Benign Prostate Hypertrophy

Benign Prostatic Hyperplasia (BPH) is a common condition that affects the prostate, a gland of the male reproductive system. Unlike prostate cancer, prostatic hypertrophy is not malignant but can still cause significant urinary symptoms. The prostate, usually the size of a walnut, surrounds the male urethra and can increase in size with age, compressing the urethra and causing obstruction to the outflow of urine.

Symptoms of Prostate Enlargement

• Urinary Urgency: a sudden and uncontrollable sensation of having to urinate;
• Urinary Flow Weakness: reduction in flow strength during urination;
• Frequent urination: need to urinate more often, especially at night (nocturia);
• The sensation of incomplete emptying: despite urination, there is a sensation that the bladder is not empty;
• Difficulty Starting Urination: Difficulty starting to urinate.

Causes of prostatic hypertrophy

The causes of prostatic hypertrophy are not fully understood, but several factors appear to contribute to its development:

• Age: Prostatic hypertrophy is more common in older men due to hormonal and cellular changes;
• Hormonal Imbalances: increased testosterone levels;
• Genetic factors: the presence of cases in the family can increase the risk;
• Chronic inflammation: Long-term inflammation of the prostate can promote prostate enlargement.

Diagnosis

The diagnosis of prostatic hypertrophy requires a complete medical evaluation. Tests and procedures include:

• Blood test for PSA (Prostate Specific Antigen): A high level may indicate prostate problems but is not specific to BPH;
• Urinalysis: to rule out urinary infections or other conditions;
• Digital rectal exam: allows the doctor to evaluate the size, shape, and consistency of the prostate;
• Prostate ultrasound: uses ultrasound to obtain detailed images of the prostate;
• Uroflowmetry: measures the speed and quantity of urine passed during urination.

Non-invasive conservative treatments

Active Monitoring: Indicated for mild to moderate symptoms, involves regular supervision without immediate intervention:

Lifestyle Changes:

• Diet: A balanced diet with fruits, vegetables and fiber can help;
• Physical exercise promotes weight control and general health;
• Stress management: Stress management techniques can relieve symptoms.
• Reduce water intake in the evening to prevent nocturnal urination, which interrupts sleep and can cause a reduction in the quality of life.

Alpha-blocker drugs relax the prostate and bladder muscles, improving urinary flow.

5-alpha reductase inhibitors help reduce the size of the prostate.

Surgery

Transurethral Resection of the Prostate (TURP): removal of part of the prostate through the urethra with the use of thermal energy for cutting and clotting;

Laser Enucleation of the Prostate (HoLEP): it is an endoscopic procedure that allows the removal of excess tissue with the use of laser;

Trans-vesical prostatic adenomectomy: with an incision above the pubis, the enlarged part of the prostate is surgically extracted "open."

Prevention Tips

Regular screening: Men over 45-50 years old, especially those with a family history of Prostate Hypertrophy, should undergo regular screening.

Healthy Lifestyle:

• Alcohol and smoking: reduce alcohol consumption and stop smoking;
• Weight control: Maintaining a healthy weight reduces the risk of prostatic hypertrophy.