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Key points
Key points- Benign prostatic hyperplasia is the growth of the prostate, which can obstruct the flow of urine from the bladder.
- Its symptoms include a weak stream, frequent urination, incomplete emptying, nocturia, and urgency.
- Age, family history, a sedentary lifestyle, and obesity are identified risk factors.
- Treatment can be pharmacological or surgical and should be determined by a urologist for each patient.
What benign prostatic hyperplasia (BPH) is
The prostate is an organ located beneath the bladder that plays a part in the formation of semen.
In many men, the prostate grows continuously throughout life, which can obstruct the flow of urine from the bladder. This growth is called benign prostatic hyperplasia (BPH).
BPH can cause bothersome urinary symptoms.
Symptoms of BPH
Weak urinary stream and frequent urination
BPH causes the need to urinate often, and the urine stream can be weak and thin.
Feeling of incomplete bladder emptying
Sometimes, patients with BPH feel that they do not empty their bladder completely when they go to urinate.
Nocturia
This is the need to urinate frequently during the night.
Urinary urgency
This is a strong, sudden need to urinate. Sometimes the urge is so intense that it can cause urinary incontinence.
Causes and risk factors of BPH
The precise mechanism by which prostatic hyperplasia develops is unknown, but some risk factors have been identified.
Aging
Prostate growth usually begins before age 40, and urinary symptoms usually appear from age 50 onward. How often BPH causes symptoms increases with age.
Family history
Having a direct relative with prostatic hyperplasia, such as a father, grandfather, or brother, makes symptoms more likely.
Lifestyle
A sedentary lifestyle and obesity have been linked to a higher risk of prostatic hyperplasia.
How BPH is diagnosed
To find out whether urinary symptoms are caused by prostate growth, a detailed medical history is taken.
First
Medical interview
Questions about family history and lifestyle.
Then
Physical exam
An exam of the prostate through a digital rectal exam (DRE).
Also
Validated questionnaires
Questionnaires for prostatic hyperplasia, such as the IPSS (prostate symptom score).
Finally
Diagnostic aids
Urinalysis, prostate-specific antigen (PSA) testing, and prostate ultrasound.
How to treat benign prostatic hyperplasia
There are different forms of treatment, divided into pharmacological and surgical. If a patient does not respond to pharmacological treatment, surgical treatment may be considered. The choice is made by the specialist and each patient.
Pharmacological treatments
These medications must be prescribed and monitored by a doctor; do not start or stop them on your own.
Alpha blockers
Alfuzosin, tamsulosin, prazosin.
5-alpha reductase inhibitors
Dutasteride, finasteride.
Herbal products
Urtica dioica, Serenoa repens (saw palmetto).
Phosphodiesterase 5 inhibitors
Tadalafil, sildenafil.
Surgical treatments
- Transurethral resection of the prostate (TURP).
- Open prostatectomy.
- Anatomical endoscopic enucleation of the prostate (AEEP), with techniques such as HoLEP, BiLEP, ThuLEP, or GreenLEP.
- Laser vaporization.
- UroLift.
- Rezūm.
If you have urinary symptoms, see a specialist for an evaluation. Dr. Bricio, a urologist in Puerto Vallarta, can evaluate your case and explain the options that are right for you.
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