Benign prostatic hyperplasia (BPH) is a common, non-cancerous condition affecting the prostate gland in aging men. It involves the enlargement of the prostate, which can lead to various urinary symptoms. This condition does not indicate the presence of cancer, nor does it increase the risk of developing prostate cancer.
Understanding Benign Prostatic Hyperplasia
Benign prostatic hyperplasia involves the gradual enlargement of the prostate gland. This gland is located beneath the bladder, surrounding part of the urethra, and produces fluid for semen. As the prostate grows, it can press against the urethra, obstructing urine flow and leading to various lower urinary tract symptoms.
Factors Increasing BPH Risk
Age is the most significant factor for BPH. Prostate growth continues throughout a man’s life, often leading to enlargement that causes issues as men age. While about 8% of men aged 31 to 40 experience an enlarged prostate, this figure rises to over 80% for men over 80.
Family history also plays a role; men with male relatives who experienced BPH show an increased risk. Hormonal changes, specifically involving testosterone and dihydrotestosterone (DHT), contribute to prostate cell growth. As men age, the balance of these sex hormones can shift, potentially triggering prostatic enlargement.
Health Conditions Co-Occurring with BPH
BPH often co-occurs with other health conditions, suggesting shared underlying mechanisms. Metabolic syndrome, a cluster of conditions including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels, has been linked to BPH. Obesity and type 2 diabetes are also frequently observed alongside BPH, potentially due to shared inflammatory processes or hormonal imbalances.
Cardiovascular disease is another condition often seen with BPH; systemic inflammation and vascular changes associated with heart disease may impact prostate health and contribute to BPH progression. Erectile dysfunction (ED) is commonly reported in men with BPH.
Potential Complications of BPH
If BPH is left untreated or progresses, several complications can arise, primarily affecting the urinary system. One common issue is acute urinary retention (AUR), where a man suddenly becomes unable to urinate. This condition requires immediate medical attention to drain the bladder. Recurrent urinary tract infections (UTIs) can also occur because the bladder may not empty completely, allowing bacteria to multiply in the residual urine.
Over time, the chronic inability to fully empty the bladder can lead to the formation of bladder stones. These stones can cause pain, bleeding, and further obstruction. Prolonged bladder outlet obstruction can also result in chronic bladder damage, as the bladder wall thickens and weakens from the effort of pushing urine against resistance. In rare but serious cases, the back pressure from urine retention can extend to the kidneys, leading to hydronephrosis and potentially kidney damage.
Distinguishing BPH from Prostate Cancer
It is possible for a man to have both BPH and prostate cancer concurrently, as both become more common with age.
Doctors differentiate between BPH and prostate cancer through various diagnostic tools. A digital rectal exam (DRE) allows a physician to feel the prostate for any abnormalities. Prostate-specific antigen (PSA) blood tests are also used, as elevated PSA levels can indicate prostate cancer, though they can also be high in BPH. If there are suspicious findings from these initial tests, a prostate biopsy may be recommended to confirm or rule out cancer. Regular check-ups are important for older men to monitor prostate health and address any concerns.