Benign prostatic hyperplasia(BPH), also known as benign prostatic hypertrophy, is a very common degenerative disease among the older men in Hong Kong. The incidence rate increases with age. About half of all men over age 50 start to develop BPH. Almost 90% of men over age 80 get BPH, and around half of them have the symptom of urinary obstruction.
BPH can cause constriction of the urethra, which may lead to severe urinary problems. Although BPH is not a life-threatening disease, it can seriously affect quality of life.
The aging of population significantly increases the number of men with prostate problems. Most men over age 50 may have experienced some of the following symptoms: frequent urination at night; increased urination during the day; sudden urge to urinate; interrupted or weak urinary stream; dribbling at the end of urinating; and feeling that the bladder is not empty even after urinating. All these are warning signs of BPH. If you have any of these symptoms, you should see you doctor as soon as possible.
Most older men have BPH problems. Men with BPH should not delay seeking treatment because of embarrassment. Early diagnosis and treatment can help relieve symptoms effectively.
What is Benign Prostatic Hyperplasia?
The prostate gland is a male organ about the size of a walnut. It is located below the bladder and surrounds the urethra. Its major function is to produce the fluid in semen that transports sperm out of the body.
The size of adult prostate generally remains stable until middle-age, when hormonal changes may cause enlargement of the prostate. Since the enlargement is non-cancerous, it is called benign prostatic hyperplasia.
When the prostate enlarges, it presses down on the urethra. This pressure can lead to difficult urination and other urinary problems. Clinical statistics show that BPH affects around 50% of men between the ages 51 and 60, 70% of men at the age of 70, and up to 90% of men over the age of 80.
What are the risk factors of Benign Prostatic Hyperplasia?
BPH is mainly produced by age-related hormonal changes and non-cancerous overgrowth of prostate tissue. Urinary infections can increase the severity of BPH symptoms. Besides, obesity, stress, depression, alcohol abuse, smoking, medications, diet habits and poor hygiene can increase the risk of BPH.
How to prevent Benign Prostatic Hyperplasia?
The risk of getting BPH increases with age. It is still uncertain what might prevent the condition. However, the following can help to reduce the risk of developing BPH:
- Regular checkups
According to the American Cancer Society, men over 50 years of age should have an annual prostate examination for early detection and treatment of BPH. - Digital rectal examination (DRE)
Men over 50 years of age should have a DRE at least once a year. The test examines the size and shape of the prostate, and checks for abnormal nodules or inflammation. - Maintaining a healthy diet and adopting a healthy lifestyle
What causes Benign Prostatic Hyperplasia?
The actual cause of BPH is still unknown. However, clinical studies show that the prostate of most men by the age of 50 will enlarge gradually due to hormonal changes that lead to overgrowth of the prostate tissue. The muscle tissue in the prostate will also contract and constrict the urethra. It can block the normal flow of urine and lead to difficulty in urination.
What are the symptoms of Benign Prostatic Hyperplasia?
BPH usually begins with slow urine flow. Since there is no pain or obvious nuisance, most men tend to ignore it. When the condition becomes more serious, there is difficulty in starting urination. This is because the enlarged prostate presses down on the urethra and causes the urethra to constrict, the bladder is then forced to press harder to push the urine out. The bladder wall becomes thicker and thicker while the bladder can hold less and less urine. It can lead to the following symptoms:
- Frequent urination. Having an urge to urinate many times during the day and getting up more often at night to urinate.
- Difficulty starting urination or delayed start while trying to urinate
- Hesitant, intermittent, weak or slow urine stream. Stopping and starting or even dribbling while urinating.
- Dribbling at the end of urination
- Feeling that the bladder is not completely emptied after urinating. Straining to urinate
- Having strong or sudden urge to urinate quite often, especially at night
- Urge incontinence, i.e. inability to control urination
- Urinary incontinence
- Acute urinary retention: A sudden, painful inability to urinate that leads to acute retention of urine in the bladder
- Lower abdominal discomfort
- Blood in the urine (hematuria)
Although BPH is not a seasonal affective condition, incidence of BPH occurs more often in winter. The reason is that cold weather stimulates the sympathetic nerves and strengthens muscle contraction of the prostate, which further constricts the urethra and brings on some of the symptoms. Besides, as people get flu more often in winter, some sinus medicines also strengthens muscle contraction of the prostate and increases the symptoms such as difficult urination.
The symptoms and severity of BPH vary from person to person, and do not necessarily correspond with the size of the prostate.
What are the complications of Benign Prostatic Hyperplasia?
Some men with BPH may not notice any symptoms. They may not know they have prostate problems until they suddenly experience painful inability to urinate. This condition is known as acute urinary retention. It demands immediate treatment. Otherwise, other complications may occur.
Common complications of BPH include:
1. Acute urinary retention
This is a sudden inability to urinate. The bladder becomes swollen and painful. It is an emergency that demands immediate medical attention.
2. Urinary tract infections
Residual urine caused by BPH may lead to recurrent urinary tract infections.
3. Bladder stones
BPH can increase the risk of bladder stone formation.
4. Blood in the urine
BPH may cause bleeding.
5. Impaired bladder function
BPH can cause bladder outlet obstruction. When the bladder has to work harder to push the urine out for a long period of time, the muscular wall of the bladder stretches and weakens and no longer contracts properly.
6. Impaired kidney function
Severe BPH can cause urine to back up in and damage the kidneys. Hydronephrosis, uremia and even kidney failure may result.
7. Prostatitis, an inflammation of the prostate gland.
It is believed that BPH does not lead to cancer, but both conditions can exist together.
