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Benign Prostatic Hyperplasia (BPH) is a very common disease among older men in Hong Kong, affecting around 50% of all men over the age of 50 in the Chinese population. BPH is not cancer but it can lead to urinary problems and affect the quality of life. Early diagnosis and treatment can help relieve symptoms of BPH effectively. Men should not delay seeking treatment for BPH.
Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate and its surrounding tissue enlarge. Prostate is usually the size of a walnut, made of glandular and muscular tissue. The main function of the prostate gland is to produce fluid in semen that transports sperm out of the body. The size of the prostate generally remains stable until middle-age. Under the influence of male hormones (androgen), the prostate gland can enlarge slowly. The enlargement is non-cancerous, it is therefore called Benign Prostatic Hyperplasia.
The prostate is located in the pelvis, between the penis and bladder. It surrounds part of the urethra, a tube that carries urine and sperm out of the body. When the prostate becomes enlarged, it can compress the urethra and hence obstruct the flow of urine, making it more difficult to pass urine and to empty the bladder completely.
Not all men with BPH experience symptoms. For those who have symptoms, commonly include:
In severe cases, the bladder cannot pass urine and may result in urinary retention, causing swelling and pain in the lower abdomen. It is a serious condition that requires immediate medical attention.
Many symptoms of BPH are similar and overlapped to those found with prostate cancer, but the two are not related. Based on research to date, having BPH does not automatically increase your risk of prostate cancer.
The exact cause of prostate enlargement is unknown, but it is believed to be linked to male hormones which can lead to overgrowth of the prostate tissue as men get older.
There are several factors found to be associated with higher risk for BPH include:
Your doctor will take a thorough medical history by asking about your symptoms and concerns, and how the symptoms might have an impact on your quality of life. Doctors will generally use the International Prostate Symptom Score questionnaire (IPSS) to evaluate the severity of symptoms and detect prostate problems at the early stage.
Besides, doctors may also perform the following tests to aid the diagnosis of BPH:
Benign Prostatic Hyperplasia (BPH) treatment typically consists of active surveillance, medications, minimally invasive surgery or more invasive surgery.
Your doctor will recommend the optimal treatment depending on the severity of the condition, patients’ general health status, along with how the condition is affecting the patient’s quality of life.
Often, BPH will only require acute surveillance (sometimes called “watchful waiting”). Meaning in patients with mild to moderate symptoms and are not bothered by the impact of BPH, they may not require treatment other than continued active observation to make sure their condition doesn’t get worse.
Appropriate education and lifestyle changes would also be advised, including reduction of fluid intake before bedtime, avoidance of caffeinated beverages, urethral milking to prevent dribbling after urination.
If your symptoms get worse, or if new symptoms appear, affecting your daily activity, your doctor may suggest that you begin active treatment with the following options:
Medication is commonly used for moderate symptoms of BPH. In most cases, medication can improve the urinary symptoms caused by BPH. Medication can be used alone or in combination, to decrease the size of the prostate or reduce the severity of symptoms. There are two main classes of medication for BPH:
Doctors may recommend minimally invasive treatments or surgery if the patients suffer from severe symptoms or if medications are not effective. The aim is to remove part of the excess prostate tissue.
Minimally invasive treatments are comparatively newer and carry less surgical risk. They can be done under local anesthesia and do not require hospitalization. Some of the minimally invasive treatments include:
The following are common options of surgery for BPH:
Some men with BPH may not have noticed any symptoms until they suddenly experience a painful inability to pass urine. This condition is known as acute urinary retention. It is an emergency that demands immediate medical attention.
Other complications of BPH include:
To date, it is believed that BPH does not lead to cancer, however, both conditions can co-exist together.
Inevitably, the risk of getting BPH increases with age. However, the following can help to reduce the risk of developing BPH:
There is a large variety of treatment options for Benign Prostatic Hyperplasia. Typically consists of active surveillance, medications, minimally invasive surgery or more invasive surgery. Your doctor will recommend the optimal treatment depending on the severity of the condition, patients’ general health status, along with how the condition affects the patient’s quality of life.
The exact cause of Benign Prostatic Hyperplasia is unknown, however, it is likely linked to hormonal changes as men get older. Several risk factors that may increase the risk of BPH include increasing age, smoking, excessive consumption of alcohol or obesity.
Benign Prostatic Hyperplasia is not typically a serious condition. BPH is not cancer, and it does not cause cancer of the prostate gland. However, if BPH was not detected early, it can lead to serious complications including acute urinary retention that requires immediate medical attention.
This article was medically reviewed by Dr. Vera Chung 鍾楊醫生. Dr. Chung is a female urologist practicing at the Hong Kong Urology Clinic. She qualified in 2003 from the University of Hong Kong and was trained as a urologist in Queen Elizabeth Hospital and obtained the Fellowship of Royal College of Surgeons of Edinburgh in 2011. Dr. Chung was promoted to associate consultant in Pamela Youde Nethersole Eastern Hospital in 2012. From 2013 to 2015 she has completed a two-year European Board of Urology (EBU) Fellowship in endourology and laparoscopy at Nuffield Department of Surgical Sciences, University of Oxford. In Oxford, Dr. Chung also consolidated her training in the management of continence and prolapse problems in the Department of Gynecology.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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