Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is the enlargement or hypertrophy of the prostate. It is the most common pathologic condition found in men over 50 years of age. It is also studied that BPH is the second most common cause of surgical intervention in men over 60 years of age. The cause of benign prostatic hyperplasia is uncertain, but evidences suggest that hormones are responsible for causing hyperplasia.

In BPH , the prostate gland enlarges, extends upward into the bladder and obstructs the outflow of urine by encroaching the vesical opening. The enlarged lobe that obstructs the vesical neck or prostatic urethra causes incomplete emptying and urinary retention. As a result, dilatation of ureters and kidneys can occur. This in turn may result in urinary tract infection caused by urinary stasis.

The symptoms of benign prostatic hyperplasia includes increased frequency of urination, nocturia (increased urination at nights), urgency, hesitancy in starting urination, abdominal staining, a decrease in the volume and force in the urinary stream, interruption of the urinary stream, dribbling (in which urine dribbles out after urination), a sensation that the bladder has not emptied completely, urinary retention (when there is more than 60 ml of urine in the bladder after urination) and recurrent urinary tract infections.

Signs of urinary tract infection like fever, vomiting, abdominal pain, painful urination, and back pain can occur. Ultimately, accumulation of nitrogengenous waste products (azotemia) results that may lead to kidney failure. Kidney failure can also occur as a result of urinary retention and large residual volumes. Other generalized symptoms may be noted, including fatigue, anorexia (loss of appetite), nausea, vomiting and abdominal discomfort.

A battery of tests confirms the diagnosis of BPH. Digital rectal examination, urine analysis and urodynamic studies are done to assess any obstruction in urine flow patterns. Renal function tests including serum creatinine is done to evaluate the function of kidneys. Complete blood studies are performed because hemorrhage is a major post operative complication.

Symptoms can be medically and surgically treated. Medicines like alpha 1 adrenergic receptor blockers and 5 alpha reductase inhibitors are used to treat BPH, but these medicines have their own side effects. Surgically, they are treated by a procedure called transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP).

The symptoms of BPH is pretty much self identifiable. Since this is very common in elderly men, it is better to anticipate and get tested frequently. If you are old and feel that you have any of the above mentioned symptoms, it is better to visit a physician immediately. This will save lot of pain and complications like kidney failure.