Benign prostatic hyperplasia—also called BPH—is a condition in men in which the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also Prostatica benigna BPH benign prostatic hypertrophy or benign prostatic obstruction.
The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. Benign prostatic hyperplasia often occurs with the second growth phase. As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing Prostatica benigna BPH the urethra and urinary retention—the inability to empty the bladder completely—cause many of the problems associated with benign prostatic hyperplasia.
The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder.
The urethra is the tube that Prostatica benigna BPH urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis. The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty.
For this reason, some researchers believe factors related to aging and the Prostatica benigna BPH may Prostatica benigna BPH benign prostatic hyperplasia. Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone DHTa male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate.
This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia. Benign prostatic hyperplasia is the most common prostate problem for men older than age Inas many as 14 million men in the United States Prostatica benigna BPH lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Benign prostatic hyperplasia affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than The size of the prostate does not always determine the severity of the blockage or symptoms.
Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms. Less than half of all men with benign prostatic hyperplasia Prostatica benigna BPH lower urinary tract symptoms.
Sometimes men may not know they have a blockage until they cannot urinate. This condition, called acute urinary retention, can result from Prostatica benigna BPH over-the-counter cold or allergy medications that contain decongestants, such Prostatica benigna BPH pseudoephedrine and Prostatica benigna BPH.
A potential side effect of these medications may prevent the bladder neck from relaxing and releasing urine. Medications that contain antihistamines, such as diphenhydramine, can weaken the contraction of bladder muscles and cause urinary retention, difficulty urinating, and painful urination.
When men have partial urethra blockage, urinary retention also can occur as a result of alcohol consumption, cold temperatures, or a long period of inactivity. Most men with benign prostatic hyperplasia do not develop these complications.
However, kidney damage in particular can be a serious health threat when it occurs. Taking a personal and family medical history is one of the first things a health care provider may do to help diagnose benign prostatic hyperplasia. A health care provider may ask a man.
A physical exam may help diagnose benign prostatic hyperplasia. During a physical exam, a health Prostatica benigna BPH provider most often. A digital rectal exam, or rectal exam, is a physical exam of the prostate. To perform the exam, the health care provider asks the man to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to the rectum.
Prostatica benigna BPH man may feel slight, brief discomfort during the rectal exam. A health care provider most Prostatica benigna BPH performs a rectal exam during an office visit, and men do not require anesthesia. The Prostatica benigna BPH helps the health care provider see if the prostate is enlarged or tender or has any abnormalities that require more testing.
Many health care providers perform a rectal exam as part of a routine physical exam for men age 40 or older, whether or not they have urinary problems. A health care provider may refer men to a urologist—a doctor who specializes in urinary problems and the male reproductive system—though the health care provider most often diagnoses benign prostatic hyperplasia on the basis of symptoms and a digital rectal exam.
A urologist Prostatica benigna BPH medical tests to help diagnose lower urinary tract problems related to benign prostatic hyperplasia and recommend treatment. Medical tests Prostatica benigna BPH include. Urinalysis involves testing a urine sample. A health care provider tests the sample during an office visit or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called Prostatica benigna BPH dipstick, into Prostatica benigna BPH urine.
Patches on the dipstick change color to indicate signs of infection in urine. PSA blood test. A health care provider may draw blood for a PSA test during an office visit or in a commercial facility and send the sample to a lab for analysis. Prostate cells create a protein called PSA. Men who have prostate cancer may Prostatica benigna BPH a higher amount of PSA in their blood. However, a high PSA Prostatica benigna BPH does not necessarily indicate prostate cancer.
In fact, benign prostatic hyperplasia, prostate infections, inflammation, aging, and normal fluctuations often cause high PSA levels. Urodynamic tests. Urodynamic tests include a variety of procedures that look at how well the bladder and urethra store and release urine. A health care provider performs urodynamic tests during an office visit or in an outpatient center or a hospital.
Some urodynamic tests do not require anesthesia; others may require local anesthesia. Cystoscopy is a procedure that uses a tubelike instrument, called a cystoscope, to look inside the urethra and bladder. A urologist inserts the cystoscope through the opening at the tip of the penis and into the lower urinary tract. A urologist performs cystoscopy during an office visit or in an outpatient center or a hospital.
The urologist will give the patient local anesthesia; however, in some cases, the patient may require Prostatica benigna BPH and regional or general anesthesia. A urologist may use cystoscopy to look for blockage or stones in the urinary tract. Transrectal ultrasound. Transrectal ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure.
The health care provider can move the transducer to different angles to make it possible to examine different organs. Urologists most often use transrectal ultrasound to examine the prostate. The ultrasound image shows the size of the prostate and any abnormalities, such Prostatica benigna BPH tumors. Transrectal ultrasound cannot reliably diagnose prostate cancer.
Biopsy is a procedure that Prostatica benigna BPH taking a small piece of prostate tissue for examination with a microscope. A urologist performs the biopsy in an outpatient center or a hospital. The urologist will give the patient light sedation and local anesthetic; however, in some Prostatica benigna BPH, the patient will require general anesthesia.
The urologist uses imaging techniques such as ultrasound, a computerized tomography scan, or magnetic resonance imaging to guide the biopsy needle into the prostate. A pathologist—a doctor who specializes in examining tissues to diagnose diseases—examines the prostate tissue in a Prostatica benigna BPH. The test can show whether prostate cancer is present. Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life.
In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia Prostatica benigna BPH become bothersome or present a health risk, a urologist most often recommends treatment. A health care provider may recommend lifestyle changes for men whose symptoms are mild or slightly bothersome. Lifestyle changes can include. A health care provider or urologist may prescribe medications that stop the growth of or shrink the prostate or reduce symptoms associated with benign prostatic hyperplasia:.
Alpha blockers. These medications relax the smooth muscles of the prostate and bladder neck to improve urine flow and reduce bladder blockage:. Phosphodiesterase-5 inhibitors. Urologists prescribe these medications mainly for erectile dysfunction. Tadalafil Cialis belongs to this class of medications and can reduce lower urinary tract symptoms by relaxing smooth muscles in the lower urinary tract. Researchers are working to determine the role Prostatica benigna BPH erectile dysfunction drugs in the long-term treatment of benign prostatic hyperplasia.
These medications block the production of DHT, which accumulates in the prostate and may cause prostate growth:. These medications can prevent progression of prostate growth or actually shrink the prostate in some men.