Benign prostate hyperplasia (BPH) is a non malignant enlargement of the prostate gland and a common disease among elderly men. The disease typically manifests with lower urinary tract symptoms (LUTS), and can be classified as either voiding or storage symptoms.Approximately 2 out of every 5 Indian men have bothersome lower urinary tract symptoms due to BPH.
Dr.Amit Kumar Agarwal, highlights that, “It revolves around the home, the office and places nearby the home. During a weekday, apart from commuting to and from office, there seems to be less movement to other places. Weekends are limited to the home or places near the home. While they do not articulate it, their behaviour reveals that they protect themselves by not straying too far and always remaining accessible to a bathroom. This is especially true for patients who are not being treated. Those who are treated also have a similar lifestyle but are more open and confident to move out of this perimeter should the need arise”.
Diagnosis of BPH is made by a mixture of physical, radiographic examinations and a few lab tests. Physical examination includes DRE (digital rectal examination), which involves a physical examination of prostate by a Urologist. Abdominal and pelvic ultrasound also indicates the size of the prostate gland. Lab tests include PSA (Prostate-specific antigen). PSA is a protein that is made only by the prostate. When the prostate is healthy, very little PSA is found in the blood.
According to Dr.Amit Kumar Agarwal “Patients are largely unaware of this condition despite high prevalence rates as they consider it a normal part of aging, which can be rectified through a targeted patient awareness campaign. BPH is diagnosed through a combination of methods including patient history, IPSS scorecard, ultrasound, and PSA tests”.
Dr.Amit Kumar Agarwal further added that “Most realized there was a problem when the frequency of washroom visits increased seemingly sudden and quick onset – not a gradual increase. This is how it started for most, described as the first symptom”.
BPH management involves management of symptoms through medications like Alpha-blockers, most commonly tamsulosin. BPH symptoms are measured by using IPSS (International Prostate symptom Score). If symptoms are uncontrolled, a combination treatment is offered. Surgical removal of prostatic tissue is the last step if symptoms are uncontrolled on medication. Since alpha-blockers are chronic treatments, there are different molecules available with alpha-blockers for comorbid patients, sexually active patients, and the general population. BPH symptoms are usually neglected until they become very bothersome, which should not be the case.