Do you often experience urinary urgency as you age? Let's talk about BPH (Benign Prostatic Hyperplasia)

A common problem for many men over the age of 50 is difficulty urinating. For example, having to get up two or three times a night to urinate, feeling weak in the bladder, or feeling like your bladder is still full after you've finished urinating. These can often be symptoms of a condition called BPH. But don't worry, it's not cancer. Let's explain everything in simple terms.

What is BPH?

Simply put, BPH is an abbreviation for 'Benign Prostatic Hyperplasia'. In Sinhala, it is an enlargement of the prostate gland. This is not caused by cancer.

Think about it this way. The prostate gland is located below the bladder in men, around the urethra. Urine and semen leave the body through this urethra. As men age, the prostate gland gradually begins to enlarge in most men. This is normal. However, when it gets too big, like a tight fitting water pipe, it begins to squeeze the urethra. That's when the aforementioned urinary problems occur.

What is the exact cause of BPH?

Doctors can't really say for sure what causes it, but they believe it's caused by hormonal changes in the body that occur with aging, especially a process involving the male hormone testosterone .

When a boy reaches puberty, the prostate gland doubles in size at once. Then, starting around age 25, it starts to grow again. This happens throughout life. In some men, this growth leads to BPH.

What exactly are the symptoms of BPH?

Lower urinary tract symptoms (LUTS) that occur when the prostate gland becomes enlarged and the urethra becomes tight can be divided into two main categories. These can be clearly understood from the table below.

These symptoms can sometimes lead to things like urinary tract infections (UTIs), bladder stones, etc. Rarely, urinary retention or kidney damage can occur. Therefore, it is very important to be aware of these symptoms.

How do you find this, Doctor?

When you go to see a doctor with symptoms like these, he will first ask about your symptoms and family medical history. Then he will do a physical examination.

• Digital Rectal Exam (DRE): In this test, your doctor inserts a gloved finger into your rectum to check the size and shape of your prostate gland. This may seem uncomfortable, but it is very important for diagnosis.

In addition, several tests can be done to confirm the condition:

• Blood tests: Check kidney function.
• Urine tests: Check for infections.
• PSA blood test (Prostate-Specific Antigen): A test that measures the level of a protein produced by the prostate gland. Elevated PSA levels can be a sign of an enlarged prostate gland.
• Ultrasound Scan: To measure the size of the prostate gland and see how much urine remains in the bladder after urination.
• Other special tests: In some cases, tests such as uroflowmetry, which measures the speed of the urine flow, or cystoscopy, which uses a camera to examine the urethra and bladder, may be ordered.

What are the treatments for BPH?

BPH cannot be cured completely. But there are many effective treatments that can help you control your symptoms and live a normal life. Your doctor will determine the best treatment based on your age, health, and the severity of your symptoms.

1. Lifestyle Changes

If your symptoms are not too severe, you can try these simple things first:

• Reduce the amount of fluids you drink, such as water, tea, and coffee, before going to bed at night and before going out.
• Limiting the use of alcohol and caffeine (coffee, some types of tea).
• Doing exercises that strengthen the pelvic floor muscles (consult your doctor about this).

2. Medications

If lifestyle changes alone are not enough, the doctor may prescribe medication.

• Alpha-blockers: These relax the muscles of the prostate gland and bladder neck, making urine flow easier.
• 5-alpha reductase inhibitors: These medications cause the prostate gland to shrink.

Some people may need to use both of these medications together.

3. Procedures and Surgeries

If symptoms cannot be controlled with medication, or if complications such as frequent urinary tract infections or bladder stones occur, surgery may be considered. Most surgeries today are minimally invasive.

• TURP (Transurethral Resection of the Prostate): The most common surgery. A small instrument is passed through the urethra to remove excess parts of the prostate gland.
• Laser Surgery: Using laser beams to vaporize and remove excess tissue.
• UroLift: The use of small implants that push prostate tissue aside so that the urethra is not blocked.

There are various methods like this. Your doctor will explain to you the method that is most suitable for you.

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