Benign Prostatic Hyperplasia Prostate of increasing size

The prostate is an organ of the male urogenital apparatus in the form of a chestnut, which surrounds the initial portion of the urethra (tube that carries urine from the bladder to the penis) and weighing approximately 20 grams. Its main function is the secretion of elements
of semen (ejaculate), participating in its propulsion through the urethra during ejaculation.

The mistaken notion that urinary symptoms are a normal occurrence of age, fear of a diagnosis of cancer or a possible surgery and the reluctance and  embarrassment of discussing urinary and sexual symptoms with a doctor, lead to many men not having regular prostate monitoring.

All men are advised to make an annual observation of this organ, from the age of 50, and, if there are direct relatives who have suffered from prostate cancer, from the age of 45 years.

Most prostate diseases are due to their benign growth (80%) and only 18% are due to cancer. This benign growth of the prostate, Benign Prostatic Hyperplasia (BPH), has multifactorial origin. Age and the presence of male hormone are essential factors for the development of the disease.

From the age of 30, the growth of the prostatic tissue begins with the formation of nodules around the urethra. About 50% to 60% of men aged 60 and over 80% of men aged 80 years have prostate enlargement. However, only half of men with BPH have symptoms caused by the disease.

It must be pointed out that HBP is not cancer, so this growth is not due to the proliferation of malignant cells, and also that BPH does not cause cancer. The two diseases may even coexist and appear at different heights of a man's life.

However, complications derived from BPH (urinary calculi, kidney failure due to kidney damage, and development of large bladder with urinary incontinence) may develop in patients whose urinary symptoms are minimal.

The most frequent symptoms are a weaker and thinner urine stream, difficulty initiating urination, prolonged urination, sometimes interrupted or intermittent, incomplete emptying of the bladder, dribble at the end of urination, increased daytime and nighttime urinary frequency, and difficulty in holding the urge to urinate (voiding urge).

The appearance of blood in the urine (hematuria) and the sudden impossibility of urinating (acute urinary retention) are serious symptoms of this disease that require rapid medical intervention.

Appropriate surveillance in all men with BPH, at least annually, will avoid these situations, while simultaneously screening for prostate cancer. This is done by the rectal touch (palpation of the prostate) and by a blood test - PSA (Prostate Specific Antigen).

For patients with symptoms caused by BPH, there are now highly effective medications. In addition to improving symptomatology, they also reduce the possibility of acute urinary retention and the future need for surgical intervention.

Surgical treatment is reserved for patients with severe symptoms who are untreated after drug therapy, or for patients who have urinary retention, repeated urinary tract infections, hematuria, and significant changes in the bladder or kidneys.

The most commonly used surgical method is endoscopic resection of the prostate, known as RTU, which consists of extracting the nodules of hypertrophy through devices that are introduced under anesthesia into the urethra.

Contrary to what is often thought, these procedures do not prevent prostate cancer, which makes regular surveillance mandatory. They do not influence sexual potency or orgasm, but in 50 to 70% of patients submited to surgery, retrograde ejaculation may be a side effect.

As an alternative to classic surgery treatment, Laser surgery presents results that have been shown as promising.