Benign prostate enlargement

Specialty of Urology

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia occurs when the size of the prostate gland increases due to a hormonal imbalance in men. The prostate is the male sex gland that surrounds the urethra. It is located below the bladder and above the rectum and is responsible for producing seminal fluid. Prostatic hyperplasia is a common pathology in men after the age of 50 and can affect their quality of life.

Prognosis of benign prostatic hyperplasia

Benign prostatic hyperplasia, or enlargement of the prostate gland, is a common pathology in men after middle age. It is not serious, nor does it increase the risk of cancer which can also affect this gland.

The main problem with benign prostatic hyperplasia is that its symptomatology is bothersome for the sufferer, and can even be incapacitating.

However, the prognosis of this pathology is positive with the proper treatment, although it may return over time.

Each case of hyperplasia will require the necessary follow-up with the urologist.

Symptoms of benign prostatic hyperplasia

The symptoms, which appear progressively, include:

  • Urinary incontinence
  • Difficulty urinating
  • Urinating more frequently
  • Urinary urgency
  • Dribbling after urination
  • Need to urinate several times a night
  • Pain when urinating
  • Blood in the urine

In severe cases, prostate hyperplasia can lead to an absolute inability to urinate, urinary tract infections or impaired kidney function.

Medical tests for benign prostatic hyperplasia

If one or more of the above symptoms are present, the urologist will assess the person’s medical history, study the severity of their symptoms and perform a rectal examination to check the condition of the prostate.

The person may also require clinical tests such as urine tests to rule out infection, or blood tests to examine prostate-specific antigen (PSA) levels and to rule out prostate cancer.

What causes benign prostatic hyperplasia?

Although there is no known direct cause or risk factor for benign prostatic hyperplasia, it occurs when the size of the prostate gland increases due to a hormonal imbalance in the testicles: the female hormone (oestrogen) increases, while the male hormone (testosterone) decreases.

Can it be prevented?

Benign prostatic hyperplasia cannot be prevented, but it can be detected in its early stage through regular check-ups with a urologist.

Specialists recommend annual prostate screening after the age of 50 when there is an increased risk of prostate enlargement.

Treatment for benign prostatic hyperplasia

If symptoms are mild, the specialist may prescribe medication and recommend lifestyle changes (such as avoiding alcohol and caffeine, playing sports, and adapting urination routines).

In more severe cases, surgery may be required.

Operations for benign prostatic hyperplasia usually include:

  • Transurethral resection of the prostate: This is the most common procedure, in which the prostate is removed through an endoscope inserted through the penis.
  • Simple prostatectomy: The inside of the prostate is removed through an incision made in the abdomen.
  • Prostate laser surgery: With this latest technique, the tissue is destroyed with a laser, making it a less invasive option.

Which specialist treats it?

The urologist is the specialist in charge of treating prostate hyperplasia.

Due to the symptoms of urinary problems, the diagnosis may be made by an andrologist and a urologist. The urologist may also perform the surgery, although some general surgeons are also specialised in these operations. 

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