Conditions InDepth: Benign Prostatic Hyperplasia (BPH)
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The prostate gland is normally a walnut-sized organ located at the base of the urinary bladder, directly in front of the lower rectum. It surrounds the urethra, or urinary tube, and is just beneath the skin in front of the anus. The prostate is part of the male reproductive system. Women do not have a prostate gland.

The Prostate Gland

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The prostate is one of the few organs that continue to grow throughout life. It is said that if you live long enough, your prostate will grow large enough to bother you. When it does, it will impede the flow of urine. Prostatism and benign prostatic hyperplasia (BPH) are the dominant terms for this nonmalignant enlargement, but they are being replaced by the terms "lower urinary tract symptoms" (LUTS) and "benign prostatic obstruction" (BPO).

BPH is one of the most prevalent health problems among aging men, affecting six million men in the United States over the age of 50 and an additional estimated 17 million men world-wide. By the age of 85, ninety percent of men have enlarged prostates, as assessed by autopsy criteria.

Growth of prostate tissue is stimulated by dihydrotestosterone, a male hormone. As long as this hormone is present, your prostate will keep enlarging. Eventually it will begin to squeeze your urethra and make it harder to pass urine. To compensate, your bladder muscle gets bigger and stronger, but the prostate will eventually win the battle.

When the passing of urine is obstructed, some urine will remain in the bladder. This residual urine may lead to complications. The urine may become infected, and the infection can be very difficult to cure until the bladder can empty completely. This is uncommon and usually occurs in elderly men. Resistant bacterial infections sometimes develop and may spread to cause serious illness. Retained urine can also back up into the kidneys and lead to chronic kidney disease or even kidney failure, which can be fatal.




References:
American Urological Association (AUA) Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. J Urol. 2003;170:530-547.

Burnett AL, Wein AJ. Benign prostatic hyperplasia in primary care: what you need to know. J Urol. 2006;175:S19-24.

Dull P, Reagan RW Jr., et al. Managing benign prostatic hyperplasia. Am Fam Physician. 2002;66:87-88.

DynaMed Editors. Benign prostatic hyperplasia (BPH). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 20, 2010. Accessed July 26, 2010.

National Kidney Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov.

Last Reviewed September 2013



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