The most common benign tumor found in men is Benign Prostatic Hyperplasia (BPH)1Hopkinsmedicine.org. n.d. Benign Prostatic Hyperplasia (BPH). [online] Available at: <https://www.hopkinsmedicine.org/health/conditions-and-diseases/benign-prostatic-hyperplasia-bph> [Accessed 13 February 2022].. It affects approximately 90% of men over the age of 85, and although it is benign, it can come with some intense anxiety, symptoms and potential complications if not treated properly. At first, the symptoms may be the sudden inability to urinate and urinary tract infections, but this can lead to bladder stones, bladder damage and kidney damage if proper treatment isn’t received2Shrivastava, A., & Gupta, V. B. (2012). Various treatment options for benign prostatic hyperplasia: A current update. Journal of mid-life health, 3(1), 10–19. https://doi.org/10.4103/0976-7800.98811. But keep in mind, most men with an enlarged prostate don’t develop these complications and instead, remain fairly asymptomatic. Unfortunately, that doesn’t mean you’re clear of the potential health risks too. So, to give you an idea of what you’re looking at in terms of BPH and whether or not you have it and should seek treatment – and if so, what treatment, consider this your go-to guide.
What is Benign Prostatic Hyperplasia
Put simply, benign prostatic hyperplasia (BPH), is an enlarged prostate gland, which is a common condition for men as they age. A noncancerous enlargement is also the most common benign tumor found in men. BPH occurs more often in Western countries than in Eastern countries. This is also true for prostate cancer, suggesting a possible link between the Western diet and lifestyle and prostate health3Wen, S., Mei, E. and Yin, K., 2017. The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: A systematic review and meta-analysis. [online] Scientific Reports. Available at: <https://www.nature.com/articles/s41598-017-06628-8> [Accessed 13 February 2022]..
This potentially serious health condition can lead to many uncomfortable and potentially life-threatening symptoms. Typically, the first signs of BPH are urinary symptoms, including a blocked flow of urine out of the bladder, the frequent or urgent need to urinate, difficulty urinating or a weak urine stream. However, symptoms gradually worsen with time (and no treatment) and can cause bladder, urinary tract or kidney problems. Keep in mind that the size of your prostate doesn’t determine the severity of your condition. You can have a slightly enlarged prostate with fairly significant symptoms and vice versa.
But what causes BPH? It isn’t entirely clear, but some studies suggest that a change in the balance of sex hormones may be a culprit or, at least, a contributing factor. Although, studies have found some common risk factors for prostate gland enlargement, including age, family history, diabetes and heart disease and lifestyle4Mayo Clinic. 2021. Benign prostatic hyperplasia (BPH) – Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087> [Accessed 13 February 2022].. It is also predominantly a health concern in Western countries than Eastern countries, suggesting a possible link between the Western diet and lifestyle and the development of BPH5Kopp W. (2018). Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension?. Nutrition and metabolic insights, 11, 1178638818773072. https://doi.org/10.1177/1178638818773072.
Common treatments for BPH
There’s no shortage of options when it comes to the treatment for benign prostatic hyperplasia. From medication to minimal invasive surgery and medical procedures, selecting the best treatment for you depends on a variety of factors. Speaking with a healthcare professional can help you go through the different options. However, as a rule of thumb, the best course of action depends on the size of your prostate, your age, your overall health and the amount of discomfort you’re experiencing. Additionally, you’ll want to think about the expense associated with the different forms of treatment, as well as the different recovery times. However, these are factors that shouldn’t take precedence over your health. For example, invasive surgery may have a longer recovery time than medication. Still, if your enlarged prostate gland requires a more intense procedure for proper treatment, then that should be your top priority.
Additionally, you may be able to postpone treatment and opt to monitor your symptoms if they are tolerable. In some cases, BPH symptoms can ease without treatment. Again, this is why it’s important to think about your case and symptoms to determine the best treatment for you.
Below is some more information about the treatment options available.
Medication
Medication: a common treatment plan for mild to moderate symptoms of BPH. There are many different options to choose from, including:
- Alpha blockers: medications designed to relax muscles in your bladder and prostate to make urination easier. These are designed to work quickly in men with relatively small prostates and slight symptoms. Though, potential side effects include dizziness and a (harmless) condition where semen doesn’t go out of the tip of the penis and goes back into the bladder instead (retrograde ejaculation).
- 5-alpha reductase inhibitors: medications that prevent hormonal changes that cause prostate growth, to shrink your prostate. These medications can take up to six months to be effective and cause retrograde ejaculation.
- Combination of the two: Your doctor can create a plan that combines the two medications mentioned if either of the medications weren’t effective when taken alone.
- Tadalafil (Cialis): medication often used to treat erectile dysfunction but has also been proven to treat prostate enlargement.
Surgery
Both minimally invasive and surgical therapy can help treat benign prostatic hyperplasia. These options are typically recommended if your symptoms are moderate to severe, medication hasn’t worked, or you have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems. Additionally, you can opt for these treatments if you prefer an ideal option.
However, surgery may not be an option if you have an untreated urinary tract infection, urethral stricture disease, a neurological disorder, such as Parkinson’s disease or M.S., or have a history of prostate radiation therapy or urinary tract surgery.
Additionally, any prostate procedure can cause side effects. These depend on the type of procedure you choose. Still, complications can include retrograde ejaculation, temporary difficulty with urination, urinary tract infection, bleeding, erectile dysfunction or, very rarely, a loss of bladder control (incontinence).
There are several types of surgical procedures available for BPH. Here are a few of the most common options:
- Transurethral resection of the prostate: procedure uses a to remove all parts of the prostate, except the outer part. This procedure typically relieves symptoms quickly.
- Transurethral incision of the prostate: procedure that uses a scope to make one or two small cuts in the prostate gland to allow for easier urination. This is an ideal surgery if you have a small or moderately enlarged prostate gland or health problems that make other surgeries too risky.
- Transurethral microwave thermotherapy: a procedure that uses a special electrode to destroy the inner portion of the enlarged prostate gland, which shrinks it and makes urine flow easier. This treatment may only partially relieve your symptoms, and it can take some time for results to appear. This surgery is generally only used on small prostates in special circumstances.
- Transurethral needle ablation: a procedure that uses a scope and needles to allow radio waves to pass through and destroy excess prostate tissue that’s creating a blockage to urine flow. This procedure is rarely used today but is still a possible option.
- Laser therapy: procedure uses a high-energy laser to destroy or remove overgrown prostate tissue. It generally relieves symptoms immediately and has a lower risk of side effects. This procedure is also typically used in men who can’t have other prostate procedures because they are on blood-thinning medications.
- Prostatic urethral lift: procedure that uses special tags to compress the sides of the prostate, allowing for increased urine flow. This procedure may not be recommended if you have lower urinary tract symptoms, but it is typically offered to men concerned about treatment impact on erectile dysfunction and ejaculatory problems.
- Open or robot-assisted prostatectomy: a procedure where an incision is made in your lower abdomen to access the prostate and remove tissue. This option is typically done if you have an extremely large prostate, bladder damage or other complicating factors. It usually involves a short hospital stay.
Benign Prostatic Hyperplasia affects approximately 90% of men over the age of 85 years old who have BPH. Studies also show that as many as 14 million men in the U.S. currently experience symptoms6National Institute of Diabetes and Digestive and Kidney Diseases. 2014. Prostate Enlargement (Benign Prostatic Hyperplasia). [online] Available at: <https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia> [Accessed 13 February 2022].. There are various treatment options to choose from, so you can quickly and effectively regain your comfort and confidence again.
: Causes and Treatments){kind=link}