HOW TO RECOGNIZE IT
Benign Prostatic Hyperplasia

HOW TO RECOGNIZE IT

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.

Bibliographical references
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.

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TREATMENT
OVERVIEW
Benign Prostatic Hyperplasia

TREATMENT

Therapies can be administered when worsening symptoms of benign prostatic hypertrophy impact on the patient's quality of life. These can be pharmacological or, in the most serious cases, even surgical, using very innovative techniques. The support of a doctor is essential during the evolution of the condition, to suggest the best course to follow and identify a treatment that is both efficacious and acceptable to the patient. The most important step is the first visit to the urology clinic to assess the primary situation and degree of disease advancement.

WHAT IS INVOLVED?
OVERVIEW
Benign Prostatic Hyperplasia

WHAT IS INVOLVED?

The symptoms of benign prostatic hyperplasia (BPH) include difficulty initiating urination accompanied by a sense of urgency, incomplete bladder emptying, straining during urination, need to urinate frequently, burn and urine leakage even after finishing to urinate.

WHAT TO DO
OVERVIEW
Benign Prostatic Hyperplasia

WHAT TO DO

It is a very common disease, but about 50% of men with BPH do not have symptoms or disturbances, and thus do not require specific treatment.