Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, affecting nearly a third of men over 50 years old globally. In Asia, studies indicate the overall prevalence rate of BPH increases rapidly with age and is tied to poor lifestyle choices. Dato Dr Khairul Asri, Head Department of Urology at Hospital Pengajar Universiti Putra Malaysia, and Consultant Urologist Surgeon, KPJ Selangor Specialist Hospital, Shah Alam, speaks on the common signs and symptoms of BPH, as well as treatments and solutions available for Malaysians seeking to address the problem.

The prostate gland, Dato’ Dr. Khairul said, is typically as large as a walnut or golf ball and is located beneath the bladder. An enlarged prostate can grow to the size of an orange – it constricts the urethra and blocks the normal flow of urine from the bladder. Besides causing discomfort, an enlarged prostate leads to several urinary symptoms exclusive to BPH.

Men over 50 years old, or have a family history of BPH, are at greater risk of the disease; as are men who are overweight, diabetic or have other comorbidities, and practice a sedentary lifestyle. However, the signs and symptoms of BPH are known to vary among men who have an enlarged prostate, the most common being:

• Frequent need to urinate throughout the day/at night (nocturia)
• Intermittent/weak urine flow
• Unable to empty the bladder
• Dribbling at the end of urination

Dato’ Dr. Khairul suggests prompt scanning and treatment as soon as one experiences any urinary changes/symptoms. The process involves a simple BPH Symptom Score or International Prostate Symptom Score (IPSS) be carried out, followed by a digital rectal exam (DRE) to screen for any tenderness, lumps or hard spot(s). Other scanning methods include an ultrasound or cystoscopy to check the size and shape of prostate; a urine test may also be performed to find out how well the patient releases urine.

Malaysian patients can opt for readily available treatments for BPH such as prescription drugs to relieve symptoms and transurethral surgery to remove an enlarged prostate gland, depending on the severity of symptoms.

Dato’ Dr. Khairul also mentions minimally invasive surgical treatment (MIST) options for BPH, namely Water Vapour Therapy that uses steam to cause cell death in the prostate gland. The Water Vapour Therapy was just recently launched in Malaysia and is a newer BPH therapy with proven prostate volume reduction and long-term durability for up to five years while preserving sexual function.

[The size of prostate might not determine the severity of the BPH symptoms, as some patients would experience significant symptoms while others only experience minor urinary symptoms. A medical consultation with a urologist is advised.]

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