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Questions and Answers
Benign Prostatic Hyperplasia (BPH)
1.
What is benign prostatic
hyperplasia (BPH)?
2. What are the symptoms of BPH?
3. How is BPH diagnosed?
4. Does BPH lead to cancer?
5.
Will BPH interfere with sexual
functioning?
6. How does BPH affect urination?
7.
When should BPH be treated?
8.
How is BPH treated?
1. What is benign prostatic
hyperplasia (BPH)?
BPH is the enlargement of the prostate, frequently occurring in men over
the age of 50. The enlargement can result in a gradual squeezing of the
urethra, sometimes causing difficulty in urinating.
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2. What are the symptoms of BPH?
Many men may not have any symptoms of BPH. If you do have symptoms, they
may include:
-
A weak urinary
stream
-
Difficulty
starting urination
-
Frequent urination
-
Frequently
awakening at night to urinate
Blockage of the urethra from BPH may lead to repeated
urinary tract infections, a sudden inability to urinate, or gradual
bladder and/or kidney damage.
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3. How is BPH diagnosed?
Since the prostate lies in front of the rectum, your doctor will most
likely perform a digital rectal examination (DRE) by inserting a gloved,
lubricated finger into the rectum. By doing this, he or she will be able
to feel the prostate and determine if it is enlarged or if it has lumps
or oth abnormalities.
Many doctors perform a prostate exam for men over the
age of 50, or over the age of 45 for those with risk factors for
prostate cancer, such as family history or African-American ethnicity.
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4. Does BPH lead to cancer?
No, BPH is not cancer and has not been shown to increase the risk of
prostate cancer. However, both conditions can exist together. Check with
your doctor about your concerns.
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5. Will BPH interfere with sexual
functioning?
BPH generally does not interfere with sexual functioning.
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6. How does BPH affect urination?
The urethra, the tube that carries urine from the bladder out through
the tip of the penis, also runs through the prostate. The enlargement of
the prostate can result in squeezing of the urethra, sometimes causing
difficulty in urinating.
Effects of BPH on urination include:
-
A weak urinary
stream
-
Difficulty
starting urination
-
Frequent urination
-
Frequently
awakening at night to urinate
It can also cause other urinary problems, such as urinary
tract infections.
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7. When should BPH be treated?
An enlarged prostate is not reason enough to consider treatment. You and
your doctor may decide on "watchful waiting," in which you are examined
periodically to check the status of your prostate. Sometimes symptoms
may lessen without active treatment. However, if symptoms from BPH are
bothering you or are severely affecting the urinary tract, treatment may
be required.
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8. How is BPH treated?
BPH can be treated with medications, nonsurgical procedures that use
heat to destroy excess tissue, or surgery. With surgery for BPH,
the enlarged tissue that is pressing against the urethra is removed. The
rest of the prostate tissue and the outside capsule are left intact. (see
side effects of conventional treatments).
For a man whose symptoms are not severe enough to be
bothersome, he and his physician may choose watchful waiting. This
involves an exam by the physician to carefully monitor the progression
of symptoms and possible complications. The problem with watchful
waiting is that prostate cancer patients often times do not experience
symptoms and "waiting" can allow the cancer to progress.
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FACTS ABOUT BPH
-
Eighty percent of the time,
irregularities of the stream of urine during
urination, control problems with
urination, and an increased frequency of urination
-when taken together-are caused by benign prostatic
hyperplasia (BPH).
-
The incidence of BPH is at least 50
percent for all men at the age of 50 and rises to at
least 80 percent of all men in their eighth decade
of life.
-
Only about 50 percent of men with BPH
have an obstruction at the outlet of their bladder.
-
Of the approximately 300,000 surgical
procedures performed each year for BPH, 90 percent
are for transurethral resection of the prostate
gland, or TURP.
-
Over 40 percent of individuals with
mild to moderate symptoms of BPH have experienced
improvement with the watchful waiting
treatment option.
-
Almost 90 percent of individuals
treated with transurethral resection of the prostate
(TURP) have experienced an improvement in the
symptoms of BPH.
-
Almost 70 percent of the men treated
with transurethral needle ablation (TUNA)
experienced an average 30 percent improvement in the
symptoms of BPH, and over 10 percent experienced a
recurrence within a four-year postoperative period
that required further treatment.
-
Following surgery for BPH, the
incidence of impotence can range
between four and 30 percent.
-
The incidence of urinary
incontinence following surgery for BPH is
one to three percent.
-
The recurrence rate for BPH following
medical treatment over a five-year period ranges
between 30 and 40 percent.
-
The recurrence rate for BPH following
surgical treatment over a five-year period ranges
between two and 10 percent.
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