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.”[i] 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.