Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The growth is not due to cancer.
The prostate is a walnut-sized gland located at the neck of the bladder. It surrounds the urethra. The gland is part of the male reproductive system.
The exact cause of BPH is unknown. It may be related to changes in hormone levels as men age. Eventually, the prostate becomes so enlarged that it puts pressure on the urethra. This causes the urethra to narrow or close completely.
A risk factor is something that increases your chance of getting a disease or condition.
The main risk factor for BPH is being over 50 years old. By age 60, 50% of all men will have some sign of BPH.
Narrowing of the urethra caused by growth of the prostate causes the symptoms of BPH. Symptoms usually increase in severity over time.
Symptoms include:
BPH diagnosis is based on:
Other tests may include:
Testing for prostate specific antigen (PSA) is often used to screen for prostate cancer. However BPH may cause a lesser elevation in PSA levels . This can raise false concerns about the presence of cancer.
Treatment is not needed for mild cases. Most men with BPH eventually request medical intervention.
Treatments include:
Medications include:
Both of groups of medications have different side effects:
Enzyme inhibitors may cause decreased sexual desire and problems with erection. The alpha-blockers may cause decreased blood pressure, dizziness, and stuffy nose. At times they are combined together.
Men with BPH should not take decongestant drugs containing alpha-agonists such as pseudoephedrine . These drugs can worsen the symptoms of BPH.
These are used when drugs are ineffective, but the patient is not ready for surgery. Nonsurgical treatments include:
Surgical procedures include:
Three different herbal products are used for BPH:
If you are diagnosed with BPH, follow your doctor's instructions .
RESOURCES:
National Kidney and Urologic Diseases Clearinghouse
http://kidney.niddk.nih.gov/
The Prostate Institute
http://www.prostateinstitute.org/
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org/
Prostate Centre
http://www.prostatecentre.ca/
References:
Berkow R, et al. The Merck Manual of Medical Information . 17th ed. Simon and Schuster, Inc.;2000.
Carson CC. Combination of phosphodiesterase-5 inhibitors and alpha-blockers in patients with benign prostatic hyperplasia: treatments of lower urinary tract symptoms, erectile dysfunction, or both? BJU Int . 2006 Apr;97Suppl 2:39-43;44-5.
Clinical Guidelines. American Urological Association. Available at: http://www.auanet.org/guidelines/bph.cfm . Accessed June 30,2008.
Fagelman E, Lowe FC. Saw palmetto berry as a treatment for BPH. Rev Urol . 2001 Summer;3(3):134-8.
Fried NM. New laser treatment approaches for benign prostatic hyperplasia. Curr Urol Rep . 2007 Jan;8(1):47-52.
Marberger M. Drug insight: 5-alpha-reductase inhibitors for the treatment of benign prostatic hyperplasia. Nat Clin Pract Urol . 2006 Sep;3(9):495-503.
Prostate enlargement: Benign prostatic hyperplasia. National Kidney Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/ . Accessed June 30, 2008.
Ulbricht C, Basch E, Bent S, et al. Evidence-based systematic review of saw palmetto by the Natural Standard Research Collaboration. J Soc Integr Oncol . 2006 Fall;4(4):170-86.
Last reviewed November 2008 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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