Dr. Ranjan Kumar Mohapatra

Benign Prostate Hyperplasia (BPH) is a condition which results in the enlargement of the prostate gland. The Prostate gland is situated near the Urethra (a tube which helps flush out the urine from the bladder). Generally, the chance of developing BPH increases after one crosses the age of 50. But it is yet unknown as to why some men experience more severe symptoms than others.

Causes of BPH
This condition generally occurs because of old age and affects almost all men above the age of 75. It occurs because of the various hormonal changes and changes in cell growth that the body goes through, as one becomes old. Sometimes BPH can set in due to genetics. If BPH sets in due to genetically reasons, it usually is quite severe and affects men before they reach 60.

Symptoms of BPH
Quite a few men who develop BPH, experience no symptoms at all. But when symptoms of BPH, known as lower urinary tract symptoms (LUT) start, they can be either mild or very severe. The severity of the symptoms is not related to the extent of the enlargement. Many a times men with only a mild enlargement complain about severe symptoms, while men with a highly enlarged prostate gland have not complained about any discomfort faced. 

Symptoms of BPH tend to worsen due to cold weather and also because of physical and emotional overexertion. There are certain medicines, which should be avoided if you suffer from BPH, as they have a tendency to worsen your symptoms, for example diphenhydramine, pseudoephedrine, oxymetazoline spray and other antidepressants.

The symptoms of BPH are related to bladder emptying and issues with bladder storage.

Symptoms related to the urine drainage from the bladder are:

1. Strain while urinating
2. Weak urine flow
3. Some dribbling after urination
4. Sudden urge to urinate
5. Pain while urinating

Symptoms related to storage of urine in the bladder are:

1. Waking during the night to urinate
2. Urinating frequently during the day and at night
3. Sudden urge to urinate, which may be hard to control

It however, has to be kept in mind that these symptoms may not primarily occur due to prostate enlargement, but are the result of other conditions like urinary tract infections, prostatitis, prostate cancer, neurological disorders and even diabetes. Thus, it is essential that you visit a doctor and get the cause for these symptoms diagnosed properly.

The prostate gland in males surrounds the urethra, through which urine and sperm are passed out of the body. Its function is to secrete a fluid, which provides nourishment to the sperm. It is about the shape of a walnut and is present between the pubic bone and the rectum.

As a man crosses 40, the prostate gland begins to increase in size due to an increase in the number of cells. This is known as hyperplasia. The condition is usually benign and therefore the name benign prostate hyperplasia (BPH). As it continues to grow, there is an increased pressure on the urethra. Therefore, there can be problems with urination. The bladder, being a muscular organ, compensates to some extent and so the problems with urination are mostly managed. If left untreated, this can continue to be a major problem and the bladder may not be able to compensate. In men who are 60-plus, BPH is very common.

Signs and symptoms 

1. One of the initial symptoms of BPH is when the urine stream begins to grow weak.
2. There could also be a reduced speed of passing urine.
3. Men with BPH never have a feeling of complete emptying of the bladder.
4. On the other hand, there is also a constant difficulty in initiating a urine stream. There could be intermittent breaks in the urine stream.
5. The person may feel the need to strain to initiate the stream and to ensure complete emptying.
6. There could be dribbling of urine after passing urine.
7. The duration between two bathroom visits can constantly reduce, with the constant urge to urinate.
8. There is a constant urge to visit the bathroom, which is more common in the night. One of the most annoying features of BPH is the walking up at night to urinate, but with an inability to initiate a stream and an inability to completely empty the bladder, it leaves the person very irritated and frustrated.
9. There could be blood in the urine. In fact, blood in the urine accompanied by fever, chills, nausea and vomiting are indications of an emergency.
10. There could be blockage of urine completely, if the enlargement is quite severe.

Diagnosis
If you are having any of these symptoms, then the doctor will first test for an enlarged prostate through a digital rectal exam. Then a test is done to check a chemical called prostate specific antigen.  Increased levels of this chemical is almost always indicative of BPH. In addition, X-rays and scanning may be used to confirm diagnosis. 

Treatment
Though medications are available, confirmatory treatment is through surgical removal. The procedure needs a inimum of 2 to 3 days. If you wish to discuss about any specific problem, you can consult a urologist and ask a free question.