Benign prostatic hyperplasia (BPH) is the most common disorder affecting the prostate. The prostate gland is a walnut-shaped gland located in front of the rectum and right below the bladder. The prostate gland can be felt upon digital examination by a physician. One of the most common roles of the prostate gland is to squeeze fluid into the urethra to move the sperm during sexual climax. The fluid that is squeezed out by the prostate gland helps make semen and also makes the vaginal canal less acidic.
Benign prostatic hyperplasia is non-malignant (not cancerous). BPH is common in men 50 and older. BPH symptoms are caused due to the enlargement of the prostate gland. Enlargement of the prostate gland is a normal condition that first occurs during puberty, again around the age of 25 and lastly in the later years.
An enlarged prostate gland becomes abnormal and thus called benign prostatic hyperplasia when it starts causing problematic symptoms. Symptoms of benign prostatic hyperplasia include a weak urine stream, frequent urination (especially at night) and urinary leakage.
Causes of benign prostatic hyperplasia:
The cause of benign prostatic hyperplasia is unknown. BPH may be caused by hormonal changes that happen as men grow older. The testicles are the part of the body that produces testosterone. Testosterone is converted to dihydrotestosterone (DHT) and estrogen in the tissues. High levels of DHT may accumulate and cause hyperplasia (enlargement caused by an increase in cells).
Diagnosis of benign prostatic hyperplasia:
The first thing the urologist (urinary tract specialist) will do is ask about the patients history of illness and symptoms. This may give him a hint about what is happening in the patients body. The urologist will ask questions about the kind of symptoms the patient is having, when the symptoms appear and if the symptoms are mild or severe.
Digital rectal examination:
The digital rectal examination is done using the urologists finger to feel any abnormalities up inside the rectum. A digital exam can tell him if there are any abnormalities such as hard areas in the prostate, nodules or tumors on the prostate or an asymmetrical (not identical) shape to the prostate gland.
Prostate-specific antigen test (PSA):
PSA is a protein that is produced by cells of the prostate. The PSA test is a blood test that determines the levels of protein in the prostate. PSA levels are normally low, but have no definitive levels for a normal or abnormal level. A baseline test is used first and further testing is used to see if that level rises, falls or stays the same. A result that is higher than the baseline test indicates prostate cancer, prostatitis (inflammation of the prostate) or BPH.
If any abnormality is felt during the digital examination, a Urodynamic study can be done. A urodynamic study is performed to determine how your bladder and urethra are functioning. Urodynamic studies can also be used to assist in the diagnosis of benign prostatic hyperplasia or other prostate problems.
A cystoscope is a small tube with a light and a lens on the end of it. After the penis is numbed completely, the scope is pushed up into the penis through the opening at the tip. This allows the urologist to determine the size of the prostate and check for obstructions.
Biopsy and ultrasound:
A biopsy can positively diagnose prostate cancer. A biopsy is done through a scope. With the help of an ultrasound as a guide, the scope is entered through the anus and a small slice of prostate removed to be examined under a microscope.
Men who are 40 and older, and especially men 65 and older should be getting their prostate checked yearly by way of the digital exam.
Benign prostatic hyperplasia is generally left untreated unless the symptoms are bothersome to the patient or the BPH poses a serious threat. Medications are usually the first type of treatment used. The medication works to shrink the prostate or stop it's growth.
For further information on benign prostatic hyperplasia visit The National Kidney and Urologic Diseases Information Clearinghouse.