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Prostate cancer may get all of the press (and a lot of mustaches, thanks to No-Shave November), but men are much more likely to develop benign prostatic hyperplasia (BPH) at some point in their lives. It's the most common benign tumor growth in aging men, with about 70% of men diagnosed by the time they are 60 and a whopping 90% diagnosed by the age of 70. Almost half a million men undergo surgery to correct BPH each year. So, what is it?
The best part of BPH is that the 'B' stands for benign.
What's happening is that the stromal and epithelial cells of the prostate are stimulated by a derivative of the male sex hormone testosterone called dihydrotestosterone. (The stroma is the foundational skin layer of an organ and the epithelium is the surface layer.) At the same time, aging men have increased concentrations of estrogen in their systems. The estrogen actually increases the amount of hormone receptors in the prostate. More hormone receptors combined with more hormones means that the prostate nodules enlarge quickly.
Why is that Bad?
Even though it's benign, BPH has a negative effect on a man's overall well-being. The prostate is normally a small gland that is practically wrapped around the the neck of the bladder and the urethra in men. Think of it as your fingers around the neck of a balloon. Held loosely, air can escape the balloon easily. Held tightly, the air stays put or comes out slowly and in fits and starts. Now imagine that full balloon is your bladder and hold on tight to the neck. As you can see, an enlarged prostate is an uncomfortable situation.
How Do I Know if I Have BPH?
The most noticeable sign is that you have trouble urinating. It could be problems starting up or stopping or it could be constantly feeling as if you need to urinate. Waking up multiple times in the night to use the bathroom is another common indicator. Since it's so difficult to empty the bladder, urinary tract infections can develop. Sometimes, men will suffer from acute urinary retention. This is when they're unable to urinate at all, not a good thing in the least. That can lead to kidney damage, bladder hypertrophy (increase in size), hydronephrosis (stretching of the kidney tissues), and even sepsis.
These tests will include a urinalysis and a digital rectal exam. The urinalysis checks for a variety of issues, while the exam allows the doctor to confirm that the prostate is enlarged.
Can I Just Take a Pill?
It depends on how bad the symptoms are. For men with mild or moderate symptoms, some prescription medications like alpha blockers and 5-alpha-reductase inhibitors are used to reduce or even eliminate the problems. Alpha blockers relax the muscles of the prostate and the urethra to allow urine to flow more easily, while 5-alpha-reductase inhibitors can actually shrink the prostate when taken consistently over the course of a year. Both classes of drugs come with side effects, though. These range from headaches and dizziness to impotence and ejaculatory dysfunction.