What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH) is a common condition in which the prostate gland gradually grows in size with age. The prostate gland sits below the bladder and surrounds the first part of the urethra in men. When the prostate enlarges, it can press on the urethra and affect the flow of urine.
BPH is a benign enlargement of the prostate gland and is not cancer. However, the condition can cause urinary tract problems and affect quality of life. Prostate enlargement is very common, and it is estimated that more than half of all men over the age of 60 develop some degree of prostate enlargement. The exact cause is not fully understood, but the condition is thought to be linked to hormonal changes that occur in men as they age, particularly changes in the balance between testosterone and other hormones.
Symptoms of prostate enlargement
The symptoms of prostate enlargement occur primarily because the enlarged prostate gland affects the function of the urethra and bladder. The problems often develop gradually over time.
Common symptoms may include:
- Weak or interrupted urine stream.
- Difficulty starting to urinate.
- Feeling that the bladder is not emptying completely.
- Increased need to urinate, especially at night.
- Sudden and severe urge to urinate.
- Dropping after urination.
In more severe cases, prostate enlargement can lead to urinary retention, which means that it becomes difficult or impossible to empty the bladder. This may require urgent medical treatment.
How is prostate enlargement detected?
Prostate enlargement is often detected in connection with the investigation of urinary tract problems in men. The doctor then makes an overall assessment based on symptoms, medical history and various examinations.
A common part of the investigation is palpation of the prostate gland via the rectum, so-called rectal palpation. The examination allows the doctor to assess the size and consistency of the prostate.
Blood samples can also be taken to analyze PSA (prostate-specific antigen). PSA is produced in the prostate gland and a small amount normally leaks into the blood. In case of prostate enlargement, PSA levels may be slightly elevated because the prostate gland has become larger. The PSA analysis is mainly used to rule out prostate cancer, since both BPH and prostate cancer can cause elevated PSA values.
In some cases, imaging diagnostics can be used to examine the prostate gland more thoroughly. Magnetic resonance imaging of the prostate, MRI prostate, is a modern and gentle method that can provide detailed images of the prostate tissue. The examination uses magnetic fields and radio waves and does not involve exposure to ionizing radiation.
MR prostate is often used to identify structural changes in the prostate gland and can help distinguish between benign prostate enlargement and changes that may need further investigation.
Treatment for prostate enlargement
The treatment for prostate enlargement depends on how pronounced the symptoms are and how much they affect everyday life. Many men have mild symptoms that do not require active treatment but only follow-up.
For more troublesome symptoms, treatment may include medications that affect the prostate muscle or hormonal signals that control prostate growth. In some cases, combinations of medications are used to reduce symptoms.
If drug treatment does not have a sufficient effect, surgical treatment may be considered. The most common operation is transurethral resection of the prostate (TURP), in which excess prostate tissue is removed via the urethra to improve urine flow.
Then you should seek medical attention
It is important to contact a doctor if urinary problems arise or gradually worsen. A medical evaluation can help identify the cause and determine whether treatment is needed.
Care should be sought in particular if you experience:
- Sudden inability to urinate.
- Blood in the urine.
- Recurrent urinary tract infections.
- Pain when urinating.
These symptoms can sometimes be due to other conditions in the urinary tract and should therefore always be investigated.
Difference between prostate enlargement and prostate cancer
Prostate enlargement and prostate cancer are two different conditions that both affect the prostate gland. BPH involves a benign growth of prostate tissue and does not spread to other parts of the body.
Prostate cancer, on the other hand, involves a malignant tumor disease. Since the symptoms can overlap, PSA tests and sometimes imaging diagnostics, such as prostate MRI, are often used to distinguish between these conditions.
Prostate enlargement prognosis
Prostate enlargement is a very common condition in older men and often develops slowly. Many men have mild symptoms that do not require treatment, while others may need medical treatment or surgery to reduce their symptoms.
With proper follow-up and treatment, most men with prostate enlargement can live a normal life without major impact on their quality of life.
