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With 50% of men in their 50s experiencing symptoms related to an enlarged prostate, health practitioners should be encouraging middle-aged men to have their prostate checked.

The call for check-ups coincides with a聽newly published Medial Journal of Australia Insight article, highlighting that benign prostatic hyperplasia (BPH) 鈥� or a benign enlargement of the prostate 鈥� compromises a man鈥檚 quality of life and his relationships with his partner and family.²

鈥婣ccording to the article author, Clinical Associate Professor of Urology at Bill Lynch, the prostate 鈥� a walnut-sized gland in the male reproductive system that聽surrounds the top of the urethra and is found under the bladder 鈥� has proven extremely burdensome聽to the lives of men. An enlarged prostate can cause difficulty in passing urine and over time can聽lead to the complete inability to pass urine, urinary infections, damage to the kidneys or bladder聽and eventually potential surgery 鈥� reportedly the major concern for men regarding their prostate.²

鈥嬧�淧rostate issues are a fact of life for men, and are just as relevant now as they have been through the ages.²

鈥淏PH is a progressive, non-cancerous disease that tends to strike ageing men.¹聽Fifty per cent of men aged in their 50s will experience BPH, increasing to 80% of men aged in their 80s,鈥�³ A/Prof Lynch said.

鈥淲hile not all men with BPH will show symptoms, more than 30% of those aged over 50 will experience moderate-to-severe lower urinary tract symptoms (LUTS), two-thirds of whose symptoms will be caused by BPH.^2,4,7

鈥淭his equates to more than a million Australian men experiencing significant symptoms due to BPH, noting most men aged over 50 must contend with LUTS,鈥�^4,8聽A/Prof Lynch said.

Impact of BPH

The quality of life for men with symptoms of BPH is significantly lower than for those exhibiting no symptoms, with daily activities, such as driving, sport, sleep and social activities considerably聽affected.⁵聽Moreover, BPH is also linked to male sexual function, with a higher International Prostate Symptom Score (IPPS) 鈥� a scoring system used to screen for, diagnose and monitor symptoms 鈥� associated with more severe erectile dysfunction.⁶

鈥淢en experience varying symptoms of BPH with different degrees of bother, including increased聽frequency and urgency of urination both day and night, difficulty starting, maintaining and finishing urination. They may also experience urine infections or urinary retention,鈥� said urological surgeon Dr Martin Elmes, Gold Coast.

Business Development Manager, weekend skateboarder and father to three adult children, David, 61, Gold Coast, has first-hand experience of BPH, having lived with the disease for almost five years before being diagnosed and treated last year.

鈥淚 was constantly going to the bathroom. I had to plan my entire day around the next toilet, and I was getting up about four to five times a night to the toilet.

鈥淚 lived with these symptoms for so long having mistakenly assumed they were normal. It wasn鈥檛 until visiting my GP for an unrelated matter that he mentioned my frequent urination may be linked to my prostate,鈥� David said.

Further testing confirmed David鈥檚 frequent urination was in fact due to BPH, and he was referred to urological surgeon Dr Elmes for treatment.

鈥淚鈥檇 never heard of BPH until being diagnosed. Up until then, I thought prostate issues were a聽reflection of poor health, and given I was so healthy and active, it never crossed my mind,鈥� said David.

Treatment improved David鈥檚 BPH symptoms and quality of life, and he now has a simple message to share with other blokes. 鈥淚f you鈥檝e got trouble with your waterworks, don鈥檛 muck around. Get checked out. Visit your doctor.鈥�

Getting to the heart of the matter

In his article, A/Prof Lynch argues that it鈥檚 important to get to聽鈥榯he heart of the matter鈥�, citing the聽management of prostate symptoms can have far-reaching benefits for a man鈥檚 general body health.

鈥淣early all documented interventions or lifestyle changes beneficial for heart health have been shown to prevent or reduce the impact of BPH and LUTS, including moderate exercise, diet (regular vegetable and water consumption, fibre and Omega-3 intake) and weight control,鈥� A/Prof Lynch said.

鈥淗igh blood pressure, excessive calorie intake (particularly foods high in saturated fats), high聽cholesterol, heart disease and conditions that heighten your risk of developing diabetes, stroke and heart disease all negatively impact BPH.

鈥淢aking lifestyle and behavioural changes to positively support prostate health should prove even more beneficial to the heart, while helping to allay men鈥檚 fears over surgery,鈥�²聽A/Prof Lynch said.

鈥淎ll of this information provides a compelling argument for men to consider their prostate.鈥�

Importantly, having BPH does not increase your chance of developing prostate cancer.¹

While the disease cannot be prevented, there are many options available to improve the symptoms of BPH. Oral medications can be prescribed by a GP or specialist (Urologist)² including alpha-blockers, 5-alpha-reductase inhibitors, phosphodiesterase-5 (PDE-5) inhibitors, anticholinergics or a combination of these agents.¹聽In addition, 鈥渟urgery is continually evolving, resulting in less invasive, less morbid and safer procedures,鈥� said Dr Elmes.

BPH worsens over time if not treated.¹聽Various tests are available to determine whether symptoms are indicative of BPH or another condition.¹

To learn more, visit:聽.

References

1. Andrology Australia. Prostate enlargement. A guide to urinary symptoms in men. 2017. Available at 聽[last accessed July, 2018].

2. Lynch, B. Men and their prostates!. . August 13, 2018.

3. Berry SJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. 1984; 132(3): 474-79.

4. Carballido j, Fourcade R, Paglarulo A et al. Can benign prostatic hyperplasia be identified in the primary care setting using only simple tests? Results of the Diagnosis IMprovement in PrimAry Care Trial (DIMPACT). 2011; 65(9): 989鈥�96.

5. Garraway WM, Russell EB, Lee RJ et al. Impact of previously unrecognized benign prostatic hyperplasia on the daily activities of middle-aged and elderly men. 聽1993; 43(373): 318-21.

6. Gacci M, Eardley I, Giuliano F, et al. Critical analysis of the relationship between sexual dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia. 2011; 60(4): 809-25.

7. Berges E et al. 聽1999; 36(3): 21-27.

8.听. Australia: Age Structure in 2013.

Image credit: www.disappearingdave.com.au/