What is Benign Prostatic Hyperplasia (BPH) or prostate adenoma?
This condition is known as Benign Prostatic Hyperplasia (or prostate adenoma) because it refers to the non-malignant growth of prostatic tissue in men from middle age onwards. In a young man, the prostate gland is at an almost undetectable rudimentary stage, and spreads across the coating of the urinary tract like a cluster of seeds. However, during puberty, its form begins to change due to the increased production of the testosterone and dihydrotestosterone hormones.
Testosterone causes the "seeds", called acini, to germinate and grow. In adult life, due to this growth and proliferation, these small glandular structures can give rise to obstructive symptoms associated with urinary flow disorders.
Benign Prostatic Hyperplasia is one of the most common diseases in men and is considered to be part of the physiological ageing process. The incidence of this disease is 51% in men aged 60 to 69, and between 75% and 90% in octogenarians.
Symptomatology
Although the definition of BPH encapsulates the enlargement of the prostate and the mechanical obstruction of the flow of urine, a direct relationship between the volume of hyperplasia and the intensity of symptoms is not always present. Very enlarged prostates do not always cause symptoms and other less enlarged organs can be a source of intense discomfort.
The symptoms of Benign Prostatic Hyperplasia can be divided into two categories: obstructive and irritative.
Obstructive symptoms
- Weak and/or intermittent flow of urine.
- Decrease in the force and calibre of the urine.
- Feeling of incomplete emptying of the bladder.
- Double voiding (urinating for a second time within a period of 2 hours).
- Post-void dribbling.
- Difficulty or delay when initiating urination.
- Urinary retention.
Irritative symptoms
- Polyuria, or increased frequency of urination.
- Nocturia, or the need to urinate frequently during the night.
- Sudden urge to urinate.
- Urge urinary incontinence.
Treatment of Benign Prostatic Hyperplasia
Early diagnosis of Benign Prostatic Hyperplasia is essential to avoid complications such as urinary tract infections, damage to the kidneys or bladder, bladder stones and incontinence.
The treatment for BPH will be determined by the potential for the existence of these secondary processes that derive from urinary obstruction, along with the patient’s level of discomfort
Medical treatment
In patients with mild or moderate symptoms, a pharmacological treatment can be administered that is based on alpha-blockers and alpha-reductase inhibitors, which can help to improve urinary flow. The former reduce the tension of the muscle cells inside the prostate, helping the patient to empty their bladder more effectively and comfortably. The latter reduce the size of the prostate, which improves the quality of urination.
Surgical treatment
For patients who have used medication without success, the symptoms of Benign Prostatic Hyperplasia can be alleviated through surgery.
The Serrate & Ribal Institute of Urology and Andrology provides cutting-edge techniques that improve results in a marked and effective way, while at the same time significantly reducing complications:
- Transurethral resection of prostate (TURP) with Bipolar plasma equipment
- Prostatic photovaporisation with KTP GreenLight 180W green laser
- Thulium laser
- Holmium laser enucleation of the prostate (HoLEP)