BENIGN PROSTATIC HYPERTROPHY

First of all, do not worry, you are not alone. Benign Prostatic Hypertrophy is a common problem, affecting approximately 1/3 of men over the age of 50 in the UK alone.

What is the Prostate Gland?

The prostate is a gland situated at the opening of the bladder and surrounds part of the urethra through which urine passes to the penis. Its purpose is to produce fluids that are mixed with semen.

What is Benign Prostatic Hypertrophy?

Benign Prostatic Hypertrophy (BPH) is a medical term which means that the prostate gland is growing larger; the word benign indicates that the condition is not malignant.

What are the Symptoms of Benign Prostatic Hypertrophy?

After early middle age in males, the prostate gradually becomes larger. Symptoms of Benign Prostatic Hypertrophy usually involve difficulty in passing urine, although the exact symptoms can differ from one man to another. You may notice that it takes longer than it used to for your bladder to empty. It may also be more difficult to empty your bladder completely, and after urinating there may still be a feeling that the bladder is partially full, or there may be some dribbling. Some men find that they need to pass urine more often, which can be very inconvenient and embarrassing. The need to urinate more frequently may be experienced both during the day and during the night when it can disrupt sleep.

What Causes the Symptoms of Benign Prostatic Hypertrophy?

The prostate gland surrounds a tube called the urethra, which connects the bladder to the penis. When you urinate, the urine from the bladder is carried along the urethra and passed out of your body. As the prostate grows larger, it may press on the urethra, making it narrower so that urine cannot flow out of the bladder as quickly.

How is this Condition Treated?

The problems caused by Benign Prostatic Hypertrophy can be relieved by medicines, or if necessary, by treatment with an operation. Your doctor has a number of medicines he can prescribe for your condition. However, he may suggest you see a consultant Urologist at a hospital for specialist attention. The exact treatment you receive will depend on how severe your symptoms actually are and the degree to which your symptoms bother you. Before deciding on a treatment your doctor will usually ask you a few questions, carry out an examination and probably arrange a few tests.

Your doctor may not prescribe any treatment, but simply ask you to come back after a certain period for a check-up. During this time you should go back to your doctor if your symptoms become troublesome. In some cases,symptoms can remain the same for many years. In others they rapidly get worse. It is unusual for them to get better by themselves.

The symptoms of BPH can be controlled by medicines. These work in one of two ways; by relaxing the muscle surrounding the prostate, bladder and urethra, or by gradually reducing the size of the prostate. Both have the effect of widening the urethra, thereby allowing urine to flow more freely.

Will I Need an Operation?

If your symptoms are severe your Doctor may well consider referring you for an operation. This involves removing part of the prostate gland. One effect of the operation is that it can sometimes cause difficulties in obtaining an erection afterwards.

How do I Assess my Symptoms?

Use the score sheet to score your symptoms. You can then assess whether drug treatment (if prescribed) is working or objectively record whether your symptoms are worsening rapidly. In many cases symptoms can remain the same for many years so treatment is not always necessary. However a rapid deterioration in symptoms may be a warning sign that the flow of urine might be about to pack up altogether. Under such circumstances the scenario usually involves a trip to hospital in the middle of the night to have a catheter inserted which is to be avoided if possible!

The international symptoms score is based on answers to the questions on the score sheet. The total score can range from 0 to 35.  Although there are at present no standard recommendations into grading patients patients can be tentatively classified as follows:

• 0-7 - asymptomatic to mildly symptomatic  
• 8-19 - moderately symptomatic  
• 20-35 - severely symptomatic