Originally published 4/5/2015
Benign prostatic hyperplasia is all too common among older men. Since we published the 2015 blog below, the data has been consistent.
According to Yale Medicine, “About 50% of men between the ages of 51 and 60 have BPH, and that number jumps to 70% among men aged 60 to 69 and around 80% of men over 70 years of age.”
A 2017 journal article still cites autopsy statistics from 1984: BPH was found in “8%, 50%, and 80% in the 4th, 6th, and 9th decades of life, respectively.”[i]
While many men with BPH are not troubled with lower urinary tract symptoms (LUTS), BPH can lead to bigger problems because it is progressive.
The American Urological Association warns, “It can lead to bladder damage and infection. It can cause blood in the urine and cause kidney damage.”
While this poses a nasty but non-life threatening risk for the individual, a 2021 journal article says it’s now becoming a global problem. As life expectancy among men is increasing worldwide, there will be more BPH and its associated LUTS.
For worldwide BPH, Launer, et al. calculated the years of living with disease (YLD) compared with other urological conditions.
For the year 2017 alone, the numbers are astounding: over 2 million YLD were tallied for BPH, compared with prostate cancer, the next highest urological disease, at nearly 845,000 YLD![ii]
The authors forecast a “continually accelerating wave of LUTS/BPH,” and point out its “serious implications for the future allocation of resources and the global urological workforce.”
Thus, the BPH burden will be more common than ever. Aging men are advised to adhere to a healthy, non-inflammatory diet, and to exercise.
Benign prostatic hyperplasia, or BPH, is an enlargement of the prostate gland that typically begins after age 50 and continues. It is a noncancerous condition, meaning it poses no life-threatening risks and cannot spread to other parts of the body. The number of cells increases, but they are normal cells. If individual cells enlarge, this is called hypertrophy. Notice that both words begin with “hyper.” In a way, that says it all. The reproduction of normal cells has gone a little hyper.
An article on WebMD has the following estimate: “Overall, the number of men with BPH increases progressively with age. By age 60, 50% of men will have some signs of BPH. By age 85, 90% of men will have signs of the condition. About one third of these men will develop symptoms that require treatment.”[iii] As the gland enlarges, it can compress the urethra, or tube that carries urine from the bladder and through the prostate on its way out of the body. The main BPH symptoms are:
- Difficulty starting urination
- Interruptions of urine flow
- Weak force of stream
- Dribbling after urination
- Sense of urgency even when the bladder is not full
- Inability to empty bladder completely
- Sleep disruption due to need to urinate
Additional problems may occur:
- Straining of pelvic muscles leading to injury or risk of infection
- Urinary tract infection (due to incomplete bladder emptying)
- Bladder stones (due to incomplete bladder emptying)
- Kidney damage (due to increased pressure caused by urinary obstruction)
Prostate inflammation can also happen as BPH grows. Both can cause an elevated PSA, because any irritation stimulates prostate cells to shed surface proteins, or antigens, which circulate in the bloodstream. This is why a rising PSA can lead to confusion—it does not always mean cancer.
I came across an interesting study on the prevalence of BPH in Caucasian and Asian men, as discovered during autopsy. The researchers were also looking for evidence of either acute or chronic inflammation along with BPH. They had access to 220 prostate glands from Caucasian men, and 100 from Asian men, all of whom died from other causes. Regardless of differences in diet and other cultural factors, over 70% of the glands had BPH. They also found that the greater the degree of BPH, the higher the chronic inflammation rates. If you are a man reading this, chances are you will be affected by BPH.
If BPH is causing problematic urinary symptoms, there are medical and surgical treatments to restore normal flow. The key is correct diagnosis and evaluation of the problem; addressing inflammation differs from managing BPH. Our Center offers state-of-the-art multiparametric MRI, which detects the difference between BPH, inflammation, and prostate cancer. No need for scopes or other intrusive tests unless the images indicate otherwise. It’s good to be able to rule out prostate cancer when BPH occurs.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Berry S.J., Coffey D.S., Walsh P.C., Ewing L.L. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132:474–479.
[ii] Launer BM, McVary KT, Ricke WA, Lloyd GL. The rising worldwide impact of benign prostatic hyperplasia. BJU Int. 2021 Jun;127(6):722-728.
[iii] http://www.webmd.com/men/prostate-enlargement-bph/benign-prostatic-hyperplasia-bph-topic-overview
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
