Benign Prostatic Hyperplasia: Symptoms, Causes and Treatment

Published at 23 September 2024

Benign prostatic hyperplasia is usually not a serious problem. It is a common and normal in most men as they age. About 60% of men aged 60 years suffer from benign prostatic hyperplasia, and the percentage increases to 80% by the age of 80. (1) (2)

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia (BPH) is a common condition in men after aging. It can cause annoying urinary symptoms in men when this hyperplasia begins to press on the urethra, including weak urine flow, difficulty urinating (Dysuria), and recurrent urinary infections, and other symptoms. These symptoms often appear after the age of 50 years. (3)

To help you imagine, the normal size of the prostate gland is similar to the size of a walnut (about 25 grams), and when benign prostatic hyperplasia occurs, this number can reach 3 times (more than 80 grams)! (4)

Benign prostatic hyperplasia symptoms

Symptoms usually appear when the prostate gland presses on the urethra around it, causing the following urinary symptoms: (5)

Poor urine flow.
An urgent need to urinate, usually at night (Nocturia).
Dysuria.
The feeling of not voiding all urine after urinating (Vesical tenesmus).
Drops of urine after urination (post-micturition dribbling).
Recurrent urinary infections.
Urinary continence and kidney infections in rare cases.

Sometimes the benign prostatic hyperplasia symptoms may not appear, or they may be minor, and the man does not notice them. The severity of the symptoms is not necessarily related to the size of the prostate hyperplasia, as symptoms may be severe even in the presence of a slight enlargement.

Book an appointment with the Urology Department at Al-Ahli Hospital if you suffer from symptoms of benign prostatic hyperplasia, as a group of specialized doctors will help you evaluate your condition and find appropriate solutions.

Causes of benign prostatic hyperplasia

The cause of benign prostatic hyperplasia in men is not known, but it is thought to be related to sex hormonal changes that occur with aging. (6)

There are some things that may worsen the symptoms of benign prostatic hyperplasia, but they do not cause it directly, including: (5) (4)

Cold weather.
Psychological stress and tension.
Some medications, such as diuretics, beta blockers, allergy and cold medications, anti-inflammatories, and some antidepression medications.
Caffeine-containing drinks, such as coffee, tea, and soft drinks.
Some types of food, such as spicy food, spices, dairy products, and red meat.

Benign prostatic hyperplasia diagnosis

It is diagnosed based on the nature of the symptoms that the man suffers from, and through a digital rectal examination (anal examination), in which the doctor inserts one finger through the rectum and checks the extent of the gland’s enlargement, or a digital rectal examination can also be performed in the same way but by using a anoscope instead of a finger. (7)

After that, the doctor requests a set of invistigations to confirm the diagnosis and rule out similar conditions, including: (7)

Blood or urine test to rule out urinary tract infections and kidney infections.
Prostate-specific antigen (PSA) test, whose levels rise when the prostate is enlarged, or when there is also prostate cancer.
Other tests, such as imaging tests, urine flow tests, biopsy, etc.

Treatment of benign prostatic hyperplasia

Most of the symptoms of benign prostatic hyperplasia are mild, and can be alleviated through some lifestyle changes, such as: (8)(9)

Urinate immediately when needed, and do not postpone it.
Go to the bathroom at regular intervals even if you do not feel an urgent need to urinate.
Wait a few minutes after you finish urinating to ensure that your bladder is completely voided.
Reduce drinking caffeine, especially in the evening.
Do not drink large amounts of fluids at once, distribute them throughout the day, and stop drinking anything at least two hours before sleep.
Keeping the body warm in cold weather.
Avoid tension and psychological stress.
Try not to use cold and allergy medications, because they make symptoms worse.

If the symptoms are very disturbing, the doctor can recommend some medications to relieve the symptoms of benign prostatic hyperplasia, the most commonly used of which are: (8)

Alpha-1 antagonist medications: such as alfuzosin (Xatral) and tamsulosin (Omnic), which help relax the bladder and prostate muscles and facilitate urination. Symptoms begin to improve after 3-7 days of use.
Finasteride (Proscar) and dutasteride (Avodart): These medications help decrease the size of the prostate, and improve symptoms after 3 to 6 months of use.
Antibiotics: They are used if there is inflammation or congestion in the prostate.

Surgery may be considered in severe conditions or in the case of complications from prostate hyperplasia. Available options include: (8)

Transurethral prostatectomy.
laparoscopic open prostatectomy (small incision in the abdomen).
New techniques such as: prostatectomy by using a holmium laser or heat, using vaporization (rhizome maneuver) and others.