Benign Prostate Hyperplasia

What is Benign Prostatic Hyperplasia?

Benign Prostatic Hyperplasia is the enlargement of the prostate gland which, due to its anatomical position, results in the obstruction of the outflow of urine from the bladder. It is one of the most common diseases affecting men.

Benign prostatic hyperplasia or prostatic enlargement manifests itself mainly after the age of 40. At this age, 40% of men present symptoms of this disease, which are mainly manifested in alterations in urinary dynamics. This percentage increases by 10% as each decade progresses, so that almost all men over 80 years of age have urinary problems.

Urinary symptoms may be due to different causes. Among these, one of the most common is benign prostatic hyperplasia, although it is necessary to rule out others: narrowing of the urine duct (urethral stricture), bladder tumor, bladder stones, urinary tract infections, etcetera.

Usually, most urinary symptoms are due to benign prostatic hyperplasia, which can cause obstruction in the flow of urine. Commonly, these clinical pictures are known as prostatism or prostate problems.

The main symptoms of Benign Prostatic Hyperplasia (BPH) are:

• Nocturnal frequency of urination (nocturia).
• Diurnal frequency of urination.
• Urinary incontinence.
• Itching or difficulty urinating.
• Sensation of incomplete urination.
• Weak urine stream.
• Delayed onset of urination.
• Dribbling after urination.

The cause of the disease is unknown, although there appear to be genetic, hormonal, dietary and health factors that may increase the risk of prostate problems.

The diagnosis of benign prostatic hyperplasia is made by clinical history and physical examination. Within the basic study, a blood test with PSA (Prostate Specific Antigen) and renal function, urinalysis (with a urine culture to rule out infection) and renal, bladder and prostate ultrasound are usually requested. Sometimes it will be necessary to perform more directed studies such as cystoscopy, urodynamics or transrectal ultrasound.

Treatments vary depending on the severity and intensity of symptoms:

• In cases of mild enlarged prostate symptoms with no associated complications, it is possible to without associated complications, it is possible to achieve very good control of the disease through periodic check-ups and by following a series of basic dietary advice: evening water restriction, avoiding spicy foods, caffeine, alcohol and carbonated or sweetened beverages.

• If we have moderate symptomsIf we have moderate symptoms, we can usually take a series of medications to improve the symptoms. Depending on the size of the prostate and the presence or not of incontinence, it will be necessary to associate phytotherapy; alpha blockers to reduce blood pressure and improve blood flow; 5-alpha-reductase inhibitors to reduce the size of an enlarged prostate and improve urine flow by blocking an enzyme that the body needs to make dihydrotestosterone; or anticholinergics. It is very important to understand the side effects of these treatments, especially on the sexual sphere, when considering the best treatment for each person.