Reasons for Abnormal Results

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), or what is commonly known as an enlarged prostate gland, is a non-cancerous growth of prostate tissue. The chance of developing BPH increases with age. More than half of men over age 50 have BPH. By age 80, about 80 percent of men have enlarged prostates. However, only 40 to 50 percent of men actually develop any symptoms due to BPH.

BPH affects the inner part of the prostate first - the part that encircles the urethra as it leaves the bladder. (The urethra is the tube that carries urine and semen through the penis and out of the body). As the prostate grows, it may begin to squeeze the upper part of the urethra and restrict the flow of urine. BPH generally does not interfere with sexual functioning.

Can BPH become prostate cancer?
Whether treated or untreated, BPH is not cancer, nor does it lead to cancer. However, it is possible to have both BPH and prostate cancer at the same time.

Symptoms of BPH

Early on in BPH, men experience few symptoms because the bladder muscles are strong enough to push urine through a narrowing urethra. However, as the prostate grows and BPH begins to restrict urine flow, men may experience the following symptoms:

• weak flow
  
• a need to push or strain to start urine flow
  
• intermittent urine stream (starts and stops several times)
  
• difficulty stopping urination
  
• "dribbling" or leakage after urination
  
• a feeling of being unable to empty the bladder completely.

As the bladder muscle works to push urine through a narrowed urethra, the bladder wall thickens and is less able to stretch. As a result, the bladder can't hold as much, causing a need to urinate more often. These symptoms can include:

• frequent urination, especially at night, disrupting sleep
• an urgent need to urinate that can't be postponed
• urge incontinence: an inability to get to a bathroom in time when the urge to urinate occurs.

American Urological Association Symptom Score

The American Urological Association (AUA) Symptom Score Index is a questionnaire that evaluates the severity of urinary difficulties that may occur with BPH and is a useful tool in determining treatment. The seven questions about urinary function are answered on a 0 to 5 scale; the higher the total score, the more severe the symptoms.


Complications from BPH

Severe BPH can cause serious problems over time, including the inability to completely empty the bladder during urination. Urine retention and strain on the bladder can lead to recurrent urinary tract infections. A small percentage of men suddenly become unable to urinate, develop bladder stones, or suffer gradual bladder and/or kidney damage. If the bladder is permanently damaged, treatment for BPH may be ineffective. When BPH is found in its earlier stages, there is a lower risk of developing such complications.

Transurethral Resection of the Prostate (TURP)

Transurethral resection of the prostate (TURP) is a surgical procedure used most often to treat men with BPH. The operation removes part of the prostate gland surrounding and constricting the urethra (the tube that takes urine from the bladder through the penis and out of the body). A tool with a wire loop on the end is passed into the penis and through the urethra to the prostate gland. Electricity is then passed through the wire to heat it and cut the tissue. A representative sample of the prostate tissue removed during TURP is examined by a pathologist to determine whether any cancer is present.

TURP is also used to treat men with prostate cancer who can't have a radical prostatectomy, or to relieve symptoms caused by prostate cancer before other treatments begin.

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The Prostate Cancer pages of this Web site are part of the Comprehensive Prostate Cancer Awareness Program (CPCAP), a major regional effort to reduce the rates of death and illness caused by prostate cancer in southwestern Pennsylvania. Funding for CPCAP is provided by a grant from the Commonwealth of Pennsylvania.

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