Enlarged prostate: when to worry

The benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, is a condition that affects many men as they age. Although it is a benign condition, it can cause bothersome symptoms and, in some cases, serious complications.

BPH is a non-cancerous enlargement of the prostate gland, which is located under the bladder and surrounds theurethra. This gland plays a crucial role in the male reproductive system, producing a fluid that forms part of the seminal fluid.

With age, it is common for the prostate to enlarge (source), putting pressure on the urethra and causing urinary problems

Symptoms of Benign Prostatic Hyperplasia

The symptoms of BPH can vary from mild to severe and tend to worsen over time. Here are the most common symptoms:

1. Difficulty in initiating urination: Many men with BPH find it difficult to start urinating, even when the bladder is full.
2. Weak or interrupted urinary flow: Urine output is weak or intermittent.
3. Frequent urinationIncreased frequency of urination, especially at night (nocturia)-
4. Feeling of incomplete bladder emptyingSome men feel that they have not emptied their bladder completely after urinating.
5. Urinary urgency: A sudden and urgent need to urinate, even if it has not been long since the last time.
6. Pain during urination or ejaculation: In some cases, BPH can cause pain during these processes

Several tests may be necessary to measure the impact of benign prostatic hyperplasia (BPH) on urinary and sexual function. Here are some of the main ones:

Urinary Function Examinations

1. Esplorazione Rettale Digitale (DRE)This examination allows the doctor to assess the size and consistency of the prostate by inserting a finger into the patient's rectum.
2. PSA test (Specific Prostate Antigen)A blood test that measures levels of PSA, a protein produced by the prostate. Elevated levels may indicate BPH or other prostate conditions.
3. Debimetria (Uroflowmetry): Measures urinary flow to assess the rate and volume of urine excreted. This test helps to identify possible obstructions in the urinary tract.
4. Transrectal ultrasoundIt uses sound waves to create images of the prostate and assess its size and structure.
5. Urine examinationIt can detect infections or other abnormalities that could be caused by BPH.

Examinations for Sexual Functions

1. Sexual Function QuestionnairesInstruments such as the International Index of Erectile Function (IIEF) possono essere utilizzati per valutare l’impatto della BPH sulla funzione sessuale del paziente.
2. Hormonal Examinations: Measuring levels of testosterone and other hormones can help identify possible imbalances that could affect sexual function.
3. Peniena ultrasoundUsed to assess blood flow in the penis and identify any vascular problems that could contribute to erectile dysfunction.

When to Worry

If symptoms such as difficulty urinating, weak urinary flow, frequent urination, pain during urination or ejaculation, or erection problems occur, it is important to consult a doctor. Some tests may be prescribed that can help determine the cause of the symptoms and plan the most appropriate treatment.

Although BPH is a benign condition, there are situations in which medical advice should be sought promptly:

1. Total inability to urinateThis condition, known as acute urinary retention, requires immediate medical intervention.
2. Painful, urgent and frequent urination urge with fever and chills: These symptoms may indicate a urinary infection or other complications.
3. Blood in urine: The presence of blood in the urine is a sign that should not be ignored.
4. Significant pain in the lower abdomen or genitals during urination: This may indicate a serious complication.

Benign prostatic hyperplasia is a common condition that can significantly affect quality of life. It is important to recognise the symptoms and know when to seek medical attention.

If you notice any of the above symptoms, do not hesitate to consult your doctor for a thorough evaluation and to discuss available treatment options.