Benign prostatic hyperplasia, or BPH, is a condition whereby the prostate gland becomes enlarged. When the prostate is enlarged, it can press on the urethra thereby causing a slower and less forceful flow of urine.
The onset of BPH is gradual, and there are several symptoms which can occur. One symptom is the need to get up more frequently at night to urinate. Other symptoms include the increased need to empty the bladder during the day, difficulty in starting the urine flow and decrease in size and strength of the urine stream.
One of the primary causes of BPH is age. Beginning at puberty, the prostate grows rapidly. This growth eventually levels off, but begins again in later life. During their lifetimes men produce both testosterone and estrogen. As men grow older, testosterone decreases, leaving a higher proportion of estrogen. Studies in laboratory animals suggest that the higher amount of estrogen within the prostate gland may increase the activity of substances that can promote cell growth, thereby causing BPH to occur. Most men will not experience symptoms before 40, but half of men in their sixties and as many as 90 percent in their seventies and eighties may have symptoms.
Diagnosis
There are a variety of tests that can help to determine if you have BPH. One of the first is a digital rectal exam. This exam is performed by a doctor inserting a gloved finger into the rectum and feeling the gland to determine its size and condition. If BPH is suspected, he may wish to refer you to a urologist.
A doctor may also recommend a PSA blood test in order to rule out cancer. PSA is a protein produced by prostate cells and is frequently elevated in men who have prostate cancer. This test is normally utilized along with the digital rectal exam in men over 50. However, much remains unknown about the interpretation of PSA levels and the test’s ability to differentiate between cancerous and benign conditions.
A rectal ultrasound and prostate biopsy may be suggested if there is a suspicion of prostate cancer. This procedure consists of a probe being inserted into the rectum and directing sound waves at the prostate. The echo patterns of the sound waves produce an image of the prostate gland on a display screen. The doctor can use the probe and the ultrasound images to perform a needle biopsy of any abnormal looking area.
Another test that may be performed is a urine flow study. The doctor may have you urinate into a special device that measures urine flow.
A cystoscopy may be performed by having the doctor insert a small tube through the opening of the urethra in the penis. After the inside of the penis is numbed, the doctor will insert a cystoscope that will help him see the inside of the urethra and bladder. He can then determine the size of the gland and pinpoint the location and dimension of the obstruction.
The symptoms of BPH may disappear over time. The doctor may wish to take a “wait and see” attitude and may suggest regular checkups to monitor you. However, if you find you need additional treatment of this condition, there are a variety of drug treatments and procedures available to you.
