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What is prostatic hypertrophy?

Benign prostatic hypertrophy (BPH), or enlarged prostate, is a very common disease in the male population. It is estimated that about 30% of men over 65 suffer from urinary symptoms related to prostatic hypertrophy. It consists of the growth of prostate tissue in the periurethral area (prostate adenoma) and can lead to difficulty in urination. About 60% of men over 60 suffer from urination disorders which may be secondary to prostatic hypertrophy or other components due to impaired bladder function.

Prostatic hypertrophy or enlarged prostate

BPH occurs with an increase in the volume of the prostate, which hinders the outflow of urine. Generally, urinary flow is reduced, often intermittent, preceded by dripping and accompanied by a feeling of incomplete emptying of the bladder after finishing urination. The urge to urinate may increase, often urgently and at night. In some cases it is possible to fail to urinate (acute urinary retention).

How is it diagnosed?

The diagnosis of BPH occurs with an accurate clinical examination, also including rectal exploration, to exclude any other pathologies that can give overlapping symptoms. Among the tests useful for the diagnosis are uroflowmetry and urodynamic pressure-flow study, which allow to evaluate the flow of urine and the consequences on bladder functioning caused by obstruction to urinary flow. In addition, the dosage of PSA (Specific Prostate Antigen) is usually required, the values ​​of which can be high due to the increase in prostate volume and must be correctly interpreted to exclude the possible coexistence of a malignant prostate disease. Among the other investigations required there is usually a urinalysis with urine culture, which allows to exclude a possible urinary tract infection, able to simulate a symptomatology similar to that of BPH. Finally, the transrectal prostatic ultrasound is a useful tool for assessing the correct volume of the prostate, especially important for any surgical intervention.

PROSTATIC HYPERTROPHY - THERAPY

Benign prostatic hypertrophy is treated with drug therapy (α-lytic drugs, 5α-reductase inhibitors and phytotherapics) or surgery. Surgical therapy is used when the drug is not effective. The goal of surgical therapy is to remove the prostate adenoma to resolve the obstruction that prevents the normal expulsion of urine. Prompt intervention is important to avoid long-term complications, such as urinary retention, bladder stones and chronic kidney failure.