What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH)

BPH, i.e. non-malignant enlargement of the prostate, is the most frequent pathology of the urogenital system in men above 50 years of age.

BPH – prostate enlargement is commonly associated with burdensome symptoms, collectively called lower urinary tract symptoms (LUTS) (see under BPH-symptoms). Enlarged prostate constricts the urethra (the passage through which urine flows from the bladder) causing problems with urine excretion, which over years may lead to unfavourable anatomical and functional changes within the urinary bladder and the kidneys (such as e.g. bladder outlet obstruction).

Normal prostate

The causes of BPH have not been elucidated completely. The most important risk factors include:

  • the man’s age – the older the man is, the higher the risk of BPH.
  • hormones – the prostate is a gland dependent on a male sex hormone – testosterone, which is in 95% produced in the testes, but also on female hormones – estrogens, formed in small amounts both in the testes and in adipose tissue as a result of testosterone metabolism to estrogens.

Symptoms of BPH

  • increased frequency of urination during the day
  • necessity of urination a few times during the night
  • sensation of incomplete voiding of the bladder
  • urgency to urinate with just a small amount of urine present in the bladder
  • burning or stinging sensation during urine excretion (dysuria)
  • problems at the start of urination
  • poor stream with an increased urination time
  • terminal dribbling
  • urinary incontinence

Also, disturbances of sexual life may appear.

Diagnosis of BPH

Diagnostic begins with a control visit at the urologist’s, who asks the patient questions about symptoms and complaints associated with the lower urinary tract, including his sexual life and potential erectile dysfunctions.

To assess the severity of lower urinary tract symptoms, the IPSS (International Prostate Symptoms Score) system is used. It is an 8-item questionnaire, consisting of seven symptom questions and one quality of life question. For each question, a score is assigned, and the summary score indicates the degree of severity of the pathology. Additionally, the answer to the question concerning quality-of-life (QoL) informs the doctor how burdensome the problems described by the patient are and how much they disorganize his work, family and social life. Scores from 0 to 7 can indicate mild symptoms, from 8 to 19 – moderate, and 20-35 – severe ones.

The obtained score is approximate in character. The doctor should be asked for interpretation of the result, and make any decisions concerning treatment. To complete the table, click the number in an appropriate column, corresponding to the answer to the particular question, e.g. How often did you experience the sensation of incomplete voiding of your bladder after urination during the last month? If your answer is: Almost always, you should click on number 5 in the same line as the question. Proceed in the same way to mark the numbers corresponding to the answers to further questions. The score resulting from all your answers will be summed up and displayed in the column at the bottom of the table.

International Prostate Symptoms Score (IPSS)


Mark only one answer to each question

Międzynarodowa skala punktowa objawów towarzyszących chorobom prostaty
IPSS
(ang. International Prostate Symptom Score )

Odpowiedz na poniższe pytania:

Never
Less than 1 in 5 times
Less than half the time
About half the time
More than half the time
Almost always

1.

Over the last month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?

2.

Over the last month, how often have you had the urge to urinate again less than two hours after you finished urinating?

3.

Over the last month, how often have you found you stopped and started again several times when you urinated?

4.

Over the last month, how often have you experienced an urgent need to urinate and found it difficult to postpone urination?

5.

Over the last month, how often have you observed a weak stream of urine?

6.

Over the last month, how often have you had to push or strain to begin urination?

tt

Wcale
1 raz
2 razy
3 razy
4 razy
5 i więcej razy

7.

Over the last month, how many times (on the average) did you most typically have to get up to urinate at night?

Score

WYNIK

0-7 pkt

Uzyskanie od 0 do 7 punktów może świadczyć o łagodnych objawach. Uzyskany wynik ma charakter podglądowy. Interpretacja wyniku, a tym bardziej decyzja o leczeniu należy do lekarza.

8-19 pkt

Uzyskanie od 8 do 19 punktów może świadczyć o objawach umiarkowanych. Uzyskany wynik ma charakter podglądowy. Interpretacja wyniku, a tym bardziej decyzja o leczeniu należy do lekarza.

20-35 pkt

Uzyskanie od 20 do 35 punktów może świadczyć o objawach nasilonych. Uzyskany wynik ma charakter podglądowy. Interpretacja wyniku, a tym bardziej decyzja o leczeniu należy do lekarza.

Drukuj wynik

Możesz wydrukować swój wynik i zabrać ze sobą na wizytę do urologa.

Following therapies are used in treatment of BPH:

Conservative
treatment
Pharmacological
treatment
  • 5 α-reductase inhibitors – inhibit the enlargement, or even reduce the size, of the prostate, provided that the treatment is continued for many months, or even for many years.
  • α 1-adrenergic receptor blockers – act by reducing smooth muscle tone, alleviating the symptoms of irritation.
  • agents of herbal origin – with anti-inflammatory, edema-reducing and anti-androgenic effect.
Surgical
treatment

In addition to the therapy of BPH recommended by the doctor, you can observe a few principles, which increase its safety and efficacy:

  • take precise notes concerning the dosage of a particular preparation, or, if it is a product bought in the pharmacy without the doctor’s prescription – use the medication exactly according to the instructions given on the package.
  • do not stop the therapy despite improvement or disappearance of symptoms; it should be discontinued according to the doctor’s instructions, or, in case of a no-prescription product, according to the information given in the leaflet accompanying the preparation.
  • remember to take the medication at fixed times during the day, in accordance with Patient Information Leaflet
  • reduce the amount of fluid drank before the night, if you suffer from night frequency (coffee and alcoholic beverages in particular increase diuresis)
  • if you are overweight, try to reduce your weight as it can cause weakening of your pelvic floor, thus having an unfavorable impact on urinary continence.

Przed użyciem zapoznaj się z ulotką, która zawiera wskazania, przeciwwskazania, dane dotyczące działań niepożądanych i dawkowanie oraz informacje dotyczące działań niepożądanych i dawkowanie oraz informacje dotyczące stosowania produktu leczniczego, bądź skonsultuj się z lekarzem lub farmaceutą gdyż każdy lek niewłaściwie stosowany zagraża Twojemu życiu lub zdrowiu.


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