Quality Of Included Studies
Overall, the quality of included studies was moderate, with 20 studies achieving an NOS score over 6 points. In terms of the case-control studies, all were adequate in case definition, no participants in the control group had a history of prostate cancer . Nine studiesS9,S10,S12,S16,S17,S19,S21,S23,S24 included consecutive or obviously representative series of cases and 6 studies S8,S10,S20,S21,S23,S24 selected community controls. All of the included studies controlled or adjusted for age or other important factors on the basis of study design or analysis. Two studiesS18,S19 had no description of the ascertainment of exposure and 7 studiesS9,S16,S18,S19,S21,S22,S24 had the same nonresponse rates for both study groups.
As for the 9 included cohort studies, 7S1S3,S5,S6,S13,S14 were considered to be truly or somewhat representative of BPH patients in the community and 6 studiesS2S6,S16 selected the nonexposed cohort from the same community as the exposed cohort. The ascertainment of exposure was not described in 1 studyS13 and 7 studiesS2S4,S6,S13,S14,S16 demonstrated that participants were cancer free at the start of the study. All of the included studies controlled or adjusted for age or other important factors on the basis of the design or analysis. The follow-up was adequate and long enough for outcomes to occur in all the studies. The detailed evaluation of risk of bias was reported in the Supplemental digital contentTables 1 and and22.
How Is Benign Prostatic Hyperplasia Diagnosed
Your healthcare provider will review your medical history, ask you questions and perform a physical examination. Part of the physical exam involves a digital rectal exam.
During a digital rectal exam, your healthcare provider will carefully insert their gloved digit into your rectum. Theyll feel the edges and surface of your prostate, estimate the size of your prostate and detect any hard areas that could be cancer.
Your healthcare provider may also order:
- A survey to evaluate the severity of your symptoms.
- A urine flow test to measure the speed of your pee stream.
- A study to detect how much pee remains in your bladder after youve finished peeing.
- A cystoscopy to look into your bladder.
Diagnosing Benign Prostate Enlargement
You might have several different tests to find out if you have an enlarged prostate.
A GP may do some of these tests, such as a urine test, but others might need to be done at a hospital.
Some tests may be needed to rule out other conditions that cause similar symptoms to BPE, such as prostate cancer.
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How Can Treatment Affect The Risk Of Prostate Cancer
While BHP is not prostate cancer, the 5-alpha reductase inhibitors can reduce a mans risk over time of developing prostate cancer by about 25%. There are two benefits to this: First, it makes prostate cancer easier to detect, and second, it prevents the treatments down the road that cause side effects. These hormonal agents are not as effective on more aggressive prostate cancers, and have not been shown to save lives due to prostate cancer. As always, its important to discuss the risks and benefits of these medicines with your doctor.
That said, symptoms are symptoms, and no matter whats most likely to be causing them, you should get them checked out by a doctor.
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The prostate uses male hormones called androgens, such as testosterone and dihydrotestosterone , to trigger and maintain male sex characteristics and reproduction. Normally,…
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Tests To Diagnose Prostate Cancer
These tests can confirm a prostate cancer diagnosis:
- Ultrasounduses sound waves to make pictures of your prostate gland.
- A biopsyremoves a sample of prostate tissue and checks it under a microscope for cancer.
Which treatments you get for BPH depend on the size of your prostate and how severe your symptoms are.
For mild to moderate symptoms, your doctor might prescribe one of these medicines:
- Alpha-blockers relax muscles in your bladder and prostate to help you urinate more easily. They include alfuzosin , doxazosin , and tamsulosin .
- 5-alpha reductase inhibitors shrink your prostate. They include dutasteride and finasteride .
Doctors use surgery to treat severe BPH symptoms:
Learn more: What you need to know about prostate surgery »
Treatments for prostate cancer include:
- Active surveillance or watchful waiting: You dont get treated right away. Instead, your doctor watches your symptoms or does regular DRE and PSA tests to check for cancer growth.
- Surgery: A procedure called a radical prostatectomy removes the prostate gland and some of the tissue around it.
- Radiation therapy: Radiation uses high-energy X-rays to destroy prostate cancer. Youre exposed to radiation from a machine outside your body. Or you can get it through small radioactive pellets or seeds placed inside your prostate.
- Cryotherapy: This treatment uses intense cold to destroy prostate tissue.
- Hormone therapy: You take medicine to block the male hormones that fuel the growth of prostate cancer.
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How Is Bph Treated
One-quarter of men with BPH will eventually require treatment, some more than once, to relieve the urinary obstruction caused by BPH.
Based on the figures mentioned above, its likely that after age 60, a majority of men will either be taking medication for BPH or considering it.
BPH is treated with alpha blockers , or 5-alpha reductase inhibitors, . Currently approved alpha blockers include: terazosin , doxazosin , tamsulosin , alfuzosin , and silodosin . Approved 5-alpha reductase inhibitors include: Finasteride or dutasteride . These classes of medications will often be used in combination to prevent urinary obstruction and ease symptoms.
Medication doesnt help everyone. Men experiencing more severe symptoms, or those who have not sought treatment until the disease has advanced, will likely find surgery to be the best option.
Turp / Greenlight Pvp Laser / Thermotherapy
Transurethral resection of the prostate has long been the mainstay of enlarged prostate surgery, but less invasive alternatives are now available, with the potential for equal results. With TURP, the obstructing portion of the enlarged prostate tissue is removed. Although effective, TURP requires hospitalization and catheterization for 48 hours or more and comes with risks associated with anesthesia bleeding during and after the operation and, in rare cases, fluid absorption that can be life-threatening.
Prostate LaserOne alternative that has emerged is laser enlarged prostate surgery. Like TURP, the so-called GreenLight PVP Laser Therapy aims to create a channel in the urethra through which men can urinate more freely but the surgery is considerably less invasive. Instead of cutting tissue out, the newer technique creates the channel by vaporizing the tissue using laser energy. Thus far, almost every study has shown that when done by experienced urologists, the laser enlarged prostate surgery produces results that are equal to those with TURP, but without the severe side effects and risks. It is an outpatient procedure with minimal to no bleeding, no risk of fluid absorption, and catheterization only overnight, if at all.
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Benign Prostatic Hyperplasia And Prostate Cancer
Benign Prostatic Hyperplasia and prostate cancer are the most common diseases of the genitourinary system in men, which occurs in every second man over 60 years of age. Still, they can also occur at the age of 40-50 . The key manifestations of BPH are painful urination, feeling of incomplete emptying of the bladder, weakening of the urine stream, and an increase in the duration of urination.
Often there is acute retention of urine, in which self-urination becomes impossible, and emergency medical care is required. The main causes of BPH are age-related hormonal changes in the body of men. Elkahwaji notes that inflammatory mediators may also generate BPH. In its turn, prostate cancer symptoms can be conditionally divided into three groups: symptoms of urine outflow from the bladder , symptoms related directly to the growth of the prostate tumor , and symptoms associated with metastatic prostate cancer .
Haj-Ahmad, Abdalla, and Haj-Ahmad propose the significance of the specific urinary miRNA biomarker that refers to non-invasive and urine-based tests. In their study, the authors claim that the sensitivity and specificity for miR-1825/484 in tandem were 45 percent and 75 percent, respectively . These results show that there is a need for prospective research aimed at the development and subsequent implementation of innovative measures to detect BPH and cancer prostate at early stages.
Bph Vs Prostate Cancer: Whats The Difference
Benign prostatic hyperplasia and prostate cancer are two of the most common conditions that affect the prostate, a gland thatâs part of the male reproductive system.
Positioned below the bladder, your prostate helps with the production of semen. In a young man, itâs generally about the size of a walnut, though it tends to get bigger as you get older. Your risk of developing a prostate problem also increases with age.
Because they affect the same gland, you may wonder if BPH leads to prostate cancer. It doesnât. While you can develop both problems, one does not lead to the other.
Some of the symptoms and risk factors are similar, though.
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What Other Problems Might An Enlarged Prostate Cause
A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:
- youre aged 70 or over
- your prostate is very large
- you have a raised prostate specific antigen level
- you have severe urinary symptoms and a very slow flow.
Chronic urine retention
This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.
Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.
There are treatments for chronic urine retention, including:
- passing a thin, flexible tube called a catheter to drain urine from your bladder
- surgery to widen the urethra.
Acute urine retention
How Do I Know If I Have Bph
To diagnose BPH you need to have typical symptoms and exclude other causes. The first test will be a digital rectal exam, which can detect some hard nodes .
With a blood test we can learn the PSA value, which rises in several diseases, mainly in cancer, BPH and prostatitis.
If there is a high suspicion of cancer, youll need other tests like an MRI, transrectal ultrasound or a biopsy. These tests are very accurate detecting cancer, but not everybody needs them.
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What Is The Long
BPH does not always need medical treatment, and self-care is often effective. Lifestyle changes are important in reducing symptoms and improving quality of life. In the event these do not work, medications and surgery are available.
BPH is not prostate cancer, but because symptoms are similar, you need to get your symptoms checked as soon as you become aware of them. With treatment, BPH is treatable, and you can live a healthy and normal life.
In This Article
Symptoms Of Benign Prostate Enlargement
The prostate is a small gland, located in the pelvis, between the penis and bladder.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
This can affect how you pee and may cause:
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
In some men, the symptoms are mild and do not need treatment. In others, they can be very troublesome.
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Treatment For Benign Prostatic Hyperplasia
Initially, you can treat BPH with self-care and remedies at home. If symptoms persist or worsen, then you need to re-visit with your doctor. When symptoms do not subside, medications and surgery may be recommended.
It is important to remember that your age and overall health will affect the prescribed treatment and its success. The medications most commonly prescribed for BPH are:
Alpha-1 blockers: These work by relaxing the bladder muscles making it easier for urine to flow
Hormone reduction drugs: These medications reduce hormone levels, such as testosterone. This can help decrease the size of the prostate to improve urine flow.
Antibiotics: These are prescribed if your prostate becomes inflamed from bacterial prostatitis. This can help reduce inflammation and symptoms, but only when a bacterium is a cause.
Benign Prostatic Hyperplasia Diagnosis
Your doctor will begin by asking you a series of detailed questions related to your symptoms, evaluate your complete medical history and perform a full physical examination. Some of the diagnostic procedures used to diagnose BPH might include:
- Digital Rectal Exam : The Digital Rectal Exam is a procedure in which the doctor will insert a lubricated gloved finger into the rectum in order to examine the prostate gland for prostate enlargement, abnormalities, and any signs of cancer.
- Urinary Flow Test : The Urinary Flow test is a procedure in which your doctor will have you urinate into a repository attached to a device. The device is designed to measure the strength and volume of your urine flow. The results from this test help your doctor determine the severity of your condition and how to efficiently address your condition.
- Cystoscopy : A Cystoscope is an optic instrument with a lighted tip. The process of inserting this instrument through the urethra to thoroughly examine the bladder and urinary tract is called a Cystoscopy. Your doctor will be looking specifically for any obstructions or abnormalities that will help to determine the severity of your condition.
For the majority of men with BPH, the prostate will continue growing until a medical intervention will become necessary. With the help of a urologist, each man will develop an individualized treatment plan with which they are both comfortable. Below are the currently available treatment options.
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Symptoms Of Prostate Cancer
- Frequent urge to pass urine, especially at night
- Weak or interrupted urine stream
- Pain or burning when passing urine
- Blood in the urine or semen
- Painful ejaculation
- Nagging pain in the back, hips, or pelvis
Prostate cancer can spread to the lymph nodes of the pelvis. Or it may spread throughout the body. It tends to spread to the bones. So bone pain, especially in the back, can be a symptom of advanced prostate cancer.
How Is Bph Diagnosed
To find out if you have BPH, your provider will:
- Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
- Ask about your family health history.
- Examine you. The exam may include a digital rectal exam of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
- Order medical tests, if needed, such as:
- Urine tests.
- A PSA blood test .
- Urodynamic testing to see how well you can hold and release urine.
- Cystoscopy to look inside your urethra and bladder.
- Ultrasound pictures of your prostate and urinary tract.
- A prostate biopsy to diagnose or rule out prostate cancer.
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Does Having Benign Prostatic Hyperplasia Increase The Risk Of Prostate Cancer
Research shows that having BPH doesnt increase your risk of developing prostate cancer. However, BPH and prostate cancer have similar symptoms. If you have BPH, you may have undetected prostate cancer at the same time.
To help detect prostate cancer in its early stages, every person with a prostate should get a prostate screening every year between the ages of 55 and 69. You have an increased risk of getting prostate cancer if youre Black or have a family history of prostate cancer. If you have an increased risk of prostate cancer, you should start getting prostate screenings at age 40.
Bph And Other Conditions
There are other conditions that affect the prostate that can have similar symptoms as prostate cancer. Those conditions include benign prostatic hyperplasia and prostatitis. BPH is a noncancerous enlargement of the prostate gland caused by aging, testosterone and genetics.
BPH is not cancer but has similar symptoms.
Another condition is prostatitis, an inflammation of the prostate gland that occurs from bacterial infection. Roughly half of all men will be affected by prostatitis during their lives.
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What Causes An Enlarged Prostate
We still dont really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.
Age
Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they dont all get symptoms. And some men have symptoms that don’t bother them.
Hormone levels
The balance of hormones in your body changes as you get older. This may cause your prostate to grow.
Other factors
Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.
There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.