What does benign prostatic hyperplasia mean for a man?

Benign prostatic hyperplasia

Benign prostatic hyperplasia (LPP) is a condition that affects many men, especially over the age of 50, becoming an increasingly common problem as the population ages. This condition is characterised by an enlargement of the prostate gland, also known as the prostate, which can lead to a variety of urinary complaints.

The prostate is a small gland that plays a key role in the male reproductive system. It is located just below the bladder and surrounds the urethra. As men age, the prostate naturally enlarges, which can lead to pressure on the urethra and consequent urinary problems.

Although LPP is a benign condition and is not associated with prostate cancer, its symptoms can significantly affect quality of life. It is worth noting that the risk of LPP increases with age. Studies indicate that approximately 50% men in their 60s and up to 90% men in their 80s experience some degree of prostate enlargement. Understanding the condition, early detection and effective management can help to alleviate symptoms and improve overall wellbeing.

Symptoms

Benign prostatic hyperplasia (LPP) can lead to a number of characteristic symptoms that significantly affect men's daily functioning. Recognising these symptoms is crucial for early diagnosis and effective treatment. Here are the most common symptoms of LPP:

  1. Problems with starting to urinate: men with LPP may find that they need more time or effort to start urinating. This may be a result of the enlarged prostate pressing on the urethra.
  2. Weak urine stream: Another common symptom is a weaker than usual urine stream. This may be the result of reduced urine flow through the urethra.
  3. Frequent pushing on the bladder, especially at night (nocturia): LPP can cause men to feel the need to urinate more frequently, especially at night, which can disrupt sleep and lead to fatigue.
  4. Sudden and strong urge to urinate on the bladder: Sudden, difficult to control urge to urinate on the bladder can be another symptom that can be not only uncomfortable but also embarrassing.
  5. Feeling of incomplete bladder emptying: After urinating, men with LPP often feel that their bladder has not been fully emptied, which can lead to more frequent toilet use.
  6. Dripping of urine after urination: This phenomenon, known as fasting, involves urine dripping even after urination is complete, which can be a source of discomfort.
  7. Urinary retention difficulties: Controlling the bladder can become a challenge, leading to cases of incontinence.

It is important that men who experience these symptoms contact their doctor. Early diagnosis and treatment can help control symptoms and prevent further complications. In addition, regular urological check-ups are recommended for older men, even if they are not experiencing clear symptoms of LPP.

Treatment

Treatment of benign prostatic hyperplasia (LPP) includes a range of approaches, tailored to each patient's individual needs and severity of symptoms. From simple changes in daily habits to advanced surgical procedures, there are many ways to manage the condition.

The first step in treating LPP is often lifestyle changes. Simple measures such as regulating fluid intake, especially before bedtime, and avoiding substances that can exacerbate symptoms (e.g. alcohol and caffeine) can provide significant relief. Additionally, regular physical activity and maintaining a healthy body weight can help reduce LPP symptoms.

When lifestyle changes are not enough, doctors may recommend pharmacotherapy. Medications such as alpha-blockers are designed to make urination easier by relaxing the muscles of the prostate and bladder neck. Other drugs, such as 5-alpha-reductase inhibitors, work to reduce the size of the prostate, which can help relieve symptoms.

In situations where drug treatment is unsuccessful, minimally invasive procedures may be considered. One popular method is transurethral thermotherapy, which uses heat to reduce the size of the prostate. This method, although less invasive than traditional surgery, can effectively improve urine flow.

For men with more severe LPP symptoms that significantly affect quality of life, surgical intervention may be an option. Transurethral resection of the prostate (TURP) is one of the most common surgical procedures, which involves removing part of the prostate. Although it is a more invasive procedure, it often provides significant symptom relief.

Some patients are also advised to follow a 'wait with active management' strategy, which involves regular monitoring of the condition without direct medical intervention. This is particularly used in cases where symptoms are mild.

Ultimately, the choice of LPP treatment should be made after consultation with the doctor, who will take into account the patient's individual needs, the severity of symptoms and the potential benefits and risks of each available option. Regular follow-ups and open communication with the doctor are key to achieving the best treatment outcome.

Diagnosis 

Early detection and appropriate management of benign prostatic hyperplasia (LPP) are key to preventing more serious health problems. Early diagnosis of LPP allows rapid action to be taken, which can significantly alleviate symptoms and improve the patient's quality of life.

One of the first steps towards effective management of LPP is to have regular urological examinations, especially in men over 50 years of age. These visits may include an assessment of symptoms, a physical examination, including a per rectum (PR) examination, and laboratory tests such as measurement of prostate-specific antigen (PSA) levels in the blood. These simple diagnostic steps allow doctors to identify potential problems early and plan appropriate treatment.

Early management of LPP often includes lifestyle changes that can help control symptoms. These include modifying diet, increasing physical activity and stress management. In some cases, the doctor may also prescribe medication to ease urination and reduce symptoms.

It is important that patients keep track of their symptoms and consult their doctor regularly to monitor the progress of the disease. Some symptoms may require more intensive treatment, including surgical procedures. Patient awareness and active involvement in the treatment process are essential for the successful management of LPP.


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