Westerners often compare the normal size of the prostate gland to the size of a walnut, which is located just below the bladder.
The prostate gland functions to produce fluid that makes up about 30% of the semen. Benign Prostatic Hyperplasia (BPH) is a condition where the prostate gland is abnormally enlarged. It is commonly found in men aged 45 and older, and especially in elderly men aged 80 and above, with a prevalence of up to 80%.
Because the prostate gland surrounds the initial part of the urethra, when the prostate enlarges, it may compress the urethra, causing it to narrow. This results in difficulty urinating. Additionally, an enlarged prostate may cause the bladder muscle wall to thicken because it has to contract more forcefully to push urine through the narrowed urethra. When the bladder wall thickens, it affects the bladder’s ability to store urine, causing frequent urination and sometimes sudden urges to urinate.
Benign Prostatic Hyperplasia is Associated with Increasing Age
The occurrence of BPH is often related to age. Evidence shows that 50% of men with BPH are around 60 years old or older. Although there is no clear evidence that BPH leads to prostate cancer, the symptoms of BPH and prostate cancer are similar, and it is possible that both conditions may occur simultaneously.
7 Warning Signs to Watch For
BPH can present with various initial symptoms. Therefore, if you experience any of the following symptoms, you should promptly see a doctor for diagnosis and appropriate treatment planning.
- Frequent urination, especially at night
- Inability to hold urine or needing to strain to urinate
- Severe pain during urination
- Difficulty urinating
- Sudden inability to urinate
- Incomplete emptying of the bladder
- Weak urine stream, intermittent flow, or dribbling near the end of urination
Methods for Diagnosing Benign Prostatic Hyperplasia
- The doctor will take a detailed medical history to clearly assess symptoms.
- Blood tests, urine tests, and measurement of urine flow rate.
- Ultrasound to measure the size of the prostate.
- Digital Rectal Examination (DRE) to palpate the prostate through the rectum to check for abnormalities.
- The doctor will plan appropriate and comprehensive treatment clearly and accurately.
How to Treat Benign Prostatic Hyperplasia
BPH can be treated and cured. Treatment is mainly divided into two types: medication and surgery, including:
- Medication to relax the contraction of the prostate muscle Medications used are alpha-blockers, which help inhibit the production of the male hormone 5-alpha reductase (DHT) and affect the size of the prostate. Treatment is based on symptoms.
- Transurethral resection of the prostate (TURP) This is a popular surgical method performed by specialized doctors. There are two types:
- Surgical treatment via cystoscopy TURP (Transurethral Resection of the Prostate) Patients receive general or local anesthesia. The doctor inserts a small tube-like camera called a resectoscope through the urethra to the prostate. Then, the doctor uses an electric loop at the tip of the camera to cut away the obstructing prostate tissue, seals the blood vessels, and cleans the area to remove tissue debris. This surgery takes about 90 minutes. After surgery, patients must stay in the hospital for 3 days and have a urinary catheter inserted.
- Transurethral vaporization resection of the prostate (TURPV) or Plasma Kinetic (PK) This method uses a bipolar electric cutting and cauterizing system that preserves the tissue beneath the cut area and prevents excessive burning. It has a vaporization system similar to laser vaporization.
- Green Light Laser PVP (Photo-Selective Vaporization of the Prostate) This innovative surgery uses a small camera inserted through the urethra, similar to cystoscopy, but instead of cutting, a high-energy laser is used to vaporize the obstructing prostate tissue gradually. This method causes less bleeding and is suitable for elderly patients or those with chronic conditions who cannot stop blood-thinning medications.
- Thulium Laser Vaporesection of the Prostate This method is as effective as PVP but differs in that it can cut the obstructing prostate tissue into small pieces for biopsy in cases where there is a risk of prostate cancer. It is also used to treat urethral strictures caused by fibrosis.
Possible Complications if Not Treated Promptly
- Bladder infection
- Hematuria (blood in urine) due to prostate enlargement
- Kidney deterioration or failure
- Frequent urinary tract infections
- Bladder stones
- Kidney damage due to urine backflow
- Inability to urinate
Therefore, all men should regularly observe any abnormalities during urination. Men aged 45 and older should have their urinary system checked by a specialist to assess risk, prevent disease, and if diagnosed, receive early treatment to avoid severe disease and subsequent complications.
