Benign prostatic hyperplasia (BPH), also known as prostatic adenoma, is a disease that occurs with an increase in prostate volume, mainly due to an increase in the number of cells in this gland. This aging-related phenomenon is a benign growth of the prostate tissue; however, it can compress the urethra and hinder the normal outflow of urine. It is a very common condition, affecting up to 50% of men around age 60 and 90% after the age of 85.

Two types of urinary tract symptoms are characteristic of benign prostatic hyperplasia: obstructive symptoms include difficulty in starting urination, intermittent urine emission, incomplete bladder emptying, weak urinary stream, and straining during urination; irritative symptoms include frequent urination with relatively small quantities of urine (pollakiuria), increased need to urinate during the night (nocturia), urgency and a pressing need to empty the bladder and a burning sensation during urination.

BPH might also be associated with sexual issues, such as reduced sex drive and erectile dysfunction; some patients report experiencing less sexual satisfaction.

Although the scientific community does not understand all the causes of this condition, it is believed that the main factors leading to its onset are aging and hormonal changes occurring in advanced age. In particular, dihydrotestosterone (DHT) - an androgen (male sex hormone) that stimulates cell growth in prostate tissue – appears to play an important role in the onset of BPH. Also oestrogens may play a role in disease onset, given that BPH often occurs in men with high oestrogen levels and low free testosterone levels, which probably triggers prostate growth.

Suggested readings

  • Roehrborn, C.G., Benign Prostatic Hyperplasia: An Overview
  • Girman, C.J., Population-based studies of the epidemiology of benign prostatic hyperplasia, Br. J. Urol. 1998;82(suppl 1):34–43
  • Berry, S.J., Coffey, D.S., Walsh, P.C., Ewing, L.L., The development of human benign prostatic hyperplasia with age, J. Urol. 1984.
  • American Urological Association Practice Guidelines Committee, AUAguidelines on management of benign prostatic hyperplasia (2003), Chapter 1: diagnosis and treatment recommendations, J. Urol. 2003;170(2 Pt 1).
  • Roehrborn, C.G., Girman, C.J., Rhodes, T. et al., Correlation between prostate size estimated by digital rectal examination and measured by transrectal ultrasound, Urology, 1997.
arrow top