What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is when there is an enlargement of the prostate gland as a result of an increase in prostate gland cells. It is common in men as they get older, with 50% of cases occurring in men between 50 and 60 years of age. It is important to note that it is not cancer, nor does it increase the risk of developing it.

Symptoms of BPH

Clinically, benign prostatic hyperplasia manifests itself with the so-called lower urinary tract symptoms (LUTS), divided into voiding, irritative filling and postvoiding symptoms.

Voiding symptoms include:

  • Weak stream.
  • Slow urination.
  • Shower urination. Occurs when the stream is not thin.
  • Choppy urination. The patient starts to urinate and stops, starting again, and then stops once or several times.
  • Delayed onset of urination. Delayed onset of urination.
  • Voiding effort. The patient makes some force to shorten the time of urination, but does not succeed.
  • Increased terminal dribbling.

As for the symptoms of irritative filling, we find:

  • Urge to urinate. From not having no urge to urinate to having a pressing urge in a short space of time.
  • Increased voiding frequency. Frequent urination. There may come a time when the patient urinates before any action.
  • Incontinence of urine.
  • Nocturia. Beginning to get up at night to urinate, with increasing frequency.

Finally, postvoiding symptoms are characterized by:

  • Sensation of incomplete voiding.
  • Postvoid dribbling.

How is it diagnosed?

It is important to consider that the symptoms of benign prostatic hyperplasia can also be present in other pathologies, so it is important to make a good diagnosis in order to resort to the appropriate treatment.

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For this purpose, a clinical examination of the patient is recommended, including a digital rectal examination, ultrasound and blood tests, in addition to a urinary sediment. This will also be accompanied by a review of the patient’s medical history.

Other optional tests that the patient may undergo are: urine flowmetry, voiding diary and sexual function.

Treatment options

Depending on the size of the prostate and the symptoms it presents, it may cause the patient some problems or discomfort that are difficult to cope with on a daily basis. Dr. Fernández Larrañaga recommends starting with a less invasive treatment that consists of prescribing oral medication.

However, for those cases in which medication does not work, it will be advisable to resort to surgical treatment, which would vary according to the patient’s age, concomitant diseases, prostate size and prostate growth.