Benign prostatic enlargement

The exact causes of BPH are not fully understood, but hormonal changes associated with aging play a crucial role. The main causes include:

• Hormonal changes: As age increases, the ratio of dihydrotestosterone (DHT), a breakdown product of testosterone, rises in the prostate, stimulating prostate growth.
• Age: Prostate enlargement occurs more frequently in older men as hormonal changes progress over the course of life.
• Family predisposition: A family history of BPH can increase the risk.

• Weak or interrupted urine stream
• Frequent urination, especially at night (nocturia)
• Difficulty starting urination
• Feeling of not being able to completely empty the bladder
• Urgency to urinate, often associated with a sudden, intense urge
• In advanced cases, urinary retention (inability to empty the bladder) may occur, which constitutes a medical emergency

The diagnosis of BPH is made through a combination of physical examination, medical history, and specific tests. The most common diagnostic methods include:

- **Digital rectal examination (DRE)**: The doctor palpates the prostate through the rectum to check its size and consistency.

- **Urinalysis**: To rule out infections or other problems that can cause symptoms similar to BPH.

- **Prostate-specific antigen (PSA)**: A blood test that helps distinguish between BPH and prostate cancer, as elevated PSA levels can occur in both conditions.

- **Uroflowmetry**: A test to measure the strength of the urine stream and assess bladder emptying.

• Medication Therapy:
  • Alpha-blockers: These medications relax the muscles of the prostate and bladder neck to improve urine flow.
  • 5-alpha-reductase inhibitors: These medications reduce the production of DHT and slow the growth of the prostate.
• Minimally Invasive Procedures: If medications are not sufficiently effective, minimally invasive procedures such as transurethral resection of the prostate (TURP) or laser therapy can be performed to remove excess prostate tissue.
• Surgical Interventions: In severe cases or with complications, a complete or partial surgical removal of the prostate may be necessary.

There is no specific prevention for BPH, but a healthy lifestyle with a balanced diet and regular physical activity can reduce the risk. Regular check-ups and early treatment of prostate problems are crucial to slow the progression of the disease and avoid complications.