Benign prostatic hyperplasia (BPH) is the most common disorder of the prostate gland. It can have a significant impact on the male’s quality of life. It commonly occurs after the age of 50 but can occur earlier. It is NOT prostate cancer. Men who are affected by BPH often present with lower urinary tract symptoms (LUTS). Some men may present with urinary retention from long-standing BPH and increasing difficulty in voiding. By the age of 60 years, 50 per cent of men have histological evidence of BPH and 15 per cent have significant lower urinary tract symptoms.
The lower urinary tract symptoms can be broadly divided into storage and voiding symptoms. The voiding symptoms include decreased force of the urinary stream, hesitation in the initiation of flow, intermittency and sensation of incomplete emptying. This is due to mechanical obstruction which may result from intrusion into the urethral lumen or bladder neck, resulting in a higher bladder outlet resistance. Storage symptoms are due to the secondary response of the bladder to the outlet resistance. The symptoms include urinary frequency, urgency, and nocturia.
Early BPH with mild LUTS can be treated with medications. Men with moderate to severe LUTS may require minimally invasive surgery such as UROLIFT or endoscopic prostatectomy either with laser or bipolar energy.