Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is the non-cancerous enlargement of the prostate gland that occurs in almost all men as they age. To compensate for the narrowing of the urethra, the muscular wall of the bladder contracts more strongly to expel urine. This increased "exercise" leads to the thickening of the bladder wall and a decrease in its urine capacity. The bladder will hold less and less urine, resulting in having to urinate more and more. Common symptoms include: an urgent feeling to urinate; an increased frequency of urination, waking multiple times during the night to urinate; some difficulty when beginning to urinate; a urine stream that is weak and thin; difficulty stopping urinating; often followed by dribbles; and a feeling that the bladder has not completely emptied, urinary retention.

In many men the tissue growth inside that prostate eventually obstructs the bladder outlet and causes difficulties with urination, sexual functions and serious disruption of lifestyle. Although BPH is not a dangerous condition in and of itself, it can lead to other potentially serious conditions. The enlargement may destroy the normal storing and emptying functions of the bladder, cause severe infections of the urinary tract, and ultimately lead to renal failure. Enlarged prostates can also indicate prostate cancer. The presence of cancer cells in the prostates of even young men is quite common and rarely indicates malignancy, although this becomes more likely with age.

If left untreated, BPH results in stagnant urinary residue, which can lead to infection and blockage of the bladder outlet. Although researchers do not know exactly why BPH develops, it appears to be related to age and increased levels of 5-alpha-dihydrotestosterone (DHT), a hormone. DHT binds to the prostate, which results in continued prostate growth. This can eventually cause the overproduction (hyperplasia) of prostate cells, which causes the prostate gland to enlarge more than it should.

BPH appears to develop as a result of hormonal changes that occur with age, notably the level of testosterone. Testosterone is the male sex hormone, and is essential for many of the more "manly" traits: a lively libido, good muscle mass, and so on. The enzyme, 5-alpha-reductase, turns testosterone to dihydrotestosterone, which plays a vital role in the development of a normal male foetus and the pubescent development of normal male sexual characteristics. Somewhere around middle age this enzyme tends to increase in its effect. This converts the already declining levels of testosterone into excessive amounts of dihydrotestosterone which, although good for young men, for a man in his forties produces hair loss and prostate enlargement. Contributing factors may be an accumulation of oestrogen in the aging prostate and fatty acid deficiencies, zinc deficiency (the prostate needs 10 times more since than other organs), and amino acid deficiencies. Other reported beneficial dietary supplements reported are extract of Saw Palmetto, which appears to work by inhibiting the production of 5-alpha-reductase, lycopene, an antioxidant found in high concentrations in tomatoes, Panax ginseng and bee pollen. Recently some surgeons have been doing prostatectomies by using microwaves to cook the gland instead of cutting it out. But many claim that no drugs or treatments are more satisfactory than removing the testicles, or at least that part of the testicles that produce testosterone.

Known traditionally as "old man's disease" because so many elderly men develop it, various reports state that 50 percent to 60 percent of men over 50 years of age and some 85 percent of men over 80 years of age have some indication of BPH. Not all men experience symptoms. Only about half of all men will have noticeable symptoms, and only half of those will experience enough discomfort to go to a doctor. The symptoms often come and go.