Benign prostatic hyperplasia (BPH) is a prevalent ailment in men, with 1.35 million Korean men seeking medical attention in 2021 alone.
While it is uncommon in younger men, middle-aged and older men aged 50 and above are primarily affected, with its development linked to male hormones and the aging process. The prevalence of BPH increases with age, estimated to affect around 50 percent of men in their 50s, 60 percent in their 60s, and 70 percent in their 70s.
Symptoms of enlarged prostate
In men, the prostate is the passageway for urine and semen, and a normal prostate is 15 to 20 milliliters (ml), about the size of a chestnut. When the prostate is abnormally enlarged, the urethra narrows, causing discomfort when urinating and passing semen. Common symptoms associated with this condition include reduced urine flow, frequent urination (more than 8 times a day), nocturia (waking up during the night to urinate), the presence of residual urine following urination, and a sense of urgency to urinate.
These urinary symptoms caused by an enlarged prostate are collectively referred to as lower urinary tract symptoms (LUTS).
Causes
BPH is a chronic condition influenced by various factors. Among these factors are male hormones and the natural aging process. Male hormones, specifically testosterone and dihydrotestosterone (DHT), play crucial roles in this condition. As men age, there can be irregularities in the secretion of DHT, which is responsible for the growth of the prostate. Consequently, this abnormal growth leads to the enlargement of the prostate, contributing to the development of BPH.
BPH primarily affects individuals over the age of 50, but it can also manifest in men as young as those in their 20s and 30s.
Individuals with sedentary occupations, such as office workers or drivers, may experience its onset at an earlier age.
Additionally, factors such as obesity, genetics, and metabolic syndrome have been identified as playing significant roles in its development.
Diagnosis, treatment
Diagnosing BPH relies on the identification of specific symptoms, including LUTS, bladder outlet obstruction, and prostate enlargement. To confirm the diagnosis, several diagnostic tests are employed, such as a physical examination, urinalysis, and ultrasound of the prostate.
Urinalysis is crucial in detecting the presence of hematuria (blood in urine) and urinary tract infections.
Medication is often the initial treatment approach for BPH. These medications function by either relaxing the muscles surrounding the prostate or reducing the size of the prostate, which helps widen the urinary passages. By doing so, drug therapy effectively improves urination and diminishes symptoms, including infections, associated with the condition. These medications play a crucial role in managing BPH and alleviating its impact on the urinary system.
Complications include acute urinary retention
Prolonged BPH can significantly impact the quality of life. It's a condition that progresses with age and cannot be completely stopped by medication.
As the disease advances, urinary flow decreases, residual urine volume increases, and symptoms worsen.
Common complications of BPH include urinary tract infections, hematuria, acute urinary retention, and bladder stones.
Acute urinary retention is characterized by a sudden inability to urinate, leading to the accumulation of urine in the bladder and intense lower abdominal pain. If this condition persists, the bladder muscle may lose its contractile power, preventing proper recovery even after treatment.
Certain cold medicines containing antihistamines can reduce the contractility of the bladder muscles, increasing the risk of acute urinary retention.
In severe cases, the symptoms may worsen to the point where urination becomes impossible, necessitating immediate medical attention, often requiring a visit to the emergency room.
BPH management tips
Managing BPH is crucial for improving the quality of life.
Regularly monitoring prostate health and avoiding prolonged sitting can be beneficial. Before taking cold medications, arrhythmia medications, or nerve medications, it is advisable to consult the doctor, as these medications might exacerbate difficulty urinating symptoms.
Additionally, moderating alcohol intake and reducing a high-calorie diet can also contribute to better BPH management.
Kim Kyung-jong, head of the urology department at Seran General Hospital, emphasized that individuals with a large prostate are at a higher risk of experiencing acute urinary retention or needing surgical treatment in the future.
“Symptoms of BPH tend to worsen due to factors such as excessive drinking, the use of cold medication, exposure to cold weather, and prolonged driving,” he said.
According to Kim, BPH is a common cause of acute urinary retention. This occurs when the prostate compresses the urethra, leading to an improper relaxation of the urinary passage and sudden retention of urine.
He also pointed out that as temperatures drop and weather changes, the muscles of the prostate and bladder tend to contract, increasing the risk of acute urinary retention.
To prevent such occurrences, Kim emphasized the importance of not holding back urine and addressing BPH promptly.
Seeking medical attention at the first signs of BPH is crucial to avoid delays in diagnosis and treatment, enabling men to manage their condition effectively and minimize the likelihood of acute urinary retention, he added.