Benign Prostatic Hyperplasia and Lab Testing

Benign Prostatic Hypertrophy, or as popularly referred to as Benign Prostatic Hyperplasia, is a non-cancerous and progressive enlargement of the prostate. Typically, the prostate is just a small gland about walnut-sized, and it encircles the male’s urethra as well as nourishes sperm using a fluid it produces. Other seminal vesicles fluid and this fluid are what make up semen. 

The prostate volume increases with BPH, which in turn puts pressure on the urethra, resulting in urine stream slowdown, a weak interrupted stream, hesitancy when urinating, and, at times, urine dribbling at the end of a flow. When urine is unable to flow via the urethra freely, the bladder’s muscular wall thickens and becomes super-sensitive to urine. This, in turn, culminates in frequent urination. As time goes by, the muscles of the bladder become weak and no longer have the power of contracting with enough force for emptying the bladder. 

Remnant urine in the bladder only increases the chances of developing bladder stones or a urinary tract infection. In other fatal situations involving BPH, urine might back up and damage the kidneys. In rare circumstances BPH may hinder a person from urinating altogether, which is something that should be addressed immediately. BPH and its treatments may also impact sexual functionality, such as painful ejaculation and erectile dysfunction. 

The originating cause of Benign Prostatic Hyperplasia has not yet been found. But some studies suggest that the balance of sex hormones changes as men age are a contributing factor. Some males may have a BPH genetic predisposition. It’s estimated that 50% of men under 60 years who have undergone surgical intervention fall under this category. 

Risk factors 

Here are some of the risk factors associated with Benign Prostatic Hyperplasia

  • Age 40 or older 
  • Family history of BPH (father or brother) 
  • Ethnic background – As compared to African American men and white men, BPH is less common in Asian men; African American men have a higher chance of developing BPH at a younger age compared to white men 
  • History of chronic health issues like obesity, heart disease, and type 2 diabetes, 
  • Lack of physical exercise 
  • Erectile dysfunction 

Signs and Symptoms 

The severity and type of signs and symptoms experienced vary from person to person and over time. For most of the men, BPH never goes beyond minor to moderate, while for others, it may pose a massive challenge to the quality of life. 

The American Urological Association has made a questionnaire intending to assist men in evaluating the seriousness of their urinary symptoms and keeping track of the treatment’s effectiveness. This is an internationally adopted questionnaire referred to as the International Prostate Symptom Score (IPSS). 

Questions on IPSS investigate the following: 

  • Incomplete bladder emptying 
  • Frequency of urination 
  • Stopping and starting the urine stream 
  • Urinary urgency 
  • Weak urine stream 
  • Straining to urinate 
  • Waking up at night to urinate (nocturia) 
  • The man’s perceived quality of life 

As men get older, BPH becomes a common condition. It’s estimated that 20% of males between 41 and 50 years are likely to experience BPH. The National Association for Continence suggests that around 50% of males will experience some form of BPH by the time they are 60, and almost up to 90% of them will be affected by 85 years old. Though BPH doesn’t necessarily cause prostate cancer, it can usually be found together. 

Laboratory tests 

Prostate-specific antigen (PSA) – This is a blood test that measures PSA levels, a protein made by prostate cells found in the blood. It may be increased in males who have prostate cancer and for those with BPH, though only slightly elevated. When assessing the lab results, the physician should take into consideration the PSA concentration in blood and the man’s prostate size. 

Urinalysis – a group of tests used for looking for urinary tract infection (UTI) signs or blood in the urine (hematuria) 

Urine culture – another test used to look for an indication of a UTI. 

Electrolytes, blood urea nitrogen (BUN) and creatinine – blood tests to assess kidney function