Back تضخم البروستات الحميد Arabic Hiperplàsia benigna de pròstata Catalan Benigní hyperplazie prostaty Czech Prostatavergrößerung German ޕްރޮސްޓޭޓް އާދަޔާ ޚިލާފަށް ބޮޑުވުން DV Καλοήθης υπερπλασία προστάτη Greek Hiperplasia benigna de próstata Spanish Prostatako hiperplasia onbera Basque هایپرپلازی خوش‌خیم پروستات Persian Eturauhasen liikakasvu Finnish

Benign prostatic hyperplasia

Benign prostatic hyperplasia
Other namesBenign enlargement of the prostate (BEP, BPE), adenofibromyomatous hyperplasia, benign prostatic hypertrophy,[1] benign prostatic obstruction[1]
Diagram of a normal prostate (left) and benign prostatic hyperplasia (right)
SpecialtyUrology
SymptomsFrequent urination, trouble starting to urinate, weak stream, inability to urinate, loss of bladder control[1]
ComplicationsUrinary tract infections, bladder stones, kidney failure[2]
Usual onsetAge over 40[1]
CausesUnclear[1]
Risk factorsFamily history, obesity, type 2 diabetes, not enough exercise, erectile dysfunction[1]
Diagnostic methodBased on symptoms and examination after ruling out other possible causes[2]
Differential diagnosisHeart failure, diabetes, prostate cancer[2]
TreatmentLifestyle changes, medications, a number of procedures, surgery[1][2]
MedicationAlpha blockers such as terazosin, 5α-reductase inhibitors such as finasteride[1]
Frequency94 million men affected globally (2019)[3]

Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland.[1] Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.[1] Complications can include urinary tract infections, bladder stones, and chronic kidney problems.[2]

The cause is unclear.[1] Risk factors include a family history, obesity, type 2 diabetes, not enough exercise, and erectile dysfunction.[1] Medications like pseudoephedrine, anticholinergics, and calcium channel blockers may worsen symptoms.[2] The underlying mechanism involves the prostate pressing on the urethra and thereby making it difficult to pass urine out of the bladder.[1] Diagnosis is typically based on symptoms and examination after ruling out other possible causes.[2]

Treatment options include lifestyle changes, medications, a number of procedures, and surgery.[1][2] In those with mild symptoms, weight loss, decreasing caffeine intake, and exercise are recommended, although the quality of the evidence for exercise is low.[2][4] In those with more significant symptoms, medications may include alpha blockers such as terazosin or 5α-reductase inhibitors such as finasteride.[1] Surgical removal of part of the prostate may be carried out in those who do not improve with other measures.[2] Some herbal medicines that have been studied, such as saw palmetto, have not been shown to help.[2] Other herbal medicines somewhat effective at improving urine flow include beta-sitosterol[5] from Hypoxis rooperi (African star grass), pygeum (extracted from the bark of Prunus africana),[6] pumpkin seeds (Cucurbita pepo), and stinging nettle (Urtica dioica) root.[7]

As of 2019, about 94 million men aged 40 years and older are affected globally.[3] BPH typically begins after the age of 40.[1] The prevalence of clinically diagnosed BPH peaks at 24% in men aged 75–79 years.[3] Based on autopsy studies, half of males aged 50 and over are affected, and this figure climbs to 80% after the age of 80.[3] Although prostate specific antigen levels may be elevated in males with BPH, the condition does not increase the risk of prostate cancer.[8]

  1. ^ a b c d e f g h i j k l m n o p "Prostate Enlargement (Benign Prostatic Hyperplasia)". NIDDK. September 2014. Archived from the original on 4 October 2017. Retrieved 19 October 2017.
  2. ^ a b c d e f g h i j k Kim EH, Larson JA, Andriole GL (2016). "Management of Benign Prostatic Hyperplasia". Annual Review of Medicine (Review). 67: 137–51. doi:10.1146/annurev-med-063014-123902. PMID 26331999.
  3. ^ a b c d Awedew, Atalel Fentahun; Han, Hannah; Abbasi, Behzad; Abbasi-Kangevari, Mohsen; Ahmed, Muktar Beshir; Almidani, Omar; Amini, Erfan; Arabloo, Jalal; Argaw, Ayele Mamo; Athari, Seyyed Shamsadin; Atlaw, Daniel; Banach, Maciej; Barrow, Amadou; Bhagavathula, Akshaya Srikanth; Bhojaraja, Vijayalakshmi S (1 November 2022). "The global, regional, and national burden of benign prostatic hyperplasia in 204 countries and territories from 2000 to 2019: a systematic analysis for the Global Burden of Disease Study 2019". The Lancet Healthy Longevity. 3 (11): e754–e776. doi:10.1016/S2666-7568(22)00213-6. PMC 9640930. PMID 36273485.
  4. ^ Silva V, Grande AJ, Peccin MS (April 2019). "Physical activity for lower urinary tract symptoms secondary to benign prostatic obstruction". The Cochrane Database of Systematic Reviews. 2019 (4): CD012044. doi:10.1002/14651858.CD012044.pub2. PMC 6450803. PMID 30953341.
  5. ^ Wilt T, Ishani A, MacDonald R, Stark G, Mulrow C, Lau J (1999). Wilt TJ (ed.). "Beta-sitosterols for benign prostatic hyperplasia". The Cochrane Database of Systematic Reviews. 2011 (2): CD001043. doi:10.1002/14651858.CD001043. PMC 8407049. PMID 10796740.
  6. ^ Wilt T, Ishani A, Mac Donald R, Rutks I, Stark G (1998). Wilt TJ (ed.). "Pygeum africanum for benign prostatic hyperplasia". The Cochrane Database of Systematic Reviews. 1998 (1): CD001044. doi:10.1002/14651858.CD001044. PMC 7032619. PMID 11869585.
  7. ^ Wilt TJ, Ishani A, Rutks I, MacDonald R (December 2000). "Phytotherapy for benign prostatic hyperplasia". Public Health Nutrition. 3 (4A): 459–72. doi:10.1017/S1368980000000549. PMID 11276294.
  8. ^ Chang RT, Kirby R, Challacombe BJ (April 2012). "Is there a link between BPH and prostate cancer?". The Practitioner. 256 (1750): 13–6, 2. PMID 22792684.

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