Benign Prostatic Hyperplasia (BPH): Causes, Symptoms, and Treatment

Discover the causes, symptoms, and advanced treatments for Benign Prostatic Hyperplasia (BPH) at Turkey Healthcare Group, including HoLEP, laser surgery, and medication.

Benign Prostatic Hyperplasia (BPH): Causes, Symptoms, and Treatment Options

The prostate gland is located directly below the bladder in men and surrounds the tube called the urethra, which carries urine from the bladder out of the body. The prostate gland of an adult male weighs approximately 25–30 grams. Its primary role is to produce seminal fluid and aid in its ejaculation.

The prostate gland gradually begins to enlarge after the age of forty. In particular, the inner part of the prostate may increase in size, transforming from its normal size, similar to a chestnut, to the size of an apple or even an orange. This condition is medically known as Benign Prostatic Hyperplasia (BPH), which is the medical term used to describe non-cancerous prostate enlargement.

Benign Prostatic Hyperplasia is not cancer. However, its symptoms may indicate more serious conditions, including prostate cancer. At Turkey Healthcare Group, we offer comprehensive diagnosis and treatment plans for all prostate conditions.

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Does Benign Prostatic Hyperplasia Increase the Risk of Prostate Cancer?

Research shows that having BPH does not increase the risk of developing prostate cancer. However, BPH and prostate cancer share similar symptoms. Therefore, a person could have prostate cancer that goes undetected while also having BPH at the same time.

To help detect prostate cancer in its early stages, every person with a prostate gland should undergo regular prostate screening every year between the ages of 55 and 69. The risk of prostate cancer is higher if the person is Black or has a family history of prostate cancer. In this case, it is recommended to start screening from the age of 40.

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What Are the Symptoms of Benign Prostatic Hyperplasia?

As the prostate enlarges, it begins to obstruct the urethra, hindering urine flow. As the condition progresses, patients begin to experience urinary symptoms that vary depending on the degree of obstruction. The symptoms are assessed in two main groups:

Obstructive Symptoms:

• Weak urine stream and slow flow.
• Difficulty initiating urination.
• Intermittent urination (stopping and starting).
• Dribbling at the end of urination.
• A feeling of incomplete bladder emptying.
• Presence of blood in the urine.

Irritative Symptoms:

• Frequent urination (both day and night).
• Sudden, urgent need to urinate.
• Urine leakage upon feeling an urgent need to urinate.
• Burning sensation and pain during urination.

In some cases, the urethra may become completely blocked due to prostate enlargement, causing the patient to suddenly become unable to urinate. At this point, it may become necessary to insert a catheter into the bladder to drain the urine.

However, it is important to note that prostate enlargement alone is not considered a sufficient indicator of the condition’s severity. Rather, the emergence of symptoms, the worsening of their severity, and the occurrence of urinary complications due to the enlargement are all factors that determine the medical significance of the condition.

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Complications in the Urinary Tract Resulting from BPH

Sudden Inability to Urinate (Acute Urinary Retention)

This occurs when the urinary tract becomes completely blocked, rendering the patient unable to urinate. This is accompanied by severe pain in the lower abdomen. It requires the insertion of a urinary catheter to drain urine from the bladder.

Urinary Tract Infections

The obstruction of the urinary tract can lead to bladder infections. When this occurs, the patient may experience severe burning during urination and a high fever.

Bladder Damage

A bladder that does not empty completely due to prostate obstruction may overstretch, weaken, and lose its ability to contract over time. If the bladder loses its contractile function, urine will remain pooled inside it. This damage can sometimes be irreversible, even after surgical intervention.

Bladder Stones

Bladder stones form due to the sedimentation of infection and minerals in the residual urine left in the bladder because of the obstruction.

Kidney Damage

Bladder infections can spread to the kidneys. Furthermore, the high pressure resulting from the bladder obstruction and the pooling of urine can lead to kidney enlargement (hydronephrosis) and impaired kidney function. In rare cases, some patients may develop kidney failure.

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How is Benign Prostatic Hyperplasia (BPH) Diagnosed?

Prostate enlargement may not be the only cause of a patient’s urinary symptoms. Therefore, the patient must be thoroughly examined by our expert doctors before being diagnosed with BPH.

It is always important to ask the patient about the medications they are taking, family history of diabetes, and any previous injuries or trauma. For example, a patient with early BPH who uses antihistamines or decongestants for colds may find their symptoms worsening.

Risk Factors

• Aging: An enlarged prostate rarely causes symptoms before the age of 40. After this age, the likelihood increases.
• Family History: Having a first-degree relative with prostate problems increases the probability.
• Diabetes and Heart Disease: Studies have shown that diabetes and heart disease may raise the risk of BPH.
• Lifestyle: Obesity increases the risk, while regular exercise helps reduce it.

Diagnostic Tests and Procedures

Our Urology Departments utilize advanced methods to diagnose BPH accurately:

• 1. Digital Rectal Exam (DRE): A urologist examines the size, firmness, and shape of the prostate.
• 2. Prostate-Specific Antigen (PSA) Test: PSA levels in the blood can rise due to BPH, prostatitis, or prostate cancer.
• 3. Urinalysis: Checks for inflammatory cells or blood in the urine.
• 4. Urine Flow Rate Test: Measures the flow rate and voiding time.
• 5. Ultrasound: Determines the prostate’s size and internal structure.
• 6. Symptom Assessment (IPSS Questionnaire): Assesses the severity of a patient’s symptoms.
• 7. Post-Void Residual (PVR) Volume Measurement: Determines the amount of urine left in the bladder after urination.
• 8. Urodynamic Studies: Measures bladder pressure, flow rate, and urethral pressure.
• 9. Cystoscopy: A thin, flexible scope is inserted through the urethra to see the degree of obstruction.
• 10. Intravenous Urogram (IVU) or CT Scan: Provides clear details about the kidneys and urinary tract.

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Treatment for Benign Prostatic Hyperplasia (BPH)

There are many treatment options for BPH. Your specialist will decide the most suitable option for your condition, ranging from medications to utilizing the latest medical technologies.

Active Surveillance

Often, BPH may only require active surveillance. This means the condition is closely monitored without direct treatment, with periodic check-ups by a urologist.

Prescription Drugs

• Alpha-Blockers: Work by relaxing the muscles of the prostate and bladder neck to relieve symptoms. (e.g., Tamsulosin, Alfuzosin).
• 5-Alpha Reductase Inhibitors: Reduce the size of the prostate by inhibiting the hormone (DHT) that causes its growth. (e.g., Dutasteride, Finasteride).
• Combination Therapy: Combines alpha-blockers and 5-alpha reductase inhibitors for better results.

Minimally Invasive Surgery

Often performed as outpatient procedures with a faster recovery time:

• Prostatic Urethral Lift (PUL): Placement of small permanent implants that lift the prostate and open the urethra.
• Water Vapor Thermal Therapy (WVTT): Uses water vapor to destroy prostate cells.
• Temporary Implantable Devices (TIPD): Placed in the urethra to temporarily widen the urinary passage.
• Prostatic Artery Embolization (PAE): Blocks the arteries supplying the prostate to shrink it.

Traditional & Advanced Surgery

Recommended for severe cases or when other treatments have failed. At our hospitals, we provide state-of-the-art surgical interventions:

• Holmium Laser Enucleation of the Prostate (HoLEP): The surgeon introduces a laser beam that destroys excess prostate tissue. No incisions are needed, and bleeding is minimal.
• Thulium Laser Enucleation of the Prostate (ThuLEP): Similar to HoLEP but uses a different type of laser. Excellent for men at higher risk of bleeding.
• Transurethral Vaporization of the Prostate (TUVP): Uses an electrical current to destroy prostate tissue, minimizing bleeding and fluid absorption.
• Aquablation Therapy (TWJA): Relies on high-pressure water jets guided by ultrasound to destroy excess prostate tissue.
• Simple Prostatectomy: The entire prostate gland is removed using laparoscopic or robot-assisted surgery for significantly enlarged prostates.

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What to Expect After Surgery?

For most men, symptoms improve significantly after treatment. It may take some time for sexual function to fully return. Most experts believe that if you were able to achieve an erection immediately before surgery, you will likely be able to do so afterwards. However, some men may experience retrograde ejaculation (semen entering the bladder).

Can Benign Prostatic Hyperplasia Be Prevented?

There is no certain way to prevent BPH, but losing weight and following a balanced diet rich in vegetables and fruits may help. Physical activity also helps control weight and hormone levels.

If you are experiencing symptoms of an enlarged prostate, don’t wait for complications. Contact us today or use our Online Services to consult with our medical experts.

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Frequently Asked Questions (FAQs) About BPH