Hyperplasia of the prostate
BPH is the most frequent benign prostate tumor in males, an enlargement of the prostate gland that is not malignant.
BPH is more common in Western countries, such as the United States than in Eastern countries, such as Japan and China. Male relatives of men with BPH had a four-fold increase in the likelihood of needing surgery than other men. According to a recent study on BPH in males younger than 65 with a significantly larger prostate, their brothers had a six-fold increase in risk.
Urinary flow through the urethra is obstructed by BPH, which causes symptoms. By the age of 55, a man is likely to suffer BPH symptoms, and if symptoms become severe, seek medical treatment. By the age of 80, between 20% to 30% of him will have BPH symptoms severe enough to necessitate medical intervention. Before the recent approval of less invasive techniques and medications that can alleviate symptoms by decreasing or relaxing the prostate muscular tissue that constricts the urethra, surgery was the sole option for treating prostatic hyperplasia.
Symptoms and Signs
- Some BPH symptoms are directly related to a urethral obstruction, while others result from subsequent bladder alterations.
- Obstructive symptoms commonly include:
- Inability to begin urinating despite my best efforts, despite pressing and straining
- The stream of pee was faint, and there were multiple breaks.
- At the finish of urinating, the dribbling begins.
- Changes in the bladder are the result of:
- an overwhelming need to relieve one’s bladder (urgency)
- urinary incontinence
- a feeling that one’s bladder is still half-full after urinating
Detection and Treatment
Assessment of BPH symptoms can be made objectively using the American Urological Association (AUA) Symptom Index. Other disorders may induce symptoms that are similar to those of BPH.
Conditions that may mimic BPH include urethral stricture, bladder cancer, stones, or irregular bladder/pelvic floor function (issues with holding or emptying pee owing to a neurologic illness (neurogenic bladder) or pelvic floor muscular spasms). This can be caused by previous trauma, instrumentation (such as catheter placement), or an infection (e.g., gonorrhea). If there is a history of blood in the urine, bladder cancer is suspected.
Bladder stones, infections, compression, or irritation of the pudendal nerve may cause pain in the penis or bladder area. A neurogenic bladder may be suspected when a man has diabetes, a neurologic condition like multiple sclerosis or Parkinson’s disease, or a recent decline in sexual performance. Inquire about any worsening of urinary symptoms while taking cold or sinus medications, as well as any prior infections of the urinary tract or prostatitis, in a comprehensive medical history (inflammation of the prostate, which may cause pain in the lower back and the area between the scrotum and rectum, and chills, fever, and general malaise). Men with BPH may worsen their voiding symptoms if they are using any over-the-counter or prescription medications, so that the doctor will inquire about this.
To begin, the doctor may watch the patient’s urinating to see if there are any abnormalities. If a lump is found in the lower abdomen, the doctor will perform an ultrasound to rule out a urinary tract infection. The physician must also complete a digital rectal exam (DRE), which measures the prostate’s size, shape, and consistency to make a thorough diagnosis. A gloved finger is introduced into the rectum during this critical inspection, which is just minimally unpleasant. Prostate cancer is suspected when hard or firm regions are found in the prostate. A physical exam may involve assessing the nervous system to see if any abnormalities could indicate the presence of a neurogenic bladder.
Suppose the symptoms of BPH are minor and no other abnormalities are detected based on the patient’s medical history and physical examination. In that case, a urinalysis may be the only laboratory test necessary. If an infection of the urinary tract is suspected, a urine culture is added. A blood creatinine of blood urea nitrogen (BUN) and hemoglobin test rule out renal impairment and anemia in patients with more severe, persistent BPH symptoms. Both the PSA blood test and the DRE are suggested to detect prostate cancer in the early stages. BPH and prostate cancer raise PSA levels, so a single test cannot distinguish between the two.