasive methods only require short-term hospitalization and can be performed under local anesthesia. Prostatic urethral lifts rely on tiny implants to support and compress the tissues that pressure the urethra. Their effects are temporary and normally last for 3-5 years. There are multiple therapy methods that use hot water vapor or microwaves to actually destroy the “extra” tissue thus freeing the urethra. They generally don’t have any sexual side effects, so they work great for men who don’t want to jeopardize their active sex life. Finally, catheterization can be the best option for men who suffer from multiple serious health conditions, so the risks of surgery outweigh the expected benefits.
If these methods are not acceptable for you, you can discuss other options with your doctor and choose from a wide range of invasive procedures available to treat BPH. The majority of these procedures aim to remove excess tissue from the prostate, but there are some alternative approaches that expand the urethra instead. Be sure to ask your healthcare provider for more details on all BPH treatment methods so that you can make an informed decision regarding the procedure that would work best for you.