Are you at risk of benign prostatic hyperplasia development?

Benign prostatic hyperplasia (BHP) is basically a benign, i.e. non-cancerous growth of the prostate gland through the proliferation of its tissue. It doesn’t cause metastases, i.e. doesn’t spread to other organs. Nevertheless, it is a dangerous condition as it can not only significantly worsen the quality of life but also cause death due to kidney failure.

BHP is a very widespread condition, it is calculated that around 85% of men develop it by the age of 75 and older. The onset of the condition can occur much earlier – at the age of 40. However, the majority of cases are diagnosed in men aged 50-60 years.

There is no precise way how a man can prevent BPH with a hundred percent certainty although certain lifestyle changes can delay the onset and even help to cure BHP.

Who is at risk of developing BHP?

Basically, every man older than 50 is at risk. However, the risk is higher in the presence of risk factors:

- History of the disease in the family;

- Obesity;

- Diabetes;

- Sedentary lifestyle (without exercising);

- Erectile dysfunction;

- Low level of androgens;

- Heart or vascular disease.

As you can see, some of the risk factors cannot be avoided but others can be quite easily managed with proper diet and exercise.

When a man should go to a doctor?

There are several stages of BHP development. Naturally, it is highly preferable to go to your doctor with the first signs of the disease to be able to prevent its further development that leads to serious health complications and may even require surgery.

The first signs of BHP in which you should go to a urologist are:

- You notice that you need to urinate more frequently than before;

- You need to urinate at night even if you haven’t been drinking before bed;

- It became difficult to start urinating;

- You notice that urine stream is weaker than usual;

- When you urinate the stream can stop and then restart;

- You notice dribbling at the end of urination;

- You feel that your bladder isn’t completely emptied after urination.

In some men, these signs occur altogether, however, in the majority of cases the first sign is just more frequent urination. It doesn’t matter what age you are, you should go to a urologist to get checked. In younger men, it could be a sign of urinary tract infection that requires treatment and in men around 50 and older it is likely to be the onset of BHP that also requires appropriate measures taken to avoid progressing of the disease.

If the disease is untreated, it causes the following complications:

- Urinary tract infections;

- Bladder stones;

- Kidney failure.

These complications develop as the disease progresses and the outflow of urine becomes lesser and residue urine is accumulated in the bladder. If these complications develop, surgery is required.

How can BHP be diagnosed?

The initial diagnosis is made based on a patient’s complaints and physical examination of the prostate done by a urologist through the rectum.

To clarify the diagnosis and know more about the tumor size, degree of urethra obstruction, to be sure that the tumor is non-cancerous, further tests are made such as:

- Ultrasound;

- X-ray;

- Blood and urine tests;

- Urine flow rate test.

It is important in the presence of symptoms exclude other health conditions that may be causing them, for instance, diabetes, heart disease, or cancer. Thus, even if a man suspects BHP, he should never start the use of BHP drugs without being properly tested first.

How is BHP treated?

The treatment of the condition is chosen based on the severity and absence or presence of complications. At the first stages of the disease, the major part of the treatment is focused on the reduction of the blockage of the urethra to avoid the accumulation of residue urine and in general facilitate urination. The drugs for this purpose are Alpha-1-blockers, 5α-Reductase inhibitors, and PDE5 inhibitors. By suppressing the effect of certain substances they promote smooth muscle relaxation in the pelvic organs resulting in facilitated urination.

Besides, to reduce the size of the tumor and slow down its growth, 5-alpha reductase inhibitors are used. These medicines prevent the transformation of testosterone into active form dihydrotestosterone which is one of the factors responsible for prostate enlargement. In the presence of androgens deficiency, androgen-replacement therapy is also prescribed.

- Incorporation of physical exercising in daily life;

- Avoiding drinking any fluids before going to bed;

- Minimizing the consumption of caffeine and alcohol to avoid frequent urges to urinate and acute retention of urine;

- Avoiding medications with anticholinergic effects (allergy drugs, opioids, tricyclic antidepressants, etc.) that can worsen urine retention.

If a man has neglected the condition for many years or if the treatment measures, although implemented are ineffective, surgery on the prostate is done. There are two types of surgery – open and endoscopic. Endoscopic surgery is less invasive but it could be unsuitable for severe cases.