Benign Prostatic Hyperplasia


Benign prostatic hyperplasia (BPH) is the most common problem of men’s health. Unlike common belief, it is even widely prevalent in young adults, though they might not have severe symptoms. Studies estimate that approximately 10% of men have BPH in their 30s.

But, of course, the problem continues to rise with age. Thus, the majority of older men have BPH. A Malay study estimates that the prevalence of BPH is 41.7% in men aged 50-59, and these numbers increase to above 65% by the age of 70. It appears that in men older than 70, perhaps most would have BPH, though not all may develop its signs and symptoms.

What is BPH?

Simply described, it is benign prostate enlargement. The prostate is a walnut-sized gland that produces seminal fluid and plays a vital role in male reproduction. However, as men get older, it becomes enlarged and thus pressurizes the adjacent structures in the body. This leads to various urinary symptoms like difficulty voiding the bladder, reduced urinary flow, and even kidney issues.

Experts warn that many people and even doctors tend to have an oversimplistic overview of BHP as merely a prostate enlargement. However, it leads to many other conditions like lower urinary tract symptoms (LUTS), bladder issues, and even kidney issues. These issues are often related to BPH, though not essentially, and hence some diagnostic challenges.

Symptoms of BPH

BPH develops slowly over the years, and thus many men fail to identify the problem, at least, in its early stages. However, symptoms keep worsening with advancing age:

  • Most men would have an issue of frequent or urgent need to urinate
  • There is increased urination at night or nocturia
  • One of the common signs is difficulty in starting urinating
  • The weak urine stream is also a significant problem, and thus a stream that starts and stops quite slowly
  • Difficulty in completely emptying the bladder – it may also explain frequent urge to urinate

However, the presentation may be atypical in some people, and other signs and symptoms may dominate or occur frequently. For example, there might be frequent episodes of urinary tract infection, inability to urinate, and even passing of blood in urine in some men.

Why is it essential to see a doctor?

It is vital to understand that severity of symptoms does not necessarily represent the prostate size. In addition, there are significant differences between the individuals. Thus, in some, symptoms may develop even on minor prostate enlargement, while in others, symptoms might be mild despite substantial prostate enlargement.

Since the severity of symptoms cannot reliably tell about the prostate enlargement, there is a need to undergo a more thorough examination in a clinic. This shows why men of middle age should not neglect even minor signs of urinary tract signs and symptoms, and moreover, it shows the need for frequent medical checkups in the age group.

Additionally, one needs to understand that not all urinary tract issues indicate BPH. Similar kinds of symptoms may occur due to many other prostate conditions like urinary tract infection, prostate inflammation (prostatitis), narrowing of the urethra, kidney or bladder stone, issues with nerves, and even prostate or bladder cancer.

As one can see, in most men, these signs and symptoms are due to BPH, but not necessarily. They could be a sign of malignancy, too. After all, prostate cancer is among the most common cancers in men.

Apart from signs and symptoms, experts recommend that men with certain risk factors should be more careful, like those with family history, diabetes, heart disease, family history of prostate cancer, and so on.

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