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Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH): Symptoms, Diagnosis, and Treatment

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that affects men as they age, causing urinary symptoms due to urethral compression. While not life-threatening, untreated BPH can lead to complications like urinary tract infections (UTIs) or kidney damage.

Symptoms of BPH

Symptoms vary by severity and may worsen over time:

1. Lower Urinary Tract Symptoms (LUTS):
   • Urinary frequency, nocturia (nighttime urination), and urgency.
   • Weak or interrupted urine stream, dribbling, or straining to urinate.
   • Incomplete bladder emptying or urinary retention.
2. Less Common Symptoms:
   • UTIs, burning/painful urination, or blood in urine.
   • Bladder stones or kidney dysfunction in advanced cases134.

Note: Symptoms may improve, stabilize, or progress unpredictably34.

Diagnosis

Diagnosis combines clinical evaluation and tests:

1. Physical Exam:
   • Digital rectal exam (DRE): Assesses prostate size and texture (smooth vs. lumpy).
   • Bladder palpation: Checks for distension.
2. Blood Tests:
   • PSA: Elevated levels may indicate BPH or prostate cancer; requires further testing (e.g., biopsy)25.
   • Kidney function: Creatinine or BUN to rule out kidney damage5.
3. Imaging:
   • Ultrasound: Measures bladder residual urine volume.
   • Uroflowmetry: Assesses urine flow rate and bladder emptying24.
4. Exclusion of Other Conditions:
   • Urinalysis: Rules out UTIs or bladder stones.
   • Multiparametric MRI: Used if PSA is elevated to exclude cancer25.

Treatment

Treatment depends on symptom severity and quality of life:

1. Watchful Waiting:
   • Active surveillance for mild symptoms, with lifestyle adjustments:
     • Limit fluids before bedtime or travel.
     • Avoid caffeine/alcohol and urinate when needed47.
2. Medications:
   • Alpha-blockers (e.g., terazosin): Relax prostate/bladder muscles.
   • 5α-reductase inhibitors (e.g., finasteride): Shrink prostate size23.
3. Minimally Invasive Procedures:
   • Laser therapy, microwave ablation, or transurethral resection (TURP).
4. Surgery:
   • Open prostatectomy for large prostates13.

Complications

• Urinary Retention: Requires catheterization.
• UTIs, bladder stones, or kidney damage from prolonged obstruction14.
• Prostate Cancer: Elevated PSA warrants biopsy to exclude malignancy25.

Risk Factors

• Age: Risk increases after 50 years.
• Family History: Genetic predisposition.
• Obesity, diabetes, or sedentary lifestyle37.

Conclusion

BPH is a common age-related condition requiring tailored management. Early diagnosis via DRE, PSA testing, and imaging helps differentiate it from prostate cancer, while medications or interventions alleviate symptoms and prevent complications.

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At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Benign Prostatic Hyperplasia (BPH) or would like more information on our services, consult with our experts today!

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References

1. MedPark Hospital: BPH Symptoms
2. MSD Manuals: BPH Diagnosis
3. Mayo Clinic: BPH Symptoms
4. NIDDK: BPH Symptoms
5. Johns Hopkins: BPH Diagnosis
6. Mayo Clinic: BPH Treatment
7. Urology Care Foundation: BPH
8. StatPearls: BPH