Benign prostatic hypertrophy
Benign prostatic hypertrophy is characterized by an increase in the size of the prostate. A large prostate compresses the urethra while putting pressure on the bladder, resulting in a frequent need to urinate and various urination problems, as appropriate (lower and intermittent flow, pain, etc.).
Presque tous les hommes sont sujets à l’hypertrophie bénigne de la prostate, en vieillissant. En effet, plus de 50 % des hommes âgés de 60 ans en sont atteints, et 90 % de ceux de plus de 80 ans. Cependant, tous n’en souffrent pas : environ 1 homme atteint sur 2 est incommodé par des symptômes urinaires. Cette affection n’est pas d’origine cancéreuse. Elle n’augmente pas le risque de cancer de la prostate, mais n’empêche pas non plus son développement.
Causes
The causes of benign prostatic hyperplasia are not clearly identified. There is probably a hereditary predisposition as some families are more affected than others. However, other factors come into play. For example, testosterone and its active derivative, dihydrotestosterone, are known to play an important role. Also, estrogen, female sex hormones found in small amounts in men, could be involved. For the moment, the exact mechanisms by which they work are unknown. The prostate may become more sensitive to these hormones with age.
Possible consequences and complications
Men with benign prostatic hyperplasia are more likely to have any of the following problems. However, the majority of them do not have it.
Urinary tract infections: a bladder that does not empty completely promotes the proliferation of bacteria. If the urinary tract infections occur repeatedly, surgery to reduce the size of the prostate and unclog the urinary tract may be considered;
Acute retention of urine in the bladder: when the urethra is completely compressed, it becomes impossible to urinate; which causes severe pain. This is a medical emergency. A catheter is inserted into the urethra to empty the bladder;
Stones in the bladder: mineral deposits can form and cause infections, irritate the bladder wall and block urine flow;
Distension of the walls of the bladder: Benign prostatic hyperplasia can accelerate the aging of the bladder wall; over time, it loses tone and its contractions are less effective. Sometimes the bladder regains tone after prostate reduction surgery;
Kidney damage: Chronic retention of a certain amount of urine in the bladder and repeated urinary tract infections can compromise kidney function in the long term.
Diagnostic
It is important to see a doctor in case of symptoms. This reduces the risk of severe complications. However, be aware that there is not always a relationship between the symptoms you experience and the size of the prostate. Indeed, some men have a large prostate without having symptoms, while others do, despite a smaller prostate.
With a rectal examination, the doctor can detect an enlarged prostate and follow the evolution. This test is also used to detect the presence of nodules in the prostate and to assess the risk of cancer. A urine test and a blood test to measure the prostate specific antigen (PSA) level may be performed, as appropriate.