Benign prostatic enlargement/Hypertrophy(BPE/BPH) and Lower urinary tract symptoms(LUTS)

What is Benign prostatic enlargement?

The prostate is a gland located in the lower urinary tract, under the bladder and around the urethra. Only men have a prostate. A healthy prostate is about the size of a large walnut and has a volume of 15-25 millilitres. The prostate slowly grows as men grow older. They can cause bothersome symptoms in the lower urinary tract in men over the age of 50. These symptoms may be caused by an enlargement of the prostate, a condition which is known as benign prostatic enlargement/Hypertrophy (BPE/BPH). Other conditions can also cause these symptoms and a urologist will take this into account.

What are Lower Urinary Tract symptoms?

Benign prostatic enlargement (BPE) can affect the way you normally urinate. This happens because the enlarged prostate compresses the urethra at the outlet of the bladder. Sometimes the symptoms are mild. For example, you may need to urinate more often or it is more difficult to empty your bladder completely. These mild symptoms can be a normal part of the ageing process just like decline in mobility, memory, or flexibility. It is possible that your doctor will not recommend treatment for mild symptoms.

Sometimes the symptoms are very bothersome and can have a negative effect on your quality of life. In this case you may benefit from treatment.

These symptoms which are called as lower urinary tract symptoms (LUTS) may be caused by BPE and may be due to other conditions which affect the urinary system.

Types of Lower Urinary Tract symptoms

In men with BPE, the symptoms can affect urination in different ways:

The way you hold the urine in the bladder (Storage Symptoms)

·         The need to urinate more often than usual

·         The need to wake up at night to urinate

·         The sudden need to urinate and having trouble postponing it

·         Any involuntary loss of urine

The way you urinate (Voiding symptoms)

·         A weak stream of urine

·         Splitting or spraying of the urine stream

·         The flow of urine starts and stops

·         Straining when urinating

·         It takes a while before the urinary flow starts

·         It takes longer to finish urinating

·         In rare cases, acute or chronic urinary retention

How you feel after you urinate (Post-micturition)

·         The feeling that the bladder is not completely empty

·         Involuntary loss or dribbling of urine into your underwear shortly after leaving the toilet

How to diagnose symptoms are due to Benign Prostatic Enlargement?

Urologist do a series of tests to understand what causes your symptoms after taking proper medical history. The symptoms listed previously can point to many diseases and not only BPE. This is why you may need to take several tests before the urologist can make a diagnosis. Tests include physical examination of abdomen and genitals, rectal examination with a finger to feel the size, shape, and consistency of the prostate (known as digital rectal examination), urine tests, blood tests (Kidney function tests, Prostate specific antigen), bladder diary( i.e. how much you drink, how often you urinate, and how much urine you produce), Uroflowmetry (electronic recording of flow of urine), Imaging of urinary tract(ultrasound) or/and urodynamics( test to know more information about your urination cycle and how your bladder muscles work) according to the need in diagnosis.

What the way ahead after Diagnosis?

Depending upon your test results urologist will decide either medical (in the form of oral drugs) or surgical management for your lower urinary tract symptoms due to benign prostatic enlargement. It’s the time to consult the urologist if you are experiencing lower urinary tract symptom as described before.