Before we talk about benign prostate hyperplasia or BPH as it commonly known, we should understand what does the term hyperplasia means? Well hyperplasia is an increase in the number of cells in a tissue or an organ. Hyperplasia can occur due to hormonal or antigenic stimulation. Benign prostate hyperplasia is a very common condition in men; in fact it is so common that it is considered by many as a part of the normal ageing process. Its incidence increases with age. Almost 80% of men above the age of 80 are likely to have BPH. The prostate enlarges in size but it is not a pre-malignant condition.
The exact cause of BPH is still unknown. However it has been suggested that androgens play quite an important role in its pathogenesis. Estrogen (the female hormone) and Androgen (the male hormone) are found in both the sexes though estrogen levels are more in females and androgen levels in males. With advancing age, androgen levels go down in males and there is a corresponding increase in the estrogen levels. The increased estrogen stimulates the prostate gland and leads to BPH.
Men having benign enlargement of prostate present with increased urinary frequency. They need to urinate several times in a day and the frequency increases in night too. Other problem is urgency, that it they have an urgent desire to pass urine. They cannot control their bladder functions fully. These patients often have trouble starting and stopping the urine stream. They are not able to empty their bladders completely and this leads to a large amount of residual urine which remains in the bladder even after the person has urinated. This eventually leads to bladder inflammation.
The complications associated with BPH are many. The prostate enlarges and compresses the urethra which becomes narrow. The bladder becomes more prone to infection and stone formation. This is because the bladder musculature thickens, and develops what are known as trabecualtions. BPH can also cause hydronephrosis, which is dilatation of the kidneys. This can eventually lead to renal failure
The diagnosis of BPH is usually done by per rectal examination. The enlarged lobes can be easily felt. In addition to this Uroflowmetry is also done in which the patient is asked to void urine from his full bladder into the flowmeter. The normal flow rate is 20ml/sec. If it’s less than 10ml/sec, then it’s almost confirmatory of bladder obstruction, which is usually secondary to BPH. Ultrasounds are quite often done in BPH patients to assess the weight and size of prostate. The effect on kidney can also be seen in an ultra sonogram.
The treatment of Benign Prostate Hyperplasia will be discussed in another article.
January 21st, 2012 at 12:50 am
Thank you for your useful informative article. I feel I’ve come away a little smarter and more open-minded by reading your article. I am saving your article to my favorites to show to my family.